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in  tfoe  mtn  oi  Ipw  ^ovU 

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MUNICIPAL    SANITATION 


IN  THE 


UNITED    STATES 


BY 

CHARLES  V.  CHAPIN,  M.  D. 

Superintendent  of  Health  of  the  City  of  Providence 


Cbc    providence    press : 

S  X  o  W    &     F  .\  RNH  A  M 

I'k<  (VIDENCE,    K.    I . 
1901 . 


COPYRIGHT,    1900, 

By  Charles  V.  Chapin. 


su 


1 


PREFACE. 


rT"4IK  preparation  of  the  present  volume  was  primarily  undertaken  to 
-*  inert  the  author's  personal  needs.  An  investigation  along  several 
lines  of  public  health  work  suggested  the  utility  of  a  comprehensive 
study  of  public  sanitary  methods.  As  a  consequence  this  volume  was 
prepared  and  it  is  hoped  that  the  material  here  gathered  will  prove  use- 
ful to  other  health  officers  as  it  has  to  the  author.  It  is  not  a  treatise 
on  the  principles  of  sanitation  and  in  Pact  these  principles  are  rarely 
referred  to,  but  it  is,  rather,  a  compendium  of  sanitary  practice.  It  is 
not  so  much  intended  to  advise  what  oughl  to  he  done  as  to  record  what 
has  heen  done.  Neither  is  it  intended  to  he  a  presentation  of  the 
author's  own  views  though  these  may  occasionally  be  indicated.  The 
subject  under  consideration  is  the  sanitary  functions  of  munici- 
palities, the  latter  term  being  usctl  in  its  broadest  sense,  Including 
cities,  villages,  townships,  and  counties.  Only  the  sanitary  work  of 
local  government  is  considered  and  not  that  of  the  state  or  the  federal 
government,  except  in  so  far  as  the  latter  engage  in  work  which  theo- 
retically belongs  to  local  officials. 

This  volume  was  begun  several  years  ago  and  though  the  attempt 
has  been  made  to  bring  the  parts  first  written  up  to  date,  yet  omissions 
will  doubtless  be  found,  During  this  time  many  cities  have  adopted 
new  sanitary  methods  and  sometimes  the  same  citj  is  used  to  illustrate 
the  workings  of  both  the  old  and  the  new  method.  Doubtless  also  man} 
errors  will  be   found  which    must    be  attributed   to  the  shortcomings  ot 

the  author.       These   will    lie  the   re   readily  forgiven  D)    those   wllO  ha\c 

experienced  the  difficult}  in  compiling  municipal  reports  and  searching 
the  maze  of  municipal  and  statutory    law. 

While  in  some  instances  the  author  has  not  heen  able  to  scenic  in- 
formation either  from  printed  reports  or  by  correspondence,  and  that 
too  from  some  important  cities,  yet  Hi"-;  municipal  officers  have  been 
very  kind   in   answering  the  queries  sent   them  and  have  often  been   to 


347498 


iv  PRE  FA  CM 

much  labor  in  preparing  a  satisfactory  reply.  The  author  thoroughly 
appreciates  the  assistance  thus  given  without  which  the  volume  would 
have  been  impossible. 

Many  blank  forms  have  been  introduced  in  the  appendices  as  it  is 
believed  that  these  often  illustrate  methods  of  work  better  than  any 
verbal  description.  A  subject  index  will  be  found  but  no  place  index. 
A  place  index  without  reference  to  the  subject  with  which  the  place  is 
connected  is  of  little  use  and  one  with  such  reference  would  have  con- 
siderably increased  the  size  of  an  already  too  bulky  volume. 

C.  V.  c. 

Providence,  March,  L901. 


CONTENTS. 


CHAPTER    I. 

SANITARY    ORGANIZATION. 

I-  M.  ES 

Importance  of  sanitation  —  spheres  of  federal,  state,  and  local  sanitation- 
control  of  the  state  in  local  sanitary  affairs  —  local  control  of  sani- 
tary affairs i    r, 

Sanitary  organization  of  counties,  townships,  and  municipalities  —  legis- 
lation concerning  local  sanitary  affairs  —  special — general  —  legisla- 
tion incidentally  establishing  local  sanitary  authority     ....  7  22 

Forms  of  local  sanitary  organization  —  ex-officio  hoards — independent 
hoards  or  officers  —  appointment  —  personnel  —  organization  —  terms 
of  office  compensation  —  duties  of  the  sanitary  department  —  execu- 
tive—  general  description  —  health  officer  and  subordinates  —appoint- 
ment, qualifications,  terms  of  service,  compensation — civil  service 
regulations  —  legislative — hy  whom  exercised  —  extent  of  power  — 
model  laws — judicial  powers    .........        23  49 

References  to  laws     .        • .49-51 

CHAPTER   II. 

REGISTRATION    <>!•'    VITAL    STATISTICS. 

Relation  of  the  subject  to  sanitation        ........        52  •">•'; 

Death   records — methods  of   collecting,  census  enumeration,    reports  by 

physicians  and  undertakers      permits  for  burial  or  removal  -  items  for 

ncord  —  investigation  of  causes 

Birth    records      methods   of   collecting,   census    enumeration,   reports   bj 

physicians,  clergymen,  parents      items  of  record  —  still-births 
Marriage   records  —  licenses,   when    required,  by   whom   issued,   form  of 

license,  licenses  for  minors  —  returns  of  marriage  by  persons  officiating. 
Returns  and  records      false  returns      original  returns     recording  officers 

in    different    states       records,  paper,  ink        forms        index       correction 

of  records— copies  of  record      ......... 

siatc  registration      reports,   local  and  state      registration  of  physicians, 

undertakers,  clergymen,  etc.      fees  for  registration      penalties 
Disposal  of  t  he  dead      regulations  in  regard  to  time,  place,  manner  of  burial 

—  graves,  vaults,  disinterments       cremation      ...... 

References  to  laws 

CHAPTER   III. 

\  i   I-  \  \.  KM, 

Duty   of   municipality      abatemenl       bj    health   authorities      inspection 

—  orders  —  hearings      Bervice   of    orders      tines      abatement    bj    the 
municipality      collection  of  costs      cleansing  the  premises   ■        ■        •     108  122 

Prohibition  of  nuisances  legislation,  general  statute,  special  acts,  local 
rule 

Administrative    methods      inspectors    and    duties      reports      records 
notices  to  abaft       results  ol   failure  to  obej      notict       lin<      ab 
nieiit  h\  municipality       vacation  of  the  premises  ....     120  in 

References  to  laws     .......••••• 


5-1 

71 

i  i 

M 

99 

104 

lot 

107 

VI 


CONTENTS. 


CHAPTER  IV. 


SPECIFIC    NUISANCES. 

P  VGES 

Mostly  under  local  regulations  —  general  prohibitions  in  regard  to  filth  on 
private  property,  in  streets — defective  plumbing  and  drainage  —  cel- 
lars—  overcrowding  —  general  rules  in  regard  to  building  —  digging 
the  soil  —  weeds  —  poison  ivy  —  street  cars  —  salt  on  streets- — noises  — 
spitting         .............     143-160 

Stables,  location  and  licensing,  floors,  manure  receptacle,  removing  manure 
—  swine  licenses — other  animals — vaults  required  where  there  are  no 
sewers,  permits  and  rules  for  construction,  location,  size,  materials  — 
cesspools  —  removal  of  vaults  and  cesspools     ......     161-192 

Filth  on  shores  —  public  dumps  —  pond-holes  and  swamps   ....     192-199 

Offensive  trades  —  1.  maybe  located  by  sanitary  authorities  —  2.  may  be 
licensed  and  controlled  by  regulations  —  public  abattoirs — rules  for 
slaughter  houses,  rendering,  dealing  in  hides,  gas  works,  tanneries, 
second-hand  clothing  —  3.  may  be  forbidden    ......     199-214 

Smoke  nuisance,  forms  of  ordinances       ........     214-219 


CHAPTER    V. 


PLUMBING. 

Authority  for  plumbing  codes,  general  sanitary  power,  special  and  general 

acts  conferring  the  authority     .........     220-222 

Plumbing  codes  —  plans  of  plumbing  —  approval  of  plans  and  permits  — 

technical  details  of  plumbing  codes  .......     222-252 

Department      controlling      plumbing  —  examination     and      licensing      of 

plumbers,  state  and  municipal  laws — fees  —  bonds  ....  252-257 
Inspectors  —  salaries —  notification    of    inspection  —  inspection  —  certili- 

cates  —  penalties  ...........     257-201 


CHAPTER    VI. 

JVATER,    ICE,    AND    SEWERS. 

Water  supplies  —  municipal  ownership  —  impurities  of  water — prevention 
of  pollution,  state  legislation  —  duties  of  state  boards  of  health —  local 
regulations  —  inspection  of  water  sheds — chemical,  microscopical  and 
bacteriological  examinations      .........     262-274 

Purification  of    Water    Supplies  —  storage   and    sedimentation  —  filtration, 

natural  filters,  mechanical  lifters 274-287 

Wells,  investigations,  closure  —  springs  ........     287-202 

Ice- — legislation  state  and  local — licensing  dealers       .....     202-200 

Sewers 296-297 

River  pollution  —  sewage  disposal    .........     207-304 

References  to  laws .;o4 


CHAPTER   VII. 

FOOD,    OTHER    THAN     DAIRY     PRODU<    rS. 

Danger  from  adulterated  food — unwholesome  food,  state  laws,  food  from 
animals,  diseased,  wounded,  emaciated  or  dead — undrawn  poultry  — 
blown  veal  —  immature  animals  —  cleanliness  of  markets  —  control  of 
markets  —  bakeries  —  hotels  and  restaurants  —  infected  food  —  veget- 
ables and  fruit  —  bread  —  canned  goods —  misrepresentation 


306-324 


CONTEXTS.  v- 


Adulteration  and  substitution  —  state  laws,  general  —  drugs,  liquors,  vine- 
gar, molasses,  sugar,  etc. —  honey,  saleratus,  baking  powders,  poi- 
sonous coloring  matter,  candy,  jelly,  coffee,  olive  oil.  catsup,  eggs,  lard  .     324-337 

Execution  of  food  laws  —  federal  —  state  —  local  —  inspectors  and  their 
work  —  persons  liable  and  acts  forbidden  —  penalties  —  condemnations 
and  seizures  ............     :;:"!T-.";."i4 

References  to  laws      ............     :;.">4  :'..">7 

CHAPTEB    VIII. 

DAIRY     PRODI  I  TS. 

Cheese  —  imitation  to  be  labeled  —  not   6©  be  colored  — not    to   be  made  or 

sold — branding  cheese       ..........     35fi 

Butterine  —  federal  legislation  —  state  legislation  —  butterine  to  be  labeled 

—  not  to  be  colored  —  not  to  be  made  or  sold  —  renovated  butter  .     361-367 
Milk  —  state    legislation  —  adulterated   denned  —  milk   standards  —  skim- 
med milk  —  condensed  milk  —  cream — penalties  —  licenses,  conditions 

for  —  enforcement  of  the  laws  by  state  and  local  inspectors  —  collectors 

of  samples — analysis — methods  of  inspection,  sampling,  records  .     367-399 

Clean  milk — its  importance  —  registration  of  producers — inspection  of 
herds  and  dairies,  tagging  animals,  tuberculin  test  —  licensing  the  pro- 
ducer—  regulations  for  the  care  of  animals  and  milk  —  pasteurized  milk  .     399  422 

References  to  laws     ............     422    124 

CHAPTER   IX. 

COMMUNK   AI'.I.K    DISEASES. —  LEGISLATION. 

Local  control  by  state  agencies  —  statute  legislation      local  legislation        .     425  429 
Reports  of  communicable  diseases  —  persons  required  t"  report,  t"  win. iii 
reports  are  made,  diseases  reported  —  form  of  report— payment  for 
reports  —  false  reports — reports  to  state  boards      penalty  .        .     129-442 

Placards      diseases  placarded— form  of   placards 142-44" 

Isolation  —  statute  law  —  isolation  of  the  patient  —  other  members  of  the 
family  —  children  —  wage-earners  -household  other  families  in  the 
house  —  duration  of  isolation  in  different  diseases      removal  of  cases 

—  infected  goods ' '*    1'i:; 

School    attendance  —  persons    excluded      responsibility    for    exclusion 

schools   included   in    tin-   rules   -duration   of    exclusion      permits 

closure  of  schools         ......•••••       163    170 

Disposal  of  dead  ho.lies  reports  by  undertaker  disinfection  "f  body, 
of  the  room,  of  die  undertaker,  of  i  he  coffin      time  of  burial      fun< 

—  burials  —  transportation       responsibility  for  violation 
References  to  laws 


170   i" 

17^-    I- 


CHAPTER    X. 

.  (,\l  \it    \  |.    \i:i.i;    DISEASES.        (fONTIXI   ED.)         VDMIXISTKAT1VI      WORK. 

Duties  of    medical    inspector      usuallj    accepts    physicians    <liaiMioSis 
sometimes  investigates      to  give  directions      sanitary  inspections      t" 
take  cultures  and  vaccinate      notices  to  scl Is,  'i'       record 

—  Biibsequenl    supervision      guarding   houses      funeral   inspectors 
determination  of  end  of  isolation      support  of  the  | r  during  isolation,     181    »■'- 

Epidemics      extraordinary  pov  imples  of  management,  smallpox, 

yellow  fever,  typhoid  fever,  typhus  fever,  scarlel  fever,  ami  dlphtl 

—  prepara! ions  foi  cholera         ...... 

Special  Diseases      tuberculosis      leprosj      renereal  diseast 


viii  CONTEXTS. 

CHAPTER    XI. 

COMMUNICABLE       DISEASES.  —  (CONTINUED.)  —  DISINFECTION,       LABORATORY 

WORK,    VACCINATION,    ANTITOXIN. 

PA<i  ES 

Disinfection  —  required  —  by  health  department  —  sulphur  —  formaldehyde 

—  steam  disinfection  —  washing  surfaces  and  goods  — details  of  muni- 
cipal work —  disinfection  of  vaults  and  yards  ......     527-556 

Bacteriological   laboratory  —  its   purposes  —  for  diagnosis  of  diphtheria, 

tuberculosis,  typhoid,  malaria 556-572 

Vaccination  —  legislation  —  of  school   children  —  control  and   distribution 

of  virus — public  vaccination  —  methods  employed  ....     573-598 

Antitoxin 598-601 

CHAPTER    XII. 

I  IOMMUNICABLE    DISK  ASKS. (CONCLUDED.) 

Hospitals  for  communicable  disease  —  authority  to  construct  and  main- 
tain—  for  smallpox  —  for  scarlet  fever  and  diphtheria  —  for  phthisis  — 
sites  for  hospitals  —  ambulances 602-630 

Quarantine — maritime — inland        .........     630-664 

CHAPTER    XIII. 

REFUSE    DISPOSAL. 

Garbage  —  definition  and  character  —  separation  from  other  wastes  —  recep- 
tacles anil  their  location  —  frequency  of  collection  —  hours  for  removal 

—  garbage  wagons  —  methods  of  collection,  by  city  employees,  by  con- 
tract, by  licensed  scavengers  —  disposal,  on  land,  in  water,  feeding  to 
animals,  reduction,  cremation    .........     665-727 

Dry  refuse  —  character  —  receptacles,  their  location  —  frequency  of  collec- 
tion—  hours  for  removal  —  ash  wagons  —  municipal  collection  —  dis- 
posal    ..............     727-738 

Mixed  refuse  —  receptacles  —  frequency   of    collection  —  refuse    wagons  — 

municipal  collection  —  disposal  ........     738-741 

Night  soil —  licenses — apparatus  —  removal  by  private  scavengers  —  price 
of  work — municipal  removal  —  frequency  of  removal—  permits —-dis- 
posal, on  land,  as  commercial  fertilizer,  into  waters,  cremation     .  .     742-757 

Grease  and  bones  —  rags  and  bones  —  dead  animals  —  other  offensive  sub- 
stances       757-763 

street  cleaning    .............  764 

CHAPTER    XIV. 

MISCELLANEOUS    SANITARY     WORK. 

Diseases  of  animals;  of  legislation  —  execution  of    laws — tuberculosis  — 

glanders  —  rabies         ...........     705-778 

School  hygiene —  medical  inspection  —  public  baths  —  control  of  barbers  — 
gas  fitting  —  lying-in  hospitals  —  baby  farms — prevention  of  blindness 

—  nursing  bottles  —  excursions  for  sick  children  —  protection  of  child- 
ren—  institutions  for  children  —  other  institutions  —  laundry  inspec- 
tion —  kerosene—  urinals  —  sick   poor  —  office   library  —advancement 

of  knowledge  —  finances  —  tenement  houses  —  lodging  houses       .         .     778-837 

Appendices  .............     841-949 


CHAPTER  I. 
SANITARY   ORGANIZATION. 

PUBLIC  sanitation  is  a  development  chiefly  of  the  hnicr  half  of  the 
present  century,  but  it  is  not  entirely  a  novelty.  Many  of  the 
evils  with  which  sanitation  deals  have  long  been  recognized,  and  reme- 
dies for  them  have  been  sought  through  legislation,  and  many  of  the 
advantages  which  sanitation  affords  social  life  arc  fully  appreciated  by 
the  more  populous  communities.  As  a  rule  the  subjects  with  which 
public  sanitation  deals  have  an  increasing  interest  with  compactness 
of  population  and  complexity  of  social  relations.  Wherever  there 
are  large  cities  with  a  highly  developed  civilization  there  the  aeed  of 
public  action  in  this  direction  is  most  acutely  felt.  Hence  we  are  not 
surprised  that  many  works  which  would  be  included  in  the  discussion 
of  the  subject  we  arc  now  considering,  such  as  a  system  of  sewerag 
public  water  supply  and  municipal  baths,  were  carried  to  a  high  degree 
of  perfection  in  the  cities  of  ancient  Greece  and  Italy,  particularly  in 
the  latter. 

<  )n  the  other  hand  public  works  of  this  kind  are  not  needed  and  are 
impossible  in  new  communities.  .Moreover  such  communities  with  a 
sparse  population  do  not  need  many  police  regulations  to  maintain 
comfort  and  health,  such  as  are  required  as  population  grows  denser. 
Vet  even  in  new  settlements  some  need  is  tell  for  public  aid  and  pro- 
tection along  these  lines.  This  was  true  of  the  growing  colonies  oi  the 
New  World.       While  an  organized   health  department   in  town  or  colons 

was  not  at  tirsi  thoughl  of, yel  il  was  not  long  before  legislation  began 
to  recognize  that  the  comfort  and  health  of  the  people  demanded  atten- 
tion, and  the  germs  of  our  modem  sanitarj  law  appeared. 

The  registration  of  vital  statistics  was  very  earl}  provided  for  in  the 
colonics.1  but  though  this  is  now  considered  the  firsl  step  to  be  taken 
in  sanitary  work  and  the  basis  0f  all  I'm nre  progress,  it  was  not  no  con- 
sidered at  that  time.  The  object  of  such  records  was  legal  rather  than 
scientific.  The  earliesl  record  thai  the  writer  has  met  with  of  sanitary 
activity,  was  the  action  of  the  selectmen  of   Boston9  in    1(578  foil 


1  Virginia,   \<i  24  Feb.,  1631  2,  Hening's  Statutes  a(  I 

'  Boston  Record  Commissioners1  Report,  Vol.  7,  p.  119,  8  Ma 


2  &  1 XI  TAX  Y    Oil  GANIZA  TION. 

shortly  by  similar  action  in  Salem,1  in  attempting  to  restrict  the  spread 
of  smallpox.  On  the  25th  of  October,2  1692,  the  General  Court  pro- 
vided that  the  selectmen  of  Boston,  Salem  and  Charlestown,  and 
other  market  towns  of  the  province,  should  regulate  slaughter  houses 
and  similar  establishments.  In  1693  the  Governor  and  Council  quaran- 
tined at  Long  Island,  Boston  Harbor,  the  fleet  of  Sir  Francis  Wheeler 
which  had  arrived  from  Martinique  sorely  afflicted  with  what  is  sup- 
posed to  have  been  yellow  fever.3  In  16994  a  law  was  enacted 
providing  for  maritime  quarantine,  which  however  was  disallowed  in 
privy  council  on  the  2  2d  of  October  of  the  same  year.  This  act  was 
followed  by  Rhode  Island5  on  the  27th  of  February,  1711. 

In  the  sanitary  legislation  previous  to  the  latter  part  of  the  eight- 
eenth century,  executive  powers  were  usually  conferred  upon  the  town 
governments  and  upon  them  fell  the  duty  of  enforcing  sanitary  law. 
This  was  true  of  the  Massachusetts  statute  of  1692.  In  other  cases 
state  officers  were  to  administer  the  law  as  in  Rhode  Island  in  1711, 
where  justices  of  the  peace  were  to  maintain  quarantine.  It  is  only 
since  the  establishment  of  independence  that  there  has  been  any  definite 
organization  of  local  government  for  sanitary  purposes. 

All  police  power  in  the  system  of  government  established  in  the 
United  States  is  vested  in  the  legislative  bodies  of  the  various  states. 
The  mechanism  by  which  this  power  is  exercised  varies  very  greatly  in 
different  states  and  at  different  times  ;  and  even  in  a  single  state  at  one 
and  the  same  time  the  police  power  may  be  exercised  in  a  variety  of 
ways. 

So  far  as  concerns  sanitary  affairs,  and  indeed  in  all  affairs  the  police 
powers  of  the  state  may  be  exercised  in  two  general  ways  :  First,  the 
state  legislature  may  enact  general  laws  and  provide  directly  for  their 
enforcement  by  the  appointment  of  officers  in  the  pay  and  directly 
under  the  control  of  the  state.  Or,  second,  the  state  may  delegate  both 
legislative  and  executive  powers  to  any  local  units  of  government  which 
may  exist  within  the  state.  The  former  of  these  two  methods  is  not 
the  one  here  under  special  discussion,  though  it  will  be  necessary  to 
consider  it  at  times,  as  spheres  of  sanitary  activity  which  in  one  group 
of  states  are  entirely  given  over  to  the  towns  or  counties,  are  in  another 
group  reserved  to  the  state.  The  details  of  legislation  in  regard  to  the 
purity  of  food  products,    especially  dairy   products,   and    the   purity  of 


1  Act  of  Salem  Selectmen,  18  October,  1678. 

2  Acts  and  Resolves  of  the  Province  of  Massachusetts  Bay,  Vol.  I.,  p.  59. 

8  Acts  and  Resolves  of  the  Province  of  Massachusetts  Bay,  Vol.  VII.,  p.  384. 
4  Acts  and  Resolves  of  the  Province  of  Massachusetts  Bay,  Vol.  I.,  p.  37*5. 
8  Laws  of  the  Colony  of  Rhode  Island  (1719),  Reprint  of  1895,  p.  65. 


&  1 XI TA 11  Y  Oli  GA  NIZ.  1  TION.  3 

inland  waters,  in  regard  to  the  communicable  diseases  of  animals,  and 
in  regard  to  quarantine  and  the  registration  of  vital  statistics,  are  very 
commonly  reserved  to  the  state.  If  not  formally  reserved,  the  state 
acts  so  efficiently  and  so  much  better  than  the  local  units  that"  these 
matters  are  neglected  by  the  latter.  Not  only  does  the  state  thus 
through  its  legislature  direct  certain  sanitary  affairs  as  above,  but  it 
employs  its  executive  powers  in  the  same  fields.  As  will  be  seen  in 
the  discussion  of  these  subjects,  many  states  not  only  have  elaborate 
laws  concerning  the  adulteration  of  food,  and  quarantine,  but  directly 
control  the  administration  of  these  laws  through  tie-  agency  of  state 
appointed  boards  or  officers.  Dairy  commissioners,  state  boards  of 
cattle  commissioners,  state  inspectors  of  food  and  state  quarantine  offi- 
cers are  not  uncommon,  and  the  state  board  of  health  frequently  is 
given  executive  control  of  any  or  all  of  these  matters. 

The  state  sanitary  organization  which  is  at  present  established  in  all 
the  states  except  Georgia,  Idaho,  Montana,  Oregon  and  Wyoming,  is 
the  embodiment  of  the  interest  of  the  state  in  sanitary  affairs.  It  is 
given  more  or  less  legislative  and  executive  authority  in  such  matters 
as  experience  has  shown,  or  as  is  hoped,  can  be  best  controlled  in  this 
way;  but  take  it  all  in  all  throughout  the  states,  the  state  board  of 
health  is  considered  chiefly  as  an  advisory  board.  It  is  not  to  meddle 
in  local  affairs  any  more  than  is  necessary.  In  other  words,  the  prin- 
ciple of  local  self-government  in  sanitary  as  in  other  affairs  is  in  the 
main  recognized  and  adhered  to. 

The  most  direct  and  complete  control  of  local  affairs  by  state  sani- 
tary organizations  was  seen  in    New    Orleans   previous  to   1898.     This 

city  was,  so  far  as  its  sanitary  affairs  were  C 'crned,  governed  entirely 

and  directly  by  the   state    board    of    health    and    its    appointees.      There 

was,  however,  a  special  reason  for  this  arrangement.     The  <'it\  oi  New 

(  Cleans   iS   much    the  largest    City  of  the   state,  indeed   of  the   W  hole  south. 

It  is  the  gateway  of  the  Mississippi  valley,  ami  an  enormous  commerce 
passes  through  it.  Epidemic  disease  ma\  find  and  has  found  entrance 
here  and  devastated  a  score  of  states.     The  safety  of  the  whole  state 

being  so  closely  dependent  u] the  city,  the  state  assumed  control  ot 

the  city  so  far  as  its  sanitation  was  concerned.  This  would  probabl) 
not  have  been  done  in  a  northern  state;  it  lias  not  been  in  Massachu- 
setts, New  York  or  Pennsylvania,  for  then  great  seaports,  but  in  the 
south  where  the  importance  of  the  state  as  compared  with  an)  oi  its 
parts  is  so  much  greater  than  it  is  at  the  north,  the  proceeding  was 
an  unnatural  one.     This  complete  control   of  local  sanitary 

the  state  is  found  not  only  in  isolated  instances  life  NYw  <  »:  i  HIS,  but 
is   the    settled     |.olic\      n\rr     the     larger     |>art     of     at     least     0ll(      state.        In 


4  SA  JSTITAR  Y  OR  GAXIZA  TION. 

Florida  the  county  boards  of  health  have  been  abolished  and  the  state 
health  officer  appoints  agents'  and  through  them  has  full  control  of 
maritime  and  domestic  quarantine,  and  the  state  health  officer  has  large 
general  powers  in  regard  to  the  abatement  of  nuisances,  and  has  special 
executive  powers  "  where  two  or  more  railroads  meet." 

The  control  of  the  state  in  local  sanitary  affairs  is  further  seen  in 
those  states  in  which  the  local  sanitary  board  or  officer  is  appointed  by 
the  state. 

In  Connecticut  the  county  health  officers  are  appointed  by  the 
judges  of  the  superior  court  and  must  be  attorneys  at  law.  These 
county  health  officers  appoint  the  local  health  officer  except  in  certain 
municipal  corporations.  This  centralizing  of  the  executive  power  in 
sanitary  matters  is  a  novel  thing  in  New  England,  and  it  is  also  an 
extremely  novel  procedure  to  vest  the  entire  control  of  sanitary  affairs 
in  the  hands  of  the  legal  profession.  It  is  not  to  be  wondered  at  that 
this  system  has  not  met  with  the  approval  of  some  of  the  best  health 
officers  in  the  state.  In  Vermont  the  state  board  of  health  appoints 
the  health  officer  who  is  ex-qfficio  a  member  of  the  local  board  of  health 
and  he  is  also  removable  by  the  state  board  of  health.  In  Indiana  the 
state  board  of  health  has  not  the  power  of  appointment  but  may 
remove  members  of  county  or  municipal  boards  of  health  and  also 
health  officers  for  specified  cause. 

In  Delaware  the  county  health  officers,  three  in  number,  are  ap- 
pointed by  the  governor. 

In  West  Virginia  three  of  the  live  members  of  the  county  boards 
are  appointed  by  the  state  board  of  health,  but  only  on  the  nomination 
of  the  county  court. 

In  North  and  South  Dakota  the  state  board  appoints  two  of  the 
three  members  of  the  county  boards. 

In  Kentucky  the  county  board,  consisting  of  three  or  more  discreet 
and  intelligent  citizens  residing  in  the  county,  is  appointed  by  the  state 
board  of  health. 

In  Mississippi  the  county  health  officers  are  appointed  by  the  state 
department  of  health. 

In  South  Carolina  it  was  formerly  provided  that  the  state  board  of 
health  should  appoint  local  boards  of  health  in  districts  where  there 
were  none,  and  under  this  law  the  state  board  did  appoint  in  towns 
and  occasionally  in  townships,  boards  consisting  usually  of  one  physician 
and  two  citizens  :  but  as  these  boards  were  often  careless  and  derelict 
and  the  state  board  had  no  authority  to  impose  a  penalty  for  neglect. 


i  Report  of  State  Board  of  Health,  Florida,  1894,  p.  21. 


SA XH\ \RY   OR G <  1 XTZ.  1  TION.  5 

the  legislature  in  1895  enacted  the  present  law  compelling  the  munici- 
palities to  organize  boards  of  health. 

There  are  certain  isolated  instances  of  a  state  appointed  sanitary 
executive  in  municipalities  as  in  Baton  Rouge  and  Shreveport  where 
the  governor  appoints  three  of  the  five  members  of  the  local  hoard  of 
health.  In  San  Francisco  previous  to  the  charter  of  1899  the  board  of 
health  consisted  of  the  mayor  of  the  city  and  four  physicians  in  good 
.standing,  residing  in  the  city  and  county  of  San  Francisco,  appointed 
by  the  governor.  So  also  the  recently  established  hoard  of  health  in 
Detroit  is  appointed  by  the  governor.1 

In  several  of  the  states2  it  is  provided  that  when  the  local  authority 
whose  duty  it  is  to  appoint  a  hoard  of  health  fails  to  appoint,  or  when 
the  local  hoard  in  any  municipality  or  county  fails  to  act,  the  state 
hoard  of  health  shall  step  in  with  full  executive  power.  In  New 
Jersey,  when  a  nuisance  in  one  township  affects  the  citizens  of  another, 
the  state  hoard  of  health  has  executive  powers.  In  .Minnesota  the  state 
board  of  health  may  compel  two  or  more  townships  to  act  together  for 
the  prevention  of  communicable  disease.  In  New-  York  the  state  board 
may  compel  action  of  the  local  hoard  in  nuisance  cases. 

It  is  evidently  not  the  intention  in  these  states  that  the  state  shall 
ordinarily  exercise  general  executive  functions  in  local  affairs,  hut  it  is 
deemed  so  important  that  no  portion  of  the  state  shall  be  without 
sanitary  protection,  that  the  state  hoard  of  health  is  given  BUCh  powers 
in  certain  contingencies.  Even  in  states  like  New  York  and  Ohioi 
where  township  or  similar  boards  of  health  are  obligatory,  or  in  North 
Carolina  and  Colorado,  where  county  hoards  are  obligatory,  the  possi- 
bility of  failure  to  appoint  or  of  failure  to  act  after  appointment  is  pro- 
vided for.  Perhaps  the  provisions  of  the  New  York  statutes  are  as 
explicit  as  any.3 

rn  Alabama  the  state  hoard  of  health,  which  is  the  state  medical 
society,  is  to  control  and  fix  the  duties  of  the  county  hoards,  which  are 
t he  count \  medical  societies. 


1  Michigan,  Chapter  10  of  L895,  Section  5. 

>  Arkansas,  Delaware,  Colorado,  Maine.   Missouri,  New    fork,   North  Carolina, 
Ohio,  Pennsylvania,  and  V Lrginia. 

n.  w  Fork,  General  Laws  (1896),  Public  Elealtb  Law,  Section  11: 

"Many  municipal  corporation,  authorized  bj  law  to  establish  a  local  boat 
health,  shall  omil  to  do  so,   the  state  board  of  health   may,   in  such  municipi 
ezercist  the  powers  of  a  local  board  of  health  and  appoint  :i  health  off! 
and  fix  his  duties  and  compensation.     The  compensation  of  Buch  health  • 
theexpenses  lawfullj   Incurred  bj    him  and  bj    the  state  board  ol   health  in 
municipality  shall  be  a  charge  upon  and  paid  bj  such  municipality    until 
as  a  local  board  of  health  shall  be  established  therein,  whereup 
such  health  officer  and  of  the  state  board  of  health  conferred  b 
.  ease.11 


6  SANITARY  ORGANIZATION. 

In  many  cases,  as  will  be  considered  later,  the  state  reserves  to  its 
state  board  of  health  executive  powers  in  matters  of  quarantine  and 
control  of  communicable  disease.  The  state  board  of  health  also  in 
some  states  does  much  executive  work  in  regard  to  nuisances,  the  dis- 
eases of  animals,  food  supplies,  the  protection  of  water  and  ice.  In 
New  York  and  Pennsylvania  and  some  other  states  the  state  board 
appoints  its  own  inspectors,  each  of  whom  has  his  own  district.  In 
Pennsylvania  these  inspectors  perform  the  duties  of  health  officers 
where  none  have  been  appointed  by  the  town,  and  may  assist  local 
health  officers  where  they  have  been  appointed. 

The  local  political  division  made  use  of  in  sanitary  administration 
varies  in  different  parts  of  the  Union  according  to  the  varying  promi- 
nence which  such  divisions  have  obtained  in  the  progressive  evolution 
of  local  government  from  colonial  times.  In  one  state  it  is  the  town- 
ship or  city,  in  another  the  incorporated  village  or  borough,  and  in  others 
still,  the  county  or  parish. 

As  a  rule,  considerable  aggregations  of  a  comparatively  dense  popu- 
lation or  what  are  known  as  cities,  control  in  their  capacity  as  cities, 
their  own  sanitary  affairs ;  but  there  are  exceptions  even  to  this. 
Reference  has  been  made  to  the  control  of  New  Orleans  by  the  state 
board  of  health.  Other  examples  are  the  former  control  of  Pensacola 
and  Apalachicola,  by  the  counties  in  which  they  are  contained,  and 
the  merging  of  the  sanitary  interests  of  Jersey  City  in  the  organization 
of  Hudson  County.  Not  only  do  cities,  as  the  term  is  ordinarily 
understood,  have  as  a  rule  an  independent  authority,  but  smaller  aggre- 
gations, even  as  small  as  five  hundred  persons  or  less,  are  often  given 
the  same  powers.  In  many  states  the  larger  number  of  the  small  but 
more  or  less  compact  communities  are  incorporated  either  by  general 
laws  or  special  acts  under  the  name  of  cities,  villages,  boroughs  or 
"  towns."  Such  incorporations  within  the  townships  are  very  common 
in  the  middle,  central,  and  western  states.  In  general  it  may  be  said 
that  wherever  municipal  corporations  are  found,  whether  they  have  a 
population  of  500  or  500,000,  they  are  usually  authorized  by  the  state 
to  establish  a  sanitary  organization. 

Outside  of  municipalities,  sanitary  organization,  usually  in  the  form 
of  boards  of  health,  may  be  established  either  in  townships  or  counties. 
The  real  political  unit  in  our  system  of  government  may  be  either  the 
township  or  the  county.  In  New  England  the  comity  has  always  been 
of  little  moment,  while  the  powers  and  importance  of  the  township  are 
very  great.  In  the  south,  on  the  other  hand,  probably  owing  in  part  to 
the  sparseness  of  the  population,  the  county  became  the  important 
political  division.     The  middle  states  more  nearly  resemble  the  south  in 


&  1  NIT  A  RY  ORG  A  XI Z A  TIO  N.  7 

this  particular  and  the  states  west  of  the  Alleghanies  and  north  of  the 
Ohio  more  nearly  resemble  New  England  :  but  nowhere  is  the  county 
of  so  little  importance  as  in  New  England.  It  would  naturally  be 
assumed,  therefore,  that  in  New  England  and  the  west  the  township 
would  be  made  the  sanitary  unit,  and  in  the  middle  states,  the  south, 
and  the  far  west,  where  New  England  influence  is  less  felt,  the  county 
would  be  the  unit.      This  is,  in  the  main.  true. 

The  following  states  have  county  sanitary  organization  :  Alabama, 
California,  Colorado,  Connecticut,  Delaware,  Idaho,  Indiana.  Kentucky, 
Kansas,  Louisiana,  Maryland,  Mississippi,  Montana.  North  Carolina, 
North  Dakota,  South  Dakota,  Tennessee,  Texas,  Utah,  Virginia,  Wash- 
ington, West  Virginia  and  Wyoming. 

In  New  Jersey  there  were  formerly  county  boards  of  health,  but 
their  place  has  been  taken  by  the  township  and  municipal  boards 
appointed  under  the  law  of  March  31,  1887,  the  board  for  Hudson 
County  only  remaining  :  but  even  in  this  county  nearly  all  the  com- 
munities have  their  local  boards,  so  that  little  opportunity  is  left  to  the 
county  board  for  usefulness,  and  its  function  is  limited  to  the  collectioE 
of  vital  statistics. 

In  Florida  there  were  until  recently  two  county  boards  of  health, 
viz.,  in  Escambia  and  Franklin  Comities,  containing  respectively  the 
important  ports  of  Pensacola  and  Apalachicola  <  >ther counties  formerly 
had  boards  of  health,  but  they  have  all  been  abolished  in  order  that  the 
state  board  of  health  might  have  entire  charge  of  quarantine.  In  Cali- 
fornia a  county  board  of  health  is  not  required  by  statute  in  every 
county,  and  in  many  counties  there  is  none.  In  the  other  slates  above 
mentioned,  the  legislature  has  provided  that  a  sanitary  organization 
shall  be  established  in  every  county. 

In  Idaho  and  Montana  the  board  of  health  consists  of  the  board  of 
county  commissioners  and  one  physician  appointed  by  them. 

[n  Colorado,  Indiana,  Kansas.  Maryland,  Tennessee,  I  tah,  Wash- 
ington and  Wyoming  certain  county  officers  are  made  ex-officio  boards 
of  health. 

In  Colorado.  Indiana.  Kansas,  Maryland.  Washington  and  Wyom 
it  is  the  countj  commissioners  that  are  the  board  of  health  ;  in  Tennes- 
see the  board  of  health  of  the  county  consists  of  the  countj   judg 
chairman,  clerk  of  county  court,  count}  health  officer  or  jail  physician, 

with  the  latter  as  president  :    in     Utah     it     is    the    COUntj     Comm 
and  the  health  officers  of  the  sanitan    «Ii>t  ri<i  >. 

In  Alabama,  under  the  sanitarj    organization   which  th< 
the  state  medical  society  is  the   state   board  of  health,  and  the  county 
medical  societies  in  affiliation    with   the  state   medica  'he 


8  SANITAliY  ORGANIZATION. 

county  boards  of  health.  These  county  medical  societies  delegate  their 
health  powers  to  their  board  of  censors.  Much  the  same  plan  is  in 
vogue  in  North  Carolina  where  the  county  boards  of  health  consist  of 
all  the  registered  physicians  in  the  county  together  with  the  mayor  of 
the  county -town,  the  chairman  of  the  county  commissioners  and  the 
city  or  county  surveyor. 

In  Delaware,  Kansas,  Louisiana,  North  and  South  Dakota  and  West 
Virginia  the  county  board  of  health  is  an  independent  organization.  In 
Delaware  it  consists  of  three  physicians  called  county  health  officers.  In 
West  Virginia  the  county  board  of  health  consists  of  three  persons,  one 
of  whom  shall  be  a  physician  and  all  of  whom  shall  be  nominated  by 
the  county  court  and  appointed  by  the  state  board  of  health,  and  these 
three  are  to  serve  together  with  the  president  of  the  county  court  and 
the  prosecuting  attorney  of  the  county.  In  North  and  South  Dakota 
the  state  board  of  health  appoints  two  persons,  who,  together  with  the 
district  attorney  of  the  county,  shall  serve  as  the  county  board  of  health. 
In  Louisiana  the  police  jury  of  each  parish  (county)  appoints  a  board 
of  health  consisting  of  one  member  from  each  ward  (except  municipal 
wards).     Three  of  the  members  are  to  be  physicians. 

In  Mississippi  the  state  department  of  health  appoints  a  physician 
as  health  officer  in  each  supervisor's  district,  and  these  constitute  the 
county  board  of  health. 

In  Virginia  the  county  judge  must,  on  recommendation  of  the 
medical  society,  appoint  a  board  of  health  to  consist  of  three  physicians, 
nominated  by  the  county  medical  society,  the  clerk  of  the  court,  and 
the  chairman  of  the  board  of  supervisors. 

In  Connecticut  and  Texas  the  sanitary  affairs  are  administered  by  a 
county  health  officer  and  not  by  a  board  of  health.  In  Texas  this 
official  is  called  the  county  physician  and  is  appointed  by  the  county 
judge. 

The  jurisdiction  of  the  county  sanitary  organization  may  extend 
over  the  whole  county  including  any  municipalities  which  it  may  con- 
tain. In  Alabama1  the  establishment  of  other  sanitary  authority  within 
the  count v  is  forbidden. 


1  Alabama  Code  (1896): 

Sec.  2433.  "  No  local  board  of  health  or  executive  medical  body  of  any  name  or 
kind  for  the  exercise  of  public  health  functions,  other  than  the  county  board  of 
health,  must  be  established  in  any  county,  town  or  city  ";  but  while  the  established 
county  board  is  the  sole  executive  it  depends  largely  for  its  initiative  on  the  local 
political  authorities. 

Sec.  2431.  "  The  court  of  county  commissioners,  or  the  proper  corporate  authori- 
ties of  any  city  or  town,  may  jointly  or  separately  invest  the  county  hoard  of  health 
with  such  executive  powers  and  duties  as  may  be  deemed  necessary  for  the  preser- 


&  i  xn\  i  a  i "  on  a  a  xrz.  1  tion.  9 

In  Connecticut  the  authority  of  the  county  health  officer  is  very 
great  and  his  jurisdiction  extends  over  the  whole  area  of  the  county. 
He  appoints  the  local  health  officers  except  in  those  municipal  corpora- 
tions where  a  sanitary  organization  is  already  established,  and  further- 
more has  control  of  all  the  boards  of  health  and  health  officers  in  his 
county.    The  following  sections  from  the  statute  explain  these  relati*  >ns:] 

It  shall  be  the  duty  of  said  county  health  officer  to  cause  the  execution  of  the  laws 
relating  to  public  health,  and  the  prevention  and  abatement  of  nuisances  dangerous 
to  public  health,  and  of  the  laws  relating  to  the  registration  of  vital  statistics,  and 
to  co-operate  with  and  supervise  the  workings  of  the  boards  of  health  and  health 
officers  within  his  county;  and  he  shall  have  all  the  powers  <>f  a  grand  juror  in  each 
of  the  several  towns  within  his  county,  in  matters  concerning  prosecutions  for  viola- 
tions of  the  laws  concerning  contagious  diseases  and  public  health,  nuisances  inju- 
rious to  health  or  life,  and  violation  of  the  by-laws  or  ordinances  relating  to  public 
health  and  contagions  diseases,  and  for  the  prevention  or  removal  of  nuisances  dan- 
gerous to  public  health,  adopted  by  any  incorporated  city  or  borough  or  any  town, 
and  for  violation  of  the  laws  relating  to  the  registration  of  \  ital  statistics. 

Said   county   health   officer  may   be  removed   at  any   time   by  any  judge  of  the 

Superior  Court.     Such  county  health  officer,  as  s i   after  his  qualification  as  may 

be,  shall  by  a  writing  under  his  hand  appoint  for  each  town  some  discreet  person, 
learned  in  medical  and  sanitary  science,  to  be  health  officer  for  said  town,  except  in 
such  towns  containing  incorporated  cities  or  boroughs  whose  limits  are  co-terminous 
with  the  limits  of  said  town  in  which  there  exists  under  and  by  virtue  of  B  charter  a 
board  of  health  or  health  officer  or  committee.  In  each  town,  except  in  towns 
having  an  incorporated  city  or  borough  within  its  limits,  said  town  health  officers 
shall  have  and  exercise  all  the  powers  and  duties  now  l>\  law  rested  in  and  imposed 
upon  town  boards  of  health  ot  health  officers  or  committees;  and  in  towns  within 
which  there  exists  a  city  or  borough  the  limits  of  which  are  not  co-terminous  with 
the  limits  of  such  town  and  where  by  charter  such  city  or  borough  is  empowered  to 
appoint  a  health  committee,  health  officer,   or  board  of  health,  such  town  health 

Officer  shall  exercise  the  powers  and  duties  of  his  said  office  only  in  such  part  of  said 
town  as  is  outside  the  limits  of  said  <it\   or  borough. 

Iii  Texas  tin-  stale  and    county   health  organization    is  established 

entirely  for  the  management   id'  c municable  disease,  and  particular!) 

for  quarantine.  The  count)  health  officer  is  here  direct!)  under  the 
control  <>f  the  state  health  officer,  ami  in  nun  controls  tin-  health  officers 
of  municipalities. 

It  would  appear  thai  in  tin-  Dakotas  tlm  count)  board  has  jurisdic- 
tion  <>\  IT   the   W  hole  ciillllt  V. 

The  more  common  plan,  however,  is  lor  the  county  board  oi  health 
to  have  no  jurisdiction  in  villages  "i  cities  with  established  sanitar) 
organization.     The  county  board    of  health   is  a  device  confined  chiefly 

ration  and  promotion  of  the  public  health,  and  for  the  preve n  ol  the  introduction 

or  spread  of  contagious  or  infectious  diseases;  such  powers  t<    '•• 
su.  h  duties  i.,  he  performed  under  such  rules  and  regulal  ona  a      lay 
upon  between  such  hoard  and  such  court,  as  corporate  a  it!  01 

'  Connecticut.  Chapter  248  of  L89  I,  Si  » 


1 0  SAJSTITAM  Y  OB  GAXIZA  TIOX. 

to  those  states  in  which  the  population  is  sparse  and  in  which  there  are 
few  large  towns.  It  is  in  these  states,  too,  that  the  township  is  least 
developed.  It  would  appear  that  the  county  board  of  health  has  proved 
useful  in  administering  affairs  for  a  widely  scattered  rural  population, 
but  that  wherever  compact  villages  and  small  cities  are  numerous,  these 
serve  better  as  administrative  units :  but  yet  much  depends  upon  the 
traditional  notions  of  the  people  in  regard  to  political  affairs.  Thus  in 
some  of  the  western  states  it  would  seem  that  the  distribution  of  the 
population  would  invite  the  development  of  the  county  ;  but  the  influence 
of  the  township  idea  was  so  great  with  the  early  settlers  that  it  stamped 
itself  strongly  on  the  political  development  of  the  state,  and  township 
and  village  boards  of  health  are  found  instead  of  county  boards.  Such 
states  are  Iowa,  Michigan,  Minnesota,  and  Wisconsin. 

In  other  cases  even  where  count)7  boards  are  established  they  have 
no  jurisdiction  over  incorporated  villages  or  cities.  Thus  in  West 
Virginia,1  "  When  any  town,  city  or  village  has  a  board  of  health  of  its 
own  the  jurisdiction  of  the  local  (county)  board  shall  not  extend 
thereto." 

In  Kansas2  the  law  provides  that  "The  local  boards  of  health 
hereby  created  shall  not  supersede  or  in  any  way  interfere  with  such 
boards  established  by  municipal  regulations  in  any  of  the  counties  of 
this  state." 

Colorado  provides  that  the  county  board  of  health  shall  exercise  its 
powers  only  "  in  all  parts  and  portions  of  each  and  every  county  not 
represented  by  town  or  city  organization." 

Owing  to  the  fact  that  the  county  in  the  south  and  west  has  been 
developed  at  the  expense  of  smaller  political  divisions,  it  has  followed, 
as  has  been  shown,  that  the  county  board  of  health  lias  in  the  states  of  this 
section  been  established  to  look  after  the  sanitary  interests  of  the  people 
outside  of  the  incorporated  municipalities ;  but  in  New  England  and 
the  northern  central  states  the  county  has  not  so  much  importance  in 
local  affairs,  for  the  township  performs  here  many  important  functions, 
and  among  them  the  supervision  of  the  public  health. 

In  the  New  England  states  and  in  Illinois,  Iowa,  Michigan,  Minne- 
sota, New  Jersey,  New  York,  Ohio,  Pennsylvania  and  Wisconsin,  the 
township  is  made  the  unit  of  sanitary  control.  It  is  true  that  the  town- 
ship has  a  considerable  importance  in  some  other  states,  as  Kansas, 
Missouri,  the  Dakotas  and  Nebraska,  but  it  is  net  so  highly  organized 
as  in  the  states  first  mentioned,  and  the  sparseness  of  the  population  is 


1  West  Virginia,  Code  (1891),  Chapter  150,  Sec.  7. 

2  Kansas,  General  Statutes  (1897),  Chapter  75,  Sec.  11. 


&  J  XI TAB  Y  OR  GA  XI Z A  TION.  \  \ 

not  conducive  to  the  formation  of  township  hoards  of  health,  and  in 
most  of  these  western  states  public  sanitation  in  any  form  does  not 
receive  as  much  attention  as  it  does  in  older  and  more  thickly  settled 
communities. 

In  most  of  the  states  where  the  township  system  is  in  vogue,  certain 
town  officials  are  made  ex-offieio  hoards  of  health.  These  states,  together 
with  the  officers  invested  with  sanitary  powers,  are  mentioned  below.1 
It  is  provided  in  some  of  these  states  that  the  townships,  although 
authorized  to  organize  an  ex-officio  hoard,  nevertheless  may  establish  a 
special  hoard  or  health  officer  and  delegate  to  it  or  him  their  sanitary 
functions.  This  is  true  in  Massachusetts.  New  Hampshire,  Rhode 
Island,  ami  Wisconsin.  In  Massachusetts  about  half  the  townships, 
including  all  of  less  than  3,000  inhabitants,  have  ex-officio  boards  of 
health,  hut  most  of  the  larger  towns  and  cities  have  independent  boards. 

In  Maine  it  is  provided  that  in  each  town  there  must  be  established 
a  hoard  of  health  of  three  members. 

In  New  Hampshire  the  selectmen  of  the  towns  must  appoint  a  board 
of  health. 

In  Connecticut,  in  1893,  the  township  hoard  of  health  was  abolished 
and  a  health  officer  appointed  in  each  town  by  the  county  health  officer, 
the  town  health  officer  to  have  all  the  powers  of  the  old  township 
boards  of  health. 

In  Pennsylvania  the  act  of  April  11,  1899,  provided  that  the  school 
directors  of  every  township  shall  have  certain  powers  for  the  control  oi 
communicable  disease.  The  feeble  development  <>t'  tin-  township  in 
Pennsylvania  has  never  rendered  practicable  the  establishment  <>t  a 
strong  township  sanitary  organization. 

As  in  most  of  the  states  which  have  established  county  boards  <•! 
health,  this  board  has  no  jurisdiction   over   incorporated    municipalities. 


1  Illinois.     Supervisors,  assessor,  ami  township  clerk. 

[owa.    Trustees. 

Massachusel  ts.    Seled  men. 

Michigan.     Township  board,  consisting  oi  the  supervisor  with   two  justices  "f 
tin-  peace  whose  terms  next  expire  and  the  township  clerk. 

Minnesota.    Supervisors  together  with  a  physician  when  the  supervisoi 
sider  it  necessary. 

\,w   Jersey,     rownship  committee  and   assessor  with   a   physician  to 
pointed  by  the  commit  tee. 

New  Fork.    Town  board  with  the  addition  of  one  ■  Ithsen  appointed  b)  the 

Ohio.    Trustees. 

Rhode  Island.     Toil  n  <  louncil. 

Vermont.     Health  officer  who  is  appointed  by  the  stat<  boardol    • 

with  the  select  men. 

Washington.     T<>\\ n  board. 

Wisconsin.      T'.u  n  In, aid. 


12  SANITARY  ORGANIZATION. 

so  in  the  states  with  the  township  system,  it  is  not  intended  that  the 
township  board  of  health  should  exercise  jurisdiction  over  such  corpo- 
rations. The  writer  has  not  found  this  power  in  any  state,  and  in 
several  it  is  expressly  provided  in  the  general  laws  that  the  townships 
shall  not  have  this  power.  Such  provisions  are  found  in  Connecticut,1 
Illinois,  New  Jersey,  New  York,  and  Ohio. 

One  of  the  problems  of  sanitation  is  to  secure  an  efficient  execution 
of  the  laws  in  rural  districts.  A  good  township  system  is  of  much 
assistance  in  this,  but  the  township  needs  to  be  pushed  some  by  the 
central  authority.  In  most  states  this  is  done  by  moral  agencies  and 
excellent  results  have  flowed  from  such  work  by  the  state  board  of 
health  in  Maine,  Massachusetts,  Michigan,  Minnesota  and  other  states. 
In  Connecticut  and  Vermont  the  state  exercises  greater  control  by  ap- 
pointing the  local  health  officer.  In  Alabama  a  different  plan  is  fol- 
lowed. The  county  medical  society  divides  up  the  county  into  "  beats," 
and  these  into  districts,  and  sometimes  sub  districts,  and  appoints  one 
of  its  members  resident  therein  a  health  officer  for  each  district. 

From  this  brief  sketch  it  is  seen  that  local  sanitary  administration  is 
provided  for  hy  law  over  the  entire  area  of  thirty-six  states  including  a 
population  of  52,304,922  in  1890,  or  eighty-three  per  cent  of  the  total 
population  at  the  census  of  that  year.  Twenty  of  these  states  have 
provided  for  a  county  form  of  sanitary  government2  and  sixteen  states 
have  a  township  form  of  sanitary  government.3 

Then,  too,  in  states  where  the  provisions  for  local  sanitary  govern- 
ment are  not  complete  for  the  whole  territory  of  the  state,  such  govern- 
ment may  be  established  by  special  enactment  or  charter,  and  thus  a 
considerable  portion  of  the  population  may  be  brought  under  sanitary 
administration.  Thus  in  Arkansas,  California,  Missouri,  and  Nebraska, 
the  general  laws  for  the  incorporation  of  municipalities  provide  for  the 
exercise  of  sanitary  functions  by  the  different  classes  of  cities.  Thus 
it  appears  that  a  large  proportion  of  the  population  of  the  country  is 
nominally  under  some  sort  of  local  sanitary  control,  either  by  the 
county,  township  or  municipality. 

In  states  where  the  people  have  been  most  thoroughly  drilled  in  the 
practice  of  local  government,  there  the  local  sanitary  organization  is  the 

1  See  Connecticut  law,  p.  9. 

2  Alabama,  Colorado,  Delaware,  Idaho,  Indiana,  Kansas,  Kentucky,  Louisiana, 
Maryland,  Mississippi,  Montana,  North  Carolina,  North  Dakota,  South  Dakota, 
Tennessee,  Texas,  Utah,  Washington,  Virginia,  West  Virginia,  and  Wyoming. 

3  Connecticut,  Illinois,  Iowa,  Maine,  Massachusetts,  Michigan,  Minnesota,  New 
Hampshire,  New  Jersey,  New  York,  Ohio,  Pennsylvania,  Rhode  Island,  Vermont, 
Washington,  and  Wisconsin. 


SANITu I n  Y  OJR dAXIZ. I  TION.  13 

best,  so  that  as  a  rule  the  township  states  are  better  provided  for  than 
those  states  in  which  the  township  system  is  not  well  developed.  If  a 
township  state  has  a  well  organized  and  energetic  state  board  of  health, 
the  chance  is  still  better  for  the  general  organization  of  efficient  local 
boards  of  health.  In  Minnesota  in  1898  all  of  the  thirty-eight  cities, 
and  all  but  twenty-two  of  the  358  villages  and  boroughs  had  a  board 
of  health.  While  a  scheme  of  sanitary  administration  is  nominally  pro- 
vided for  the  larger  portion  of  our  population,  it  must  In-  admitted  that 
it  is  not  as  a  rule  very  efficient  in  really  rural  communities.  Little 
attention  is  paid  to  sanitation  in  the  country,  and  it  is  almost  entirely 
in  compact  villages,  towns  and  cities,  that  successful  administration  is 
found.  It  is  with  such  communities  that  this  wort  is  chiefly  con- 
cerned. 

In  New  England  the  dual  conception  of  the  township  as  both  a 
political  and  corporate  unit,  has  prevented  the  development  of  the  true 
municipality.  In  New  England  townships  have  often  attained  a  popu- 
lation of  25,000  or  30,000  before  changing  their  democracy  for  a  repre- 
sentative form  of  government  and  taking  on  the  habiliments  of  a  city: 
and  in  Connecticut,  even  with  the  incorporation  of  its  largest  cities,  the 
township  system  was  still  retained,  the  town  and  city  governments  ex- 
isting at  one  and  the  same  time  over  the  same  area.  The  evils  of  town- 
ship government  in  populous  communities  have  been  partly  overcome 
by  the  limited  establishment  of  tire,  school,  or  taxing  districts ;  bul  the 
incorporated  village  and  the  small  city  are  not  common  in  New  Eng- 
land. Outside  of  this  region  the  advantages  of  establishing  separate 
and  corporate  government  for  small  aggregations  of  population  have 
Long  been  recognized,  and  laws  for  their  incorporation  are  found  on  the 
statute  hooks  of  most  states.  According  to  the  census  of  1890  the 
urban  population  of  the  United  States  was  estimated   as  about  20,000,- 

000.  As  a  huge  pari  of  this  population  is  living  under  a  pretty  well 
developed  sanitary  organization,  the  importance  of  this  pari  of  our  sub- 
ject is  apparent. 

The  organization  of  municipalities  may  he  under  special  charte 
general  laws.      In  New  England,  the  cities  are   usually  organized  under 

a  special  charter    for  each  city:     and   this  LS  true  of    man\    of  the    larger 

cities  in  other  parts  of  the  country  :  bul  niosl  of  the  smaller  cities  and 
boroughs,  and  the  villages,  are  incorporated  under  general  laws.  We 
may  look  lor  the  authority  for  their  sanitarj  organization  in  their  char- 
ters or  genera]  incorporation  laws,  or  in  special  laws  ha  their 
objeel  the  preservation  of  the  public  health. 

Tli.'    following  is  a  brief  summary  ofgeneral    legislation   in 
leiviit  states  in  regard  to  municipal  sanitary  organization  : 


14  SANITARY  ORGANIZATION. 

Arkansas  has  two  classes  of  cities  and  incorporated  towns.  The 
city  councils  in  cities  of  the  first  and  second  classes  have  power  to  es- 
tablish boards  of  health. 

California.  "  The  board  of  trustees,  council  or  other  corresponding- 
board  "...  shall  "  eatablish  by  ordinance  a  board  of  health  to 
consist  of  five  persons,  one  of  whom  at  least  shall  be  a  practising 
physician     .     .     .     or  if  practicable,  a  civil  engineer." 

Colorado.  The  mayor  and  council  or  trustees,  except  when  it  is 
otherwise  provided  by  charter,  are  ez-officio  boards  of  health. 

Connecticut.  "  Where  it  is  not  otherwise  provided  by  charter,  the 
mayor  of  such  city,  or  the  warden  of  such  borough,  shall  nominate  some 
discreet  person,  learned  in  medical  sanitary  science,  to  be  health  officer 
for  such  city  or  borough,  which  nomination  will  be  confirmed  or  rejected 
by  the  common  council  of  such  city  or  the  burgesses  of  such  borough 
within  thirty  days  thereafter."  In  case  of  failure  on  the  part  of  the 
mayor  or  warden,  the  county  health  officer  appoints  the  local  health 
officer  in  cities  and  boroughs.  As  a  matter  of  fact,  of  the  eighteen 
cities  and  twenty  boroughs  about  one-third  have  health  officers  appointed 
by  the  county  health  officer. 

Delaware.  The  common  council  of  every  city  must  appoint  annu- 
ally a  board  of  health  of  not  less  than  three  nor  more  than  seven 
persons,  one  of  whom  must  be  a  physician  and  one  the  port  physician 
if  there  be  one. 

Illinois.  Cities  have  power  "  to  appoint  a  board  of  health  and 
prescribe  its  duties  and  powers." 

Indiana.  In  Indiana  in  all  three  classes  of  cities  the  mayor  nomi- 
nates, with  the  confirmation  of  the  council,  three  commissioners  of 
health  and  charities.  In  unclassified  cities  the  mayor  and  common 
council,  and  in  towns  the  trustees,  are  ex-offieio  boards  of  health. 

Iowa.  The  mayor  and  aldermen  of  cities  and  the  mayor  and  council 
of  villages  or  towns  are  ez-officio  boards  of  health. 

Kentucky.  The  cities  of  the  state  are  divided  into  six  classes  and 
incorporated  under  general  laws.  Cities  of  10,000  and  over  are  to 
appoint  a  board  of  health  consisting  of  the  mayor  and  six  others.  In 
all  other  cities  the  boards  of  trustees  or  the  council  must  appoint  a 
board  of  health  of  three  persons  not  members  of  the  appointing  board. 

Louisiana.  The  council  of  all  municipalities  is  to  appoint  a  board 
of  health  of  five  members. 

Maine.  It  is  provided  that  "There  shall  be  a  local  board  of  health 
in  each  city  and  town  in  this  state,  to  be  composed  of  three  members, 
anything  in  the  charter  of  such  city  notwithstanding." 


SANITu IBY   OB GAJSTIZ. 1  TION.  \  .5 

Massachusetts.  Chapter  332  of  the  Acts  of  1895  provides  for  a 
board  of  three  in  all  cities  except  those  where  there  is  some  other 
charter  provision. 

Michigan.  The  mayor  and  aldermen  of  cities  and  the  president  and 
council  or  trustees  of  each  village  which  has  no  charter  provisions  to 
the  contrary,  are  ex-officio  boards  of  health,  but  when  they  deem  it 
necessary,  the  council  of  a  city  or  village  may  establish  a  hoard  of 
health. 

Minnesota.  The  Statutes  (1894),  Sec.  7048,  provide  "that  all 
villages,  boroughs,  and  cities  shall  have  a  board  of  health  to  he  chosen 
and  to  consist  of  the  number  hereinafter  provided,  anything  in  the 
charter  of  such  village  or  borough  notwithstanding."  The  hoard  is  to 
consist  of  not  less  than  three,  one  of  wiiom  is  to  Ik-  a  physician  to  be 
elected  by  the  council  or  corresponding  body. 

Mississippi.  "A  city,  town  or  village  may  pass  sanitary  laws. 
establish  a  board  of  health,  and  enforce  the  collection  of  births,  health 
and  mortuary  statistics." 

Missouri.  Municipalities  are  divided  into  four  classes  of  cities  and 
villages.  In  cities  of  the  first  class,  of  over  1 00,000.  the  hoard  of  health 
consists  of  the  mayor,  the  presiding  officer  of  the  council,  a  commis- 
sioner of  police,  and  two  regular  practising  physicians.  The  health 
commissioner,  appointed  by  the  mayor  and  council.  is  also  a  member 
of  the  hoard. 

Nebraska.  Boards  of  health  in  municipalities  are  organized  under  a 
general  grant  of  authority  to  Legislate  for  the  preservation  of  the  public 
health. 

North  Carolina.  In  North  Carolina  municipal  boards  of  health  are 
organized  under  the  following :  "  The  authorities  of  au\  «it\  or  town 
are  hereby  authorized,  not  already  authorized  in  its  charter,  to  make 
such  regulations,  paj  such  fees  and  salaries  and  Impose  such  penalties 
as    iii    their    judgment    max     he    necessarj     for    the     protection    and    the 

advancement  of  the  public  health." 

North  Dakota.     Cities  are  to  have  a  board  of  health   to  cone 
four   aldermen    appointed    by    the    mayor,    the    health    office]    wl 
appointed  by  the  mayor,  and  the  cit\  engineer. 

Ohio.  There  are  in  Ohio  general  incorporation  laws  forthe  munici- 
palities of  the  state  as  required  1>,\  the  constitution,  bul  the  classification 

LS  such    that    what    are    practically    charters    have    been    enacted    tor  the 

more  important  cities.     There  are  ostensiblj  ten  classes  of  citi< 
villages.     Except  in  the  largest   cities  there   must    for  all  incorpoi 
places  lie  a  board  of  health  consisting  of  si\   members  app  • 

council  with  the  mayor  in  addition  as  a  seventh  mm- jim 


1 6  X ANITA  R  Y  OB  GAXIZA  TIOJST. 

Pennsylvania.  The  organization  of  cities  and  boroughs  is  provided 
for  by  the  general  laws  of  Pennsylvania  and  the  cities  are  divided  into 
six  classes.  In  cities  of  the  first  class  —  Philadelphia  —  the  board  of 
health  is  a  bureau  in  the  department  of  public  safety.  By  a  recent  act 
it  consists  of  three  members. 

In  cities  of  the  second  class  —  Allegheny  and  Pittsburgh  —  the 
health  department  is  also  a  bureau  in  the  department  of  public 
safety.  The  superintendent  of  the  bureau  and  the  other  employees  are 
appointed  by  the  director  of  public  safety. 

In  cities  of  the  third  class  the  board  of  health  consists  of  the  mayor 
and  four  other  persons,  or  a  separate  board  of  health  may  be  appointed 
as  in  boroughs. 

In  cities  of  the  fourth,  fifth  and  sixth  classes,  and  in  boroughs,  the 
board  of  health  consists  of  five,  of  whom  not  less  than  two  in  cities  and 
one  in  boroughs  shall  be  physicians,  to  be  appointed  by  the  mayor  or 
buro-ess  with  the  consent  of  the  council. 

Rhode  Island.  The  board  of  aldermen  (equivalent  in  the  statute  to 
town  council)  is  ex-officio  board  of  health  in  cities. 

South  Carolina.  Every  city  or  village  shall  have  a  board  of  health 
of  five  persons  not  members  of  the  council,  except  that  in  cities  the 
number  may  be  increased  to  twenty  as  the  city  council  may  determine. 
The  board  of  health  was  formerly  elected  by  the  freeholders,  but  by 
chapter  285  of  1897  it  was  changed  to  appointment  by  mayor  or 
intendant. 

Texas.  The  court  of  county  commissioners  may  appoint  a  board  of 
health  for  towns  and  villages  which  shall  be  under  the  direction  of  the 
state  health  officer. 

Tennessee.  Cities  of  over  5,000  inhabitants  must  have  a  board  of 
health. 

Utah.  Cities  must  create  a  board  of  health  and  prescribe  the 
powers  and  duties  of  the  same. 

Vermont.  The  health  officer,  together  with  "the  trustees  or  bailiff 
of  villages  and  the  aldermen  of  cities,"  constitutes  the  board  of  health. 

Virginia.  Each  municipality  must,  if  required  by  the  medical 
society,  have  a  board  of  health  to  consist  of  three  physicians  appointed 
by  the  corporation  judge,  but  nominated  by  the  local  medical  society, 
together  with  the  clerk  of  the  municipal  court  and  the  mayor. 

Washington.  The  common  council  of  cities  shall  be  ex-offieio  board 
of  health,  or  shall  appoint  wholly  or  partially  from  its  members  a 
suitable  number  of  persons  as  a  board  of  health. 

Wisconsin.  All  the  cities  of  over  2,000  inhabitants  are  divided 
into  four  classes  and  in  these  the  mayor  is  to  appoint  a  commissioner  of 


SANITARY    ORGANIZATION.  \~ 

health  who  holds  his  office  for  two  years,  but  only  a  few  cities  are  or- 
ganized under  the  provisions  of  this  general  law,  and  most  cities  have 
either  special  charters  providing  for  a  sanitary  organization  or  else  have 
established  hoards  of  health  under  Sec.  1411,  Annotated  Statutes 
(1898).  This  provides  that  the  town  board,  village  hoard  or  , sommon 
council  of  every  city  shall  within  thirty  days  after  each  annual  election 
organize  as  a  hoard  of  health,  or  shall  appoint  wholly  or  partially  from 
its  own  members  a  suitable  number  of  competent  persons  who  shall  or- 
ganize as  a  hoard  of  health. 

In  Wyoming  the  city  council  of  cities  and  the  trustees  of  towns  are 
ea>-officio  boards  of  health,  and  each  board  of  health  must  appoint  a 
health  officer. 

Sanitary  organization  in  most  of  the  villages  and  cities  of  the 
country  is  thus  provided  for  by  general  laws,  and  this  practice  of  incor- 
poration by  general  legislation  has  in  some  states  been  extended  to  all 
the  cities  even  the  most  populous.  Nevertheless  the  principle  of  class- 
ification is  such  in  these  laws  that  of  the  largest  cities  each  stands  alone 
in  its  class,  and  practically  receives  a  special  charter.  This  is  true  of 
Cincinnati,  Cleveland,  and  indeed  the  larger  Ohio  cities  generally, 
Philadelphia,  Indianapolis,  Louisville,  [Milwaukee,  Omaha,  St.  Louis, 
and  several  others.  Besides  these  the  following  important  cities  de- 
pend upon  special  charters  for  their  sanitan  organization:  Atlanta. 
Baltimore,  Boston,  Brooklyn,  Buffalo,  Charleston,  Chicago,  Denver. 
Detroit,  Hartford,  .Milwaukee.  .Minneapolis.  New  Haven,  New  York, 
Providence,  Richmond,  St.  Paid,  San  Francisco.  In  Massachusetts  and 
Rhode  Island,  though  the  cities  generally  have  special  charters,  their 
sanitary  affairs  are  in  most  cases  governed   by  general  laws. 

There  has  been  much  charter  making  of  late  and  man\  charters  of 
important  cities  are  of  \er\  recent  date.  The  tendency  of  these  char- 
ters is  towards  making  the  (hatter  a  framework  onl\  of  government, 
and  of  Leaving  the  details  to  he  Idled  in  by  general  legislation.  The 
appointmenl  and  tenure  of  office  of  officials,  and  the  relation  of  depart- 
ments, the  organization  of  the  legislative  branch,  and  the  separation  o\ 
Legislative  and  executive  functions  are  the  matters  generall}  considered. 
Hence  in  the  Cleveland,  Philadelphia  and  San  Francisco  charters  the 
powers  and  duties  of  the  board  of  health  are  nol  referred  to,  the}  lia 
been  provided  for  by  special  enactments  or  general  laws.  Notwith- 
standing this  teiideiiiw  towards  general    legislation  for  tl rganization 

of   cities,  ami    the  limitations  of    the  scope  of   such    legislation  to  funda- 
mentals, it    is  nevertheless  true  that  some  of  the  recenl    - 
Lation  for  cities  has  been  both  special  and   specific;  see  Chapt< 
special    laws   of    Minnesota,    Is-0-1.    for   sanitary    ■ 


18  &  I  -W  7'.  IB  Y   OR  G.  1 XTZ.  I  ZmM 

neapolis  :  and  Chapter  10  of  1895  of  Michigan  for  Detroit,  and  Chap- 
ter 105  of  1891  of  New  York  for  Buffalo.  The  charter  of  the  City 
of  New  York,  Chapter  378  of  1807,  contains  much  specific  sanitary 
legislation,   but  it   is    mostly   adopted    from    the   consolidation    act  of 

1882. 

While  it  is  generally  so  arranged  by  statute  that  the  jurisdiction  of 
county,  township  and  municipal  health  departments  shall  not  overlap, 
it  is  not  always  so.  The  authority  of  count}'  over  local  boards  in  West 
Virginia  and  elsewhere  has  previously  been  alluded  to.  Reverse  con- 
ditions sometimes  prevail.  In  the  East  it  would  be  rare  for  a  munici- 
pality to  exercise  any  authority  outside  of  its  own  corporate  limits  ;  Inn 
in  other  sections  of  the  country  it  is  by  no  means  uncommon.  In 
Illinois,  cities  may  legislate  concerning  offensive  trades  and  similar 
nuisances  for  one  mile  beyond  the  limits  of  the  city.  Chicago  by  a  former 
city  charter  was  permitted  to  enforce  quarantine  regulations  to  a  dis- 
tance of  fifteen  miles  beyond  the  city  bounds.  Indiana  cities  have 
jurisdiction  for  four  miles  in  regard  to  offensive  trades  and  ten  miles  in 
regard  to  river  pollution.  Cities  in  Arkansas  have  jurisdiction  of  five 
miles  for  quarantine,  and  in  Nebraska,  three  miles:  in  Texas  and  Utah. 
ten  miles.  Baltimore  has  quarantine  powers  for  three  miles  outside  the 
city  limits  on  land  and  fifteen  miles  on  water. 

County,  township  and  municipal  boards  of  health  are  merely  different 
forms  of  local  sanitary  organization  which  have  been  developed  by  the 
varying  history  of  the  different  sections  of  our  country,  or  have  been 
necessitated  by  varying  densities  of  population.  In  their  nature  they 
are  all  the  same,  and  therefore  in  considering  their  powers  and  duties 
provided  for  by  statute  law,  they  may  all  be  considered  together.  The 
organization  of  boards  of  health  may  be  provided  for,  and  their  duties 
and  powers  prescribed  in  various  ways.  In  the  first  place  the  legislature 
of  the  state  may  provide  by  special  enactment  for  a  sanitary  organiza- 
tion in  any  particular  city,  county  or  other  political  unit.  Second,  the 
state  may  provide  for  the  establishment  of  boards  of  health  in  any  group 
of  localities  by  means  of  general  laws  ;  and  lastly,  the  powers  of  the 
local  sanitary  authority  may  be  greatly  affected  incidentally  by  laws 
enacted  for  specific  purposes,  but  which  recognize  and  make  use  of  an 
already  established  organization.  Each  of  these  three  methods  will  be 
separately  considered. 

I.     Special  Legislation  for  Sanitary  Organization. 

Local  sanitary  authority  may  be  established  by  a  law  specifically  en- 
acted for  that  purpose,  or  second  it  may  be  established  by  special  muni- 
cipal charter.     Special  legislation  is  of  course  more  apt  to   be  found   in 


SANITARY    ORGANIZATION.  [9 

thr.se  states  in  which  the  method  of  dealing  with  municipalities  is  chiefly 
by  means  of  special  legislation,  and  where  there  are  no  general  pro- 
visions for  municipal  incorporation,  but  it  may  be  found  anywhere,  ii 
was  more  common  in  the  past  than  at  present  for  two  reasons;  first. 
because  the  method  of  dealing  with  these  matters  by  genera]  Legislation 
is  recognized  more  and  more  as  the  better  way,  and  second,  because  in 
former  years  when  public  sanitation  was  somewhat  novel,  it  was  only 
exceptional  circumstances  which  could  lead  a  community  to  see  the 
necessity  for  any  sanitary  organization  at  all.  An  epidemic,  either 
actual  or  potential,  has  been  in  the  past,  and  is  even  now.  the  most  com- 
mon cause  for  special  legislative  action  in  the  direction  indicated.  The 
presence  of  yellow  fever  in  Boston  in  17s'.'1  was  the  cause  of  the 
establishment  of  the  hoard  of  health  in  the  following  year.  The  hoard 
of  health  in  Philadelphia  in  17l»4  was  the  result  of  smallpox  in  1793.9 
The  health  department  in  Providence  was  organized  in  1856  as  a 
result  of  the  cholera  epidemic  in  the  preceding  year,  and  the  Chicago 
board  of  health  was  established  in  1867  in  consequence  of  the  interest  in 
sanitary  affairs  created  by  cholera  in  1866.3  Yellow  fever  in  Memphis 
not  only  resulted  in  the  formation  of  a  well  organized  health  department, 
hut  caused  the  revocation  of  the  city  charter  and  a  reorganization  of 
the  city  government.  The  reorganization  of  the  Detroit  health  depart- 
ment in  1895  was  due  to  an  extensive  outbreak  of  scarlet  fever  and 
diphtheria. 

//.      General  Sanitary  Legislation  for  Sanitary  Organization. 

Jn  the  early  history  of   public  sanitation  in  this  couiitrx    most  of  the 
Legislation   would    naturally  he  of  a  special  and   local  character,  called 

for  by  special  events,  and  fitted    for    certain  localities,  usually  the  more 

populous  centres.     General  laws  for  the  establishment  of  local  sanitary 

authority  onl\  came  with  the  development  of  popular  interest  in  sani- 
tary affairs.      The  growth  of   public  sentiment  in  this  direction  has  been 

greatly  favored  by  the  establishment  "i  -tate  boards  of  health.  These 
boards  have  done  much  to  produce  a  demand  for  local  saniiarv  organiz- 
ation and  to  shape  the  laws  to  eflecl   it.       At   the  present   time,  much  the 

larger  pari  of  our  population  is  under  general  saniiarv  legislation  ;  and* 
this  is  true  of  even  the  largest  cities,  for  the  tendencj  towards  uniform 
methods  of  municipal   incorporation  is  yearly  wiping  out  old  cha 

and    special    acts   I    making    general    laws   of    incorporation    in    their 

place. 

1  Report  of  the  Sanitary  Commission  of  Massachusetts,  1850,  p 
-  Philadelphia,  Reporl  <»f  the  Board  oi  Health,  1895,  p.  • 
"Chicago,  Reporl  ol  the  Board  of  Health   L867  9,  it-  IW  121. 


2( )  SAJSTIT.  I  R  Y    OB  GA  XIZ.  i  TION. 

It  has  been  shown  that  twenty-three  states  have  general  laws  for 
the  organization  of  county  boards  of  health.  In  all  but  California  still 
greater  uniformity  is  secured  by  making  such  organization  obligatory. 
County  organization  is  almost  invariably  under  general  laws.  Some  of 
the  few  exceptions  have  been  noticed  as  San  Francisco  County  in  Cali- 
fornia, Escambia  and  Franklin  Counties  in  Florida,  Jackson  County  in 
Mississippi,  and  Hudson  Comity  in  New  Jersey. 

For  township  boards  of  health  also  it  will  be  found  that  general 
legislation  prevails.  The  number  of  townships  in  most  of  the  states  is 
very  large,  and  the  importance  of  the  individual  township  is  not  very 
great:  moreover  the  similar  character  of  many  townships  lends  itself 
to  general  legislation.  Hence  in  nearly  every  state  in  which  the  town- 
ship system  is  at  all  well  established,  general  laws  are  found  providing 
for  township  boards  of  health.  There  are  such  laws  in  fifteen  states, 
and  in  all  they  are  mandatory. 

Besides  county  or  township  boards  of  health,  thirty-one  states  pro- 
vide general  laws  for  the  municipal  health  organization  in  cities,  towns, 
boroughs  or  villages. 

III.      Greneral  Legislation  which  Incidentally  Confers  Sanitary  Powers. 

While  both  general  and  special  legislation  establishing  local  sani- 
tary authority  define  to  a  greater  or  less  extent  the  powers  and  duties 
of  such  authority,  it  often  happens  that  much  of  this  power  is  derived 
from  other  laws  having  specific  objects  in  view,  and  which  simply  make 
use  of  the  existing  sanitary  organization  or  perhaps  other  departments 
or  officers,  for  executive  purposes.  Thus  quarantine  laws  have  from 
time  to  time  since  1699  been  enacted  by  the  different  maritime  colonies 
and  states.  Such  laws  usually  impose  duties  upon  and  grant  powers 
to  the  local  officials  of  seaport  towns  and  cities,  or  in  many  cases  im- 
pose these  duties  on  state  officers.  Laws  for  the  prevention  of  com- 
municable disease,  for  the  abatement  of  nuisances,  for  the  prevention 
of  the  adulteration  of  foods,  and  for  many  similar  purposes,  usually 
rely  tor  their  execution  upon  the  local  government.  When  the  local 
government  has  an  established  board  of  health  or  other  sanitary  organ- 
ization, it  is  usually  upon  such  that  the  duty  of  enforcing  the  law  is 
placed.  It  is  from  such  laws  that  much  of  the  power  of  the  board  of 
health  is  derived. 

Laws  for  establishing  boards  of  health  provide  for  their  organization, 
their  membership,  election,  terms  of  office,  the  appointment  of  sub- 
ordinates and  the  like,  all  of  which  matters  will  be  duly  considered. 
Sometimes  the  statute  does  little  more  than  this,  scarcely  giving  any 
power  or  defining  any  duties.      Thus  for  the   county   boards  of  health 


SANITARY    ORGANIZATION.  •_>  j 

established  in  Kansas  the  only  duties  prescribed  by  the  statute  are  by 
implication,  that  the  health  officer  appointed   by  the   county    board   of 

health  shall  transmit  to  and  fr.uu  the  the  state  board  of  health  forms 
for  the  registration  of  vital  statistics.  But  generally  the  law  providing 
for  a  health  organization  defines  its  powers  more  or  less  explicitly. 
though  many  additional  powers  and  duties  may  be  provided  for  in- 
cidently  in  other  statutes  or  by  special  Legislation. 

The  powers  which  may  he  conferred  upon  a  board  of  health  an-  very 
great.  They  belong  to  the  general  police  powers  of  the  state,  hut  it  is 
not  the  purpose  here  to  discuss  their  nature  or  extent.  It  is  rather  the 
purpose  to  consider  what  are  the  powers  and  duties  with  which  the 
various  state  legislatures  have  invested  the  local  sanitary  organization 
within  their  jurisdiction,  as  well  as  the  nature  of  the  organization,  and 
the  channels  through  which  the  power  is  conferred.  Most  sanitary 
organizations  perform  functions  which  belong  in  a  certain  sense  to  the 
three  greal  spheres  of  governmental  activity,  the  executive,  Legislative, 
and  judicial.  Primarily  the  board  of  health  is  to  see  to  the  enforce- 
ment of  law.  Its  chief  function  is  executive,  hut  it  happens  that  the 
subjects  with  which  it  deals  require  such  technical  knowledge,  and  the 
conditions  vary  so  rapidly  with  the  advance  of  science,  that  it  is  often 
deemed  wise  that  boards  of  health  should  he  empowered  to  make  rules 
in  regard  to  certain  matters,  such  as  quarantine  and  the  management  of 
contagious  disease,  such  rules  to  have  the  force  of  law.  Then  again, 
the  local  saintary  authority  frequently  exercises  semi-judicial  powers 
as  when  it  determines  the  fact  of  a  nuisance,  or  the  offensiveness 
of  a  trade.  Our  purpose  now  is  to  consider  the  laws  h\  which 
these  greal  and  varied  powers  are  conferred.  Sometimes  the  powers 
and  duties  are  provided  for  in  the  mosl  general  \\a\  and  again  tiny  arc 
enumerated  with  the  greatesl  detail  and  exactness. 

The  following  are  instances  where  the  law  is  expressed  in  verj  gen- 
eral terms.     In    Providence  the  citj  council    may   make  ordinances  ** in 

d   to  health  and    the  prevention  and    abatement  of   nuisances.*'       Iii 
North  Carolina  cities  and  towns  may  "  make  such  regulations,  |>;i\    such 

fees  and  salaries  and  impose  such  penalties  as  in  their  judgment  ma> 
be   necessarj    for  the   protection  and    the   advancement  of   the   public 

health."      The  health  depart  n  hi  1 1  of  Ball  imore  is  organized  chielh   under 

the  charier  which  gives  the  mayor  and  council  power  "  to  pass  ordi- 
nances to  preserve  the  health  of  the  city."  In  Massachusetts'  the 
hoard  of  health  of  a  town  -shall  make  such  regulations  as  il  judges 
iiecessan  for  the  public  health  and  safety,  respecting  nuin 

of    tilth,  and  causes  of   sickness." 


Massachusetts  Public  si  itutes,  1882,  Chaptei  80   Sec.  18. 


22  SANITARY    ORGANIZATION. 

Legislatures  in  providing  for  local  government,  seem  to  have  taken 
very  different  views  of  the  safest  and  surest  form  in  which  their  acts 
should  appear.  ( >ccasionally,  as  in  the  instances  above  cited,  the  acts 
are  brief  and  the  provisions  very  broad  in  their  grant  of  powers.  That 
such  simple  acts  and  general  provisions  are  sufficient  to  meet  all  emer- 
gencies is  probable.  See  Boehm  v.  Baltimore  61  Md.  259.  Other 
decisions  of  the  courts  would  appear  to  uphold  this  view:  but  generally 
state  law  makers  are  not  content  with  simple  laws  of  broad  scope,  but 
attempt  to  specify  in  detail  each  of  the  powers  which  local  govern- 
ments may  exercise,  and  to  map  out  for  them  as  closely  as  possible  their 
functions,  and  prescribe  with  exactness  the  manner  in  which  they  shall 
be  exercised.  In  providing  for  the  department  of  health,  the  legislature 
generally  adds  to  a  general  grant  of  power,  prescriptions  as  to  the  form 
of  organization,  and  enumerates  at  lesser  or  greater  length  the  various 
powers  which  are  conferred  and  the  duties  imposed.  Thus  acts  of  every 
variety  of  extent  and  complexity  of  detail  are  found  varying  from  a 
few  lines  to  many  pages.  These  different  ways  of  regarding  the  form 
of  legislation  do  not  seem  to  depend  much  upon  either  time  or  place. 
Some  of  the  most  general  provisions  were  among  the  earliest,  as  the  act 
for  establishing  boards  of  health  in  Massachusetts  in  1797  and  the 
charters  of  Providence  and  Baltimore  which  were  among  the  earliest  to 
provide  for  the  regulation  of  sanitary  affairs  ;  but  recently  the  same 
broad  legislation  is  seen  in  Kansas,  Kentucky,  North  Carolina,  and 
several  western  states.  On  the  other  hand,  recent  acts  for  the  organ- 
ization of  cities  of  the  first  class  in  Indiana  occupy  about  two  pages  in 
the  bare  enumeration  of  powers  concerning  sanitary  affairs.  The  same 
detail  is  seen  in  the  charter  of  Buffalo  1891,  in  the  act  of  1895  estab- 
lishing a  bureau  of  health  in  Pennsylvania  cities  of  the  second  class, 
and  the  act  of  1895  establishing  a  board  of  health  in  Detroit  is  one 
of  the  best  examples  of  the  control  of  the  legislature  over  the  details 
of  local  sanitary  affairs.  This  act  covers  nearly  fourteen  pages.  It 
can  however  scarcely  be  said  that  there  is  an  increasing  tendency  of 
late  years  for  the  legislature  to  legislate  more  in  detail  in  regard  to 
sanitary  affairs,  and  when  this  is  done  it  is  doubtless  due  to  an  increased 
interest  in  sanitary  matters.  Probably  the  tendency  of  legislation  in 
regard  to  local  affairs  may  be  said  to  be  the  other  way.  Special  charters 
and  general  incorporation  laws  of  late  are  apt  to  provide  merely  for  the 
form  of  the  sanitary  organization,  and  leave  its  powers  and  duties  to 
general  state  legislation  appertaining  to  these  matters.  The  present 
charters  of  Philadelphia,  Cleveland  and  San  Francisco  may  be  cited  as 
examples  of  this  tendency. 


&  J  XI T.  1  R  Y   OR  a.  1  XI Z.  I  TION.  23 

/.     Form  of  the  Local  Sanitary  Organization. 

1.     Ex-officio  Boards  and  Officers.     The  legislature  very  frequently 

makes  use  of  already  existing  officers  to  administer  sanitary  laws:  how 
frequently  is  shown  by  a  glance  at  the  state   legislation  that  has  been 

tlms  far  summarized.  Colorado.  Idaho.  Indiana,  Kansas.  Maryland, 
.Montana.  Tennessee  Washington  and  Wyoming  have  ex-officio  county 
hoards  of  health,  with  the  addition  in  Kansas.  Idaho,  and  Montana  of 
one  or  more  physicians.  Illinois,  Iowa.  Massachusetts,  Michigan,  Min- 
nesota. New  Jersey,  Xew  York.  Ohio.  Pennsylvania,  Rhode  Island.  Ver- 
mont and  Wisconsin  have  ex-officio  township  boards  pf  health.  New  York 
and  Xew  -Jersey  having  one  citizen  in  addition.  In  Colorado,  Iowa, 
Louisiana.  Michigan,  Nebraska,  Rhode  Island,  and  Vermont,  general 
laws  provide  that  the  cities  shall  have  ex-officio  hoards  of  health.  More- 
over, many  of  the  Ohio  cities  have  ex-officio  hoards:  thus  in  Cincinnati 
the  board  of  administration  is  the  hoard  of  health.  In  New  York  the 
mayor  of  cities  is  a  member  of  the  board  of  health  unless  otherwise 
provided,  and  the  same  is  true  in  many  cities  with  special  charters. 
There  are  other  instances  also  where  special  charters  provide  tor  the 
membership  of  certain  officials  on  the  hoard  of  health.  Below  are 
mentioned  sonic  of  the  officials  who  are  found  on  hoards  of   health.1 


1  Asheville.  W  (  .     .Mayor.  City  Engineer,  and  Chairman  of  Committee  on  Finance. 

Atlanta.     Mayor  and  Chairman  of  Sanitary  Committee  of  Council. 

Buffalo.     Mayer  and  President  of  Hoard  of  Puhlic  Works. 

Grand  Rapids.     Mayor  and  President  of  Council. 

Jersey  City.  Hoard  of  Police  Commissioners  (three  in  number).,  the  Health 
Inspector  and  one  City  Physician  appointed  by  President  of  Board  of  Police  Com- 
missioners. 

Kansas  City,     city  Physician,  Chief  of  Police  and  Chief  of  Fire  Department 

Knoxville,     Mayor  and  Chairman  of  Board  of  Public  Works. 

Macon.  Mayor.  Chairman  of  Cemeterj  Committee  of  Council  and  Clerk  of 
(  oiincil. 

Memphis.     Mayor,  Chief  of  Police. 

Nashville.     Chairman  of  Board  of  Public  Works. 

N.w  York.     Health  Officer  of  Pori  and  President  Board  of  Police. 

North  Dakota  Cities.  Four  aldermen  appointed  by  the  Mayor/the  City  Engineer, 
and  the  health  officer  who  is  appointed  by  ill"  mayor. 

Omaha.     Mayor,  Chief  of  Police,  Chairman  of  Commit! n  Sewers,  (  hairman 

of  Committet Streets  and   Uleys,  and  inspector  of  Plumbing. 

Portland,  Ore.     Mayor.  Chairman  of  Committee  on  Health  and  Poli 
moil  Council,  Chief  of  Police,  <it.\  Physician,  and  the  Health  Commissioi 

Philadelphia.     Mayor  and  the  Director  of  Public  Safety. 

Raleigh.     Mayor,  two  Lldermen,  Chief  of  Police,  Cit)   Utornej  and 

Rochester  and  Somersworth,  N.  H.     City   Physician,  Ovei 
Sanitarj  « Officer. 

Rockville,  111.     Commissioner  of  Health,  Mayor  and  Chief  of  Pol 

St.  Paul.     Chief  of  Police,  Citj  Solicitor  and  Commissioner  oi   Health. 


24  &  J  -V/  7'.  IB  Y   OB  G.  1  WIZA  TION. 

Thus  it  appears  that  the  majority  of  the  county  and  township  hoards 
including  those  in  the  most  populous  states  and  with  the  best  sanitary 
organization,  have  ex-ojjicio  hoards  of  health.  Moreover,  many  of  the 
municipalities  have  similar  hoards,  and  in  some  states  this  includes  all 
the  cities  except  those  provided  for  by  special  statute. 

In  other  states,  county,  town  or  city  authority  may  exercise  certain 
powers  in  sanitary  affairs,  as  county  supervisors  and  justices  of  the  peace 
in  Virginia. 

2.  Independent  Sanitary  (  hganizations.  In  Alabama,  California, 
Connecticut,  Delaware,  Florida,  Kentucky,  Louisiana,  Mississippi,  North 
Carolina,  North  Dakota,  South  Dakota,  Texas  and  West  Virginia,  pro- 
visions are  made  for  an  independent  county  hoard  of  health  or  health 
officer,  but  in  Alabama  and  North  Carolina  it  consists  of  members  of 
the  medical  society  or  the  physician  of  the  county,  and  in  North  Dakota 
the  district  attorney  is  added.  Among  the  township  states,  Maine  and 
New  Hampshire  have  independent  hoards  of  health,  and  Connecticut, 
a  health  officer;  but  it  is  in  cities  that  the  administration  of  sanitary 
affairs  is  most  commonly  provided  for  by  a  separate  department. 
Arkansas,  Louisiana,  .Maine  Massachusetts,  New  York,  New  Jersey, 
Pennsylvania  in  cities  of  the  third  class,  Delaware,  North  Carolina. 
Ohio  (in  the  smaller  cities),  South  Carolina,  Utah,  Mississippi,  Ken- 
tucky, Tennessee,  Indiana,  Illinois,  Wisconsin,  Minnesota,  and  Cali- 
fornia provide  for  the  establishment  of  independent  municipal  boards 
of  health,  and  in  Rhode  Island  and  Washington,  they  are  permitted; 
and,  as  has  been  said,  special  municipal  legislation  usually  provides  for 
an  independent  rathe!'  than  an  ex-officio  hoard.  In  some  cities,  how- 
ever, while  there  are  special  sanitary  officers,  they  are  made  a  division  of, 
or  are  under  the  control  of,  some  other  department.  This  is  true  of  some 
of  the  larger  cities  as  provided  for  by  recent  charters.  .In  Philadelphia, 
Pittsburgh,  Louisville,  Baltimore,  Allegheny  and  New  York  cities  of 
the  second  class,  the  health  department  is  a  bureau  of  the  department 
of  public  safety;  in  the  first  there  is  a  hoard  of  health  of  three  members1 
and  in  Allegheny  and  Pittsburgh  the  bureau  consists  simply  of  a 
superintendent  and   other  officers  appointed    by  the  director.      In    Balti- 


St.  Louis.  Mayor,  President  of  Council  and  Police  Commissioner  appointed  by 
Mayor. 

San  Francisco.     Chief  of  Police  and  Board  of   Public  Works. 

Santa  Barbara,  Cal.     Mayor  and  City  Engineer. 

Savannah.  The  Board  of  Sanitary  Commissioners  consists  of  the  Mayor  and 
Health  Officer,  and  live  others  who  may  be  members  of  the  council. 

Wilmington,  Del.  Port  Physician  and  Chief  Engineer  of  Surveying  Department 
1Inl899an  attempt  was  made  to  abolish  the  board  of  health,  and  appoint  a 
single  health  officer,  but  the  act  was  defective. 


SANITARY    ORGANIZATION.  25 

more  the  commissioner  of  health  is  appointed  by  the  mayor  but  acts 
under  the  department  of  public  safety.  In  Cleveland  and  Toledo  tin- 
department  of  police  has  charge  of  all  matters  relating  to  the  public 
health.  The  department  of  police  is  in  charge  of  a  director  appointed 
by  the  mayor  in  whom  are  vested  all  the  duties  and  powers  of  the  former 
board  of  health.  In  certain  cases,  particularly  among  the  larger  cities 
another  form  of  sanitary  organization  has  been  developed.  In  these  cities 
the  health  department  is  a  single-headed  department.  The  tendency  of 
city  government  at  the  present  time  is  towards  single-headed  depart- 
ments, hut  this  plan  has  been  extended  to  the  health  department  perhaps 
less  than  to  any  other.  It  is  probably  because  in  this  department  are 
usually  lodged  great  legislative  as  well  as  executive  powers  and  it  is  not 
in  accord  with  American  notions  to  give  much  legislative  power  to  one 
man:  and.  indeed,  it  usually  happens  that  when  a  health  commissioner 
is  appointed,  his  power  in  this  direction  is  limited  or  denied  entirely, 
being  reserved  to  the  proper  legislative  branch  of  the  city  government. 
Among  the  eities  with  a  single-headed  department  are  Baltimore,  Chi- 
cago, Colorado  Springs,   Denver,  the  District  of  Columbia,  Milwaukee. 

Minneapolis,  New   York   and    Pennsylvania  cities  of   the  sec 1  class, 

and  also  a  number  of  the  smaller  Wisconsin  and  Connecticut  cities. 

In  Brooklyn  formerly  the  health  commissioner  was  appointed  ly  the 
mayor  for  a  term  of  two  years,  lie  was  not  only  the  executive  head  of 
the  health  department,  appointing  all  subordinates  ami  enforcing  the 
laws  and  ordinances,  bul  he  had  also  ••  power  to  act  in  a  legislative 
capacity  in  regard  to  all  matters  pertaining  to  the  public  health.  He 
possessed  this  legislative  power  however,  only  eo-ordinatel}  with  the 
council  by  whom  all  ordinances  prepared  l>\  him  were  to  he  approved 
before  they  become  a  law;  and  the  law  read  ••  No  ordinance  so  prepared 
and  approved  shall  he  repealed  01'  amended   without   the  approval  oi    the 

health   commissioner."     In    Milwaukee,  the   health   commissi \x  is  to 

■•  provide  rules  and  regulations  "  to  be  approved  l>\  the  common  council, 
hut  it  does  not  appear  thai  he  has  the  quasi  veto  power  which  the 
Brooklyn  commissioner  possessed.  In  Chicago,  Baltimore,  District  oi 
Columbia  and  Denver  the  commissioner  is  simpl)  the  executive  office] 
in   charge  of  sanitary    affairs.      He    has  little  or  no   legislative   powers 

these  being   vested   in  other  branches  of  the  city    goveri ml   or  in  the 

case  of  the  District  of  Columbia  in  Congress,      hi  Denver  and  Colorado 
Springs  the   possible  disadvantages  oi   ••  one   man   power     arc   met,  oi 
attempted   to   be,  b}  the  unique  arrangemenl   of  an  advisor)    hoard   oi 
health.     This  board   is  extra-legal  and   is  appointed   l>)  the  health 
mission, m.     In    Denver  il  is   frequentl}  ■■ailed   togethei    b)  ! 
advice  is  considered    of  erreal  value.      Ii  was   the  intention  in    thai 


26  SANITARY  ORGANIZATION. 

that  the  health  department  should  be  a  bureau  in  the  department  of 
public  safety,  the  board  of  public  safety  to  consist  of  the  health  com- 
missioner and  the  commissioners  of  fire,  police  inspection  and  excise, 
but  for  many  years  that  department  has  had  no  meeting.1  In  Rich- 
mond, Va.  there  is  an  advisory  board  of  health  in  addition  to  the  reg- 
ularly established  board. 

While  there  are  not  very  many  cities  in  which  the  sanitary  powers 
are  formally  conferred  upon  one  man,  there  are  many  cities  including 
some  of  the  most  important  in  which  this  is  practically  the  result  of 
the  existing  organization.  This  is  true  of  those  cities  in  which  the 
health  department  is  a  bureau  in  the  department  of  public  safety.  In 
Cleveland  and  Cincinnati  the  department  is  practically  single-headed, 
and  in  many  cities  with  independent  boards  of  health  it  is  often  the 
case  that  a  single  member,  or  perhaps  the  executive  officer  appointed  by 
the  board,  practically  controls  all  its  action.  In  some  of  these  cities 
the  other  members  of  the  board  are  a  hindrance  rather  than  a  help  to 
the  one  efficient  officer.  In  smaller  communities  especially  when  the 
city  or  township  council,  or  county  commissioners  are  ex-officio  the  board 
of  health,  the  health  officer  appointed  by  the  board  really  performs  all 
the  necessary  functions  of  the  department,  except  that  of  legislation. 
It  may  thus  be  fairly  stated  that  while  nominally  a  single-headed  health 
department  is  not  very  common,  as  a  matter  of  fact  efficiency  is  in  the 
majority  of  cases  throughout  the  United  States  secured  only  by  -allow- 
ing one  man  to  control  sanitary  affairs.  A  single  health  officer  with- 
out legislative  power  is  by  most  state  officials  of  experience,  considered 
more  efficient  than  a  board  of  health. 

II.     Appointment  of  Mauler*. 

Wherever  there  is  an  independent  board  of  health  it  must  be  either 
elected  or  appointed.  In  almost  all  cases  its  membership  is  made  up 
by  the  latter  method,  though  until  1897  the  South  Carolina  law  pro- 
vided that  the  board  of  health  of  cities,  towns,  and  villages  should  be 
elected  by  the  freeholders.  In  Massachusetts  "  the  town  at  the  annual 
meeting  or  a  special  meeting  called  for  the  purpose  may  choose  by  ballot 
a  board  of  health." 

In  a  few  instances  the  local  board  of  health  is  appointed  by  the 
governor  of  the  state.  This  is  true  of  the  county  board  of  health  in 
Delaware  and  of  Jackson  County  in  Mississippi.  In  certain  cities,  too 
as  in  Shreveport  and  Baton  Rouge,  La.,  and  hi  San  Francisco  (until 
1000),  and  in  Detroit. 


1  Denver  Report  of  Bureau  of  Health,  1895,  p.  7. 


SANITARY   ORGANIZATION.  ^7 

In  Connecticut  the  county  health  officers  are  appointed  by  the 
Supreme  Court.  In  West  Virginia,  Mississippi,  and  North  and  South 
Dakota  the  county  board  is  appointed  by  the  state  board. 

In  Vermont  the  state  board  of  health  appoints  the  health  officer  who 
is  ex-officio  a  member  of  the  local  hoard  of  health. 

The  control  of  the  state  authorities  in  these  appointments  is,  how- 
ever, very  exceptional,  and  almost  always  the  appointment  of  the  local 
board  of  health  is  in  the  hands  of  the  local  government,  either  connty 
or  municipal.  In  most  states  the  county  boards  are  ex-officio  boards,  but 
in  Texas  the  county  health  officer  is  appointed  by  the  county  judge. 
In  California  the  county  board  of  health  is  appointed  by  the  super- 
visors, and  in  Idaho,  Montana,  and  Kansas  the  board  of  health  consists 
of  the  county  boards  with  the  addition  of  one  physical]  appointed  by 
the  board.  Township  boards  of  health  also  are  usually  ex-officio  boards 
though  sometimes  with  the  addition  of  another  member  usually  a 
physician  appointed  by  the  board  as  in  Xew  York.  New  -Jersey,  and 
Minnesota:  but  in  Maine  the  "  Municipal  officers"  of  towns  (town- 
ships) and  in  Xew  Hampshire  the  selectmen  are  required  to  appoint  a 
board  of  health,  and  in  Rhode  Island  the  town  council  is  permitted  to 
do  so. 

It  is  in  municipalities,  particularly  the  larger,  that  independent 
boards  of  health  are  most  common,  and  here  they  are  usually  appointive. 
In  Xew  Hampshire,  Delaware,  Ohio,  Arkansas,  Minnesota,  Kentucky. 
and  California  the  general  laws  provide  that  the  city  board  of  health 
shall  be  appointed  by  the  ••council."'  "common  council,"  or  "city 
council"  as  the  case  may  be.  In  Massachusetts  the  mayor  and  board 
of  aldermen  conjointly,  and  in  New  York,  Wisconsin.  North  Carolina, 
Arkansas,  and  Pennsylvania  in  cities  of  the  third  class  and  in  boroughs 
the  mayor  and  council  have  the  appointing  power.  In  Indiana  in  the 
classified  cities  the  commissioners  of  health  and  charities  are  appointed 
by  the  mayor,  and  in  Wisconsin  the  commissioner  of  health  is  appointed 
bythe  mayor.  In  Texas  the  board  of  health  of  towns  and  villa- 
appointed  bythe  county  commissioners.  In  New  Mexico  the  county 
commissioners  may  appoint  health  officers  for  towns,  and  in  California 
they  must  do  so  for  unincorporated  towns  of  over  500  inhabitants.  In 
inia  count}  and  municipal  boards  of  health  are  appointed  b\  the 
county  <»r  municipal  judge. 

In  those  cities  which  have  special  charters  or  special  acts  establish- 
ing the  department   of  health,  all  sorts  of  methods  are  in  vogue,  the 

tendency    being  in   recent  charters  to  vest    the  appointing  <<\  the  head     t 
the  health  as  of   all    other  departments,  exclusively    in  the  hands  of    the 

mayor.     This  is  tine  of  Charleston,   Milwaukee,  New    II.; 
New   York,  Cleveland,  Philadelphia,  and  San  Francisco. 


28  &  '  #Z  7'.  1 22  F   OR  £.  1 V7Z.-1  ZYOiV: 

///.      Qualifications  of  Manlier*. 

In  the  majority  of  cases  the  control  of  local  sanitary  affairs  is  vested 
in  a  board  of  health  as  distinguished  from  a  bureau  or  a  single  com- 
missioner. The  membership  of  the  board  of  health  established  under 
tla-  different  statutory  provisions  varies  greatly.  Some  of  the  ex-officio 
boards  are  very  large,  too  large  to  be  useful  it  is  said,  as  when  county 
boards  are  composed  of  the  town  supervisors,  or  when  the  board  is  com- 
posed of  the  aldermen  or  council  of  a  city.  Independent  boards  are 
usually  smaller,  though  in  South  Carolina  the  number  may  be  twenty  : 
in  Charleston  it  is  eleven,  three  of  whom  are  physicians.  Newark  lias 
a  board  of  ten.  Seven,  five,  and  three  are  favorite  numbers.  There 
seems  to  be  little  choice  among  these,  except  that  the  larger  number  is 
usually  provided  for  in  the  larger  communities.  In  Ohio,  New  York, 
and  Kentucky  it  is  seven  for  cities  ;  in  New  Jersey,  five  to  nine  ;  in  New 
Jersey  and  Delaware,  five  to  seven  for  towns:  in  Pennsylvania,  South 
Carolina,  and  Colorado,  five  for  towns  ;  in  Maine,  Massachusetts,  Min- 
nesota, and  Missouri,  three  for  cities  and  towns. 

In  the  larger  Georgia  cities  and  in  South  Carolina  it  was  originally 
provided  that  there  should  be  one  member  of  the  board  of  health  from 
each  ward,  but  this  has  since  been  modified  in  Atlanta,  Augusta,  and  in 
South  Carolina. 

As  regards  the  occupation  of  the  members,  the  various  public  offi- 
cers who  are  ex-officio  members  of  boards  have  already  been  considered. 
The  importance  of  having  a  medical  man  on  the  board  is  generally 
recognized,  and  it  is  customary  to  elect  them  even  when  it  is  not  re- 
quired  bylaw;  but  it  is  so  required  in  many  instances.  In  Alabama 
and  North  Carolina  the  county  boards  of  health  are  in  the  one  case  all 
the  members  of  the  county  medical  society,  and  in  the  other  all  the  reg- 
istered physicians  in  the  county.  In  Connecticut  the  town  health 
officer,  and  in  Texas,  the  county  health  officer  are  to  be  physicians. 
In  New  York,  New  Jersey,  Pennsylvania  and  Minnesota,  it  is  provided 
that  one  member  of  the  township  board  of  health  shall  be  a  physician. 
In  Delaware  the  comity  board  of  health  consists  of  three  physicians,  in 
Virginia  three  members  must  lie  physicians,  and  in  West  Virginia  one 
member  is  a  physician. 

The  secretary  of  the  state  board  of  health  of  Connecticut1  thinks 
that  laymen  make  excellent  health  officers  for  small  townships,  and  the 
secretary  of  the  Maine  state  board  of  health  has  found  them  very  use- 
ful as  members  of  the  board  of  health  in  country  towns. 

Some  of  the  general  laws  for  the  organization  of  municipal  boards 
of  health  also  require  the  appointment  of  medical  men,  as  in    Pennsyl- 


1  Connecticut,  Report  state  Board  of  Health  1898,  \>.  XVII. 


SANITARY    ORGANIZATION.  29 

vania,  Indiana.  Delaware,  SoutL  Carolina.  Kentucky  and  California. 
Usually  when  there  is  a  single  head  for  the  department  it  is  required 
that  he  be  a  physician.  It  is  not  always  possible  to  obtain  the  service 
of  a  physician  for  this  office,  and  so  most  laws  make  the  provision  that 
a  physician  shall  be  appointed  if  one  is  available.  The  California  law 
requires  in  municipalities  the  appointment  on  the  hoard  of  health,  of  a 
civil  engineer  if  possible.  Connecticut  is  the  only  state  that  requires 
that  the  health  officer  shall  he  an  attorney. 

The  disadvantage  of  having  -'polities'"  affect  the  membership  or 
working  of  a  hoard  of  health  is  <>t  course  apparent.  It  is  so  apparent 
that  public  opinion  has  made  a  stronger  demand  for  purity  in  the  health 
department  than  in  any  other  department  of  municipal  affairs.  A  large 
proportion  of  health  officers  are  free  from  the  taint  of  partisanship, 
though  of  course  there  arc  conspicuous  exceptions.  Bi-partisanship 
which  is  generally  recognized  as  a  futile  means  of  combating  partisan- 
ship, has  rarely  been  tried  in  the  health  department.  In  New  Jersey, 
however,  by  the  act  of  1  5  .March.  1894,  it  was  provided  that  in  cities 
of  the  first  class,  the  hoard  of  health  should  be  bi-partisan. 

TV.      Details  of  Organization. 

In  a  number  of  states  the  statute  makes  provision  for  the  organiza- 
tion and  meetings  of  the  hoard  of  health.  Such  provisions  are  found 
in  .Minnesota.  New  York.  Ohio,  Iowa.  South  Carolina,  New  Jersey, 
Michigan,  North  Carolina,  and  North  and  South  Dakota.  AmOng  the 
items  prescribed  are  the  dates  and  frequency  of  meetings,  advertise- 
ment of  meetings,  regulation  of  terms  of  service,  the  election  of  presid- 
ing and  recording  officers,  the  keeping  of  records,  taking  of  oaths  ami 
giving  of  bonds.     The  following  is  an  example  of  these  laws.-1 

11  The  members  of  the  board  shall  severally  take  and  subscribe  the  oatli  pre 

scribed    for  borough  officers,  and  shall  annual  1;   organize,  by  the  cboice  of  "i t 

their  members  as  president.     They  shall  eleel  a  secretary,  who  shall  keep  the 
utes  of  their  proceedings,  and   perform  such  other  duties  as  maj  '"•  directed   by  the 
board  ami  a  health  officer,  who  shall  execute  the  orders  of  the  board,  and  for  thai 
purpose,  the  said  health  officer  shall  bave  and  exercise  the  powers  and  authority 
of  a  policeman  of  the  borough.     The  secretary  and  tin-  health  officer  shall  r< 
such  salarj  a-   may  be  fixed   by  the  board,  and  shall  bold   their  office  during  the 
pleasure  of  the  board.     Thej  shall  severallj  give  bond  to  the  borough  in  such 
as  may  be  fixed   by  ordinance  for  the  faithful  discharge  of  their  duties,  and   shall 
also  take  and  subscribe  the  oath  required   bj  the  members  of  the  In. aid.     \i 

which  shall  be  collected  or  received   bj    the  board,  or  bj  anj  ofttci  i   i 

official   capacity,  shall   be   paid   over  inn.  the  borough   treasury  monthly 
with  all  penalties  which  shall  be  recovered  for  the  violation  of  anj  r< 
board.     The   president   and  secretary  shall   have  full  power  to  adn 
affirmations,  In  anj  proceedings  or  investigations  touching  the  regulal 
board,  bul  shall  nol  be  entitled  to  receive  anj  fees  tin  i 

:  Pennsylvania,  Chapter42  of  1898,  Sec.  3.    Breghtly's  Purd 


30  &  J  Nl TAR  Y   OR  QA XIZA  TION. 

The  matters  referred  to  above  are  generally  left  largely,  if  not  en- 
tirely, to  the  discretion  of  the  local  sanitary  authority.  Rules  and  by- 
laws are  usually  adopted  by  boards  of  health  to  govern  them  in  the 
conduct  of  their  affairs.  Such  by-laws  may  cover  such  subjects  as: 
1.  The  appointment  or  election  of  officers  as  president,  secretary  or 
clerk,  treasurer,  etc.  2.  The  appointment  of  employees  and  terms  of 
service  of  these.  3.  The  duties  of  all  officers  and  employees.  4. 
The  appointment  of  committees  and  their  duties.  5.  Time  and  man- 
ner of  calling  meetings.  6.  Order  of  business  and  similar  parlia- 
mentary rules.  7.  Manner  of  adopting  rules  and  orders.  8.  Office 
rules  for  business  hours,  etc.  It  often  happens  that  some  of  the  above 
matters  are  dealt  with  by  statute,  and  others  left  to  the  local  govern- 
ment, or  they  may  be  covered  by  municipal  ordinance.  Regulations 
for  the  appointment  and  duties  of  officers  are  perhaps  more  often  to  be 
found  in  statute  or  ordinance,  than  in  by-laws,  but  the  other  subjects 
are  usually  left  to  the  sanitary  department.  References  to  some  of 
these  by-laws  are  given  below.1 

V.      Terms  of  Office. 

It  is  natural  that  the  terms  of  office  of  sanitary  officials  should  vary 
very  much.  Unfortunately  the  idea  that  fitness  is  a  matter  to  be  at  all 
considered  in  appointments  to  office  is  a  somewhat  rare  notion  among 
the  every  day  citizen  as  well  as  among  those  who  are  active  in  political 
life;  and  the  idea  that  fitness  can  be  acquired  and  increased  by  service 
is  still  more  rare.  The  common  notion  is  that  one  man  is  as  good  as 
another,  and  that  in  a  democracy  everybody  ought  to  have  a  chance  at 
public  honor  and  emolument.  Hence  short  terms  of  office  are  found  in 
many  boards  of  health,  f ar  oftener,  however,  in  the  ex-officio  boards  than 
in  the  independent  boards,  and  oftener  in  former  times  than  at  present. 
A  lengthened  term  of  service  for  minor  executive  officers  is  one  line  of 
improvement  which  American  politics  are  following.  This  change 
showed  itself  as  early  in  the  sanitary  department  as  anywhere.  The 
importance  of  keeping  the  department  of  public  health  free  from  "  pol- 
itics "  lias  been  very  generally  recognized,  and  also  the  necessity  of  liav- 


1  Albany.     Rules  of  Board  of  Health,  1892,  1-21. 
Augusta,  Ga.     Rules  of  Board  of  Health,  1888,  1-23. 
Camden.     Rules  of  Board  of  Health,  1896,  1-10. 
Cornellsville,  Pa.     Rules  of  Board  of  Health,  1894. 
Erie.     Rules  and  Regulations  of  the  Board  of  Health,  1898,  pp.  3-9. 
Macon,  (ia.     By-Laws  of  Board  of  Health,  1894,  pp.  5-12. 
Newark.     Rules  of  Board  of  Health,  1896. 

Philadelphia.    Rules  of  Board  of  Health,  1895,  1-36  and  198-9. 
.Syracuse.     Rules  and  Regulations  of  the  Board  of  Health,  1898,  1-27. 


.v J NITu VET   OB GA XIZ. !  TION.  3 ] 

ing  trained  and  experienced  men  at  its  head.  A  long  term  of  office  has 
been  considered  a  means  to  these  ends.  Maine,  Massachusetts,  New 
York.  Ohio,  Minnesota,  and  Kentucky,  prescribe  three  years  for  their 
municipal  boards  of  health.  Connecticut  health  officers  are  appointed 
for  four  years  and  the  terms  of  members  of  the  municipal  board  of 
health  in  Pennsylvania  and  South  Carolina  is  five  years.  In  the  new 
charter  for  New  York  cities  of  the  second  class,  the  term  of  office  of 
the  health  officer  is  for  good  behavior.  Some  of  our  best  sanitary 
officials  have  been  in  office  for  a  long  time.  The  writer's  predecessor, 
Dr.  Snow  of  Providence,  was  in  office  from  1856  to  1**4.  l)r.  Durgin 
has  been  an  employee  of  the  Boston  hoard  of  health  since  1867,  and 
secretary  of  the  hoard  since  1873  :  Dr.  Horlbeck  has  been  health  officer 
of  Charleston  since  1*7'.'.  Mr.  Gray  has  been  connected  with  the 
Pittsburgh  health  department  for  twenty-five  years,  and  lias  been 
superintendent  of  the  bureau  since  Inns. 

Another  means  of  securing  intelligent  and  consistent  action  in  san- 
itary  affairs,  is  to  so  arrange  appointments  to  the  board  of  health,  that 
only  a  part  of  the  membership  can  he  changed  at  any  one  time.  Thus, 
if  there  are  three  members  with  terms  of  three  years,  one  may  be  ap- 
pointed each  year.  This  arrangement  is  prescribed  in  the  statute  1  s- 
tablishing  municipal  boards  of  health  in  Maine.  .Massachusetts.  New 
York,  New  Jersey,  Pennsylvania,  Ohio,  Minnesota.  South  Carolina,  and 
Kentucky,  and  in  various  .special    acts  ami  charters. 

17.      Compensation. 

A  very  large  portion  of  the  country  has  its  sanitary    affairs  presided 

over  by  ex-officio  boards  of  health,  and  as  a  rule  its  members  receive  no 
extra  compensation  for  their  services  as  health  officials.  This  is  not. 
however,  always  the  case.  In  New  Jersey,  members  of  township 
boards  of  health  are  to  receive  $2  for  each  meeting  attended.  Even 
w  heiv  there  ;nv  i nde] iciidci 1 1  boards  of  health,  it  is  probabl)  the  rule 
for  them  to  serve   for  nothing  iii  most  "f  the  smaller  communities  and 

even  in  son f  the    larger,      lint    in   the  cit)  of    New    York,  the    ; 

dent  of  the  board  of  health  receives  87,000,  and  the  others  -',.0011  p,., 
annum.     In  Boston,  the  members  receives   14,000;  in  St,  Louis,  #500 
in    New    Bedford,  $500 ;   in    Lynn,  $300 ;  in    Fitchburg,  #300;  in   At- 
lanta. $100;  and  in  Wilmington,  Del.,  #100. 

'The    work    of    the    local    sanitary  organization,  while    prima 

chiellv  executive,  also  usually  includes  legislative   fum 
may  perhaps  be  called  judicial  functions  also. 


3 2  s- ' &IT- IKY  OR G . i JSTIZ. I  TION. 

I,     Executive  Functions. 

Boards  of  health  are  intended,  first  of  all,  to  execute  the  sanitary 
laws  of  the  state  or  of  the  locality  which  they  serve.  The  obligation 
to  perforin  executive  duties  is  often  implied,  but  sometimes  expressed. 
At  times  the  duty  is  imposed  in  very  general  terms,  and  at  others  it  is 
quite  fully  specified  as  in  Connecticut1  and  the  city  of  New  York.2 
The  first  step  to  be  taken  by  boards  of  health  is  to  organize.  Presiding 
and  other  officers  arc  to  be  elected,  the  time  and  manner  of  meetings 
settled,  rules  of  business  adopted,  and  the  keeping  of  records  to  be  pro- 
vided for.  Many  of  these  matters  are  to  be  provided  for  by  statute,  but 
as  was  stated  on  page  30,  most  local  boards  of  health,  on  their  organiza- 
tion, proceed  to  adopt  by-laws  for  their  subsequent  guidance. 

The  direct  control  of  communicable  diseases  and  their  prevention  is 
the  chief  purpose  of  public  sanitation.  Hence,  the  sanitary  authority 
has  control  of  all  cases  of  communicable  diseases  which  are  reported  to 
it,  and  must  seek  out  any  that  may  be  concealed.  Isolation  of  the  sick 
person  and  attendants,  disinfection,  ambulance  and  hospital  service, 
maritime  quarantine,  vaccination,  the  distribution  or  production  of  anti- 
toxin, the  maintenance  of  laboratories,  inspection  of  lodging  houses  and 
of  tenements,  sweat  shops,  bakeries,  and  laundries,  are  all  phases  of  in- 
fectious disease  work. 

Second  only  to  this  in  the  estimation  of  the  public,  and  in  the  labor 
required,  is  the  abatement  of  nuisances.  While  in  many  cases  the  pre- 
liminary steps  are  of  a  judicial  character,  the  actual  abatement  of  the 
nuisance  is  executive  work ;  and  in  a  large  number  of  cases  the  nui- 
sance has  been  so  defined  by  law  that  only  executive  functions  are  re- 
quired on  the  part  of  the  health  department.  The  inspection  and 
analysis  of  foods,  and  the  seizure  of  unwholesome,  diseased  or  adulter- 
ated food,  and  the  apprehension  of  the  sellers,  are  matters  frequently 
under  the  control  of  the  board  of  health.  The  attempt  is  also  made  to 
regulate  many  kinds  of  business  and  the  professions  as  well,  in  the  in- 
terests of  public  health.  Licenses  are  required  for  physicians,  mid- 
wives,  undertakers,  plumbers,  pharmacists  and  the  like,  and  for  keeping 
swine,  or  other  animals,  maintaining  stables,  or  certain  kinds  of  manu- 
facturing establishments,  or  keeping  a  baby  farm.  Many,  and  in  fact 
most  of  these  licenses  are  issued  by  the  board  of  health.  Most  of  the 
above  named  executive  functions  are  either  expressly  provided  for  in 
the  fundamental  law  establishing  the  sanitary  authority,  or  they  are  so 
commonly  recognized    as   proper   and   necessary   sanitary   functions    of 


1  See  p.  9. 

-  New  York,  Chapter  378  of  1897,  Sec.  1109  and  1183. 


8ANITA 11  Y  OR  G.  J  X/Z.  i  TION. 


33 


local  government,  that  the  power  to  perform  them  is  construed  by  the 
courts  as  residing  even  in  the  most  general  grant  of  sanitary  authority. 

Other  functions,  though  perhaps  of  as  much  real  sanitary  value  to 
the  community,  are  not  usually  performed  by  the  health  department  un- 
less expressly  so  provided.  Thus,  many  cities  collect  and  dispose  of 
ashes,  night  soil,  and  garbage,  hut  all  do  not,  and  in  the  majority,  per- 
haps, this  business  is  not  in  the  hands  of  the  health  department.  Street 
cleaning,  sewer  maintenance  and  construction  are  less  frequently  eon- 
trolled  by  the  health  department.  The  maintenance  of  an  out  door 
medical  relief  is  occasionally  in  the  hands  of  health  officials,  and  very 
rarely  the  general  public  hospitals.  The  registration  of  vital  statistics 
while  intimately  connected  with  public  sanitation,  is  often  in  the  hands 
of  officials  not  connected  with  this  department.  All  these  functions 
and  any  other  novel  or  unusual  action  is  usually  provided  for  by  spe- 
cific legislative  action. 

It  is  not  intended  here  to  give  a  summary  of  legislation  on  these 
subjects,  or  even  to  give  a  complete  enumeration  of  the  executive 
functions  of  boards  of  health.  Their  proper  consideration  is  the  pur- 
pose of  this  hook  and  the  most  important  functions  will  he  treated  in 
the  different  chapters,  where  also  the  statute  laws  on  the  subject  will 
be  referred  to. 

Subordinate  Officers.  The  appointment  of  subordinate  officers  and 
the  hiring  of  employees  is  usually  in  the  hands  of  the  hoard  of  health. 
though  sometimes,  as  in  Buffalo  and  North  Dakota  cities,  the  appoint- 
ment of  the  health  officer  is  made  by  the  mayor.  The  power  to  appoint 
Officers  and  employees  may  doubtless  he  assumed  as  implied  in  the 
broader  grants  of  sanitary  authority,  but  \er\  often  statutes  specifically 

provide    for  the    appointments.      Perhaps    it »st  cases  the  officers  ami 

their  manner  of  appointment  are  specifically  mentioned.  In  other cas<  s 
the  authority  to  appoint  Subordinates  is  general.  The  Minnesota1  law 
is  shown  helow  . 

Of  all  employees  the  health  officer  is  the  most  important.  As  has 
been  shown,  almost  all  counties,  townships,  and  municipalities  are  pro- 
vided with  a  hoard  of  health  consisting  of  three  or  more  members  and 
invested  with  very  great  powers,  and  upon  whom  are  imposed  uian\ 
duties.     In  small  communities,  especially  rural  .• munities,  the  actual 

1  Minnesota,  Statutes  1 1894),  Sec.  7n7'_': 

••  Said  Boards  of  Health  may  emploj  :iii  such  persons  as  shall  be  neci 
into  effect  the  pwn  isions  of  this  aci   and   the  regulations  dulj  established   b 
Boards  as  herein  provided,  and  maj  fls  their  compensation.     The  said   Bi 
liaye  power  to  employ  physicians  and   provide  necessaries  foi 
poverty,  and  generally  to  pay  Buch  expenses  as  are  necessarily  incurred  bj  th< 
taking  precautions  which  they  may  deem  aecessarj  to  the  public  health. 


34  SANITAE  Y   OM  GA  JSTIZA  TION. 

labor  which  they  are  usually  called  upon  to  perform  is  not  very  great, 
and  oftentimes  is  divided  among  the  members  without  the  necessity  of 
other  assistance.  This  is  the  more  feasible  when  one  or  more  medical 
men  are  upon  the  board ;  but  in  nearly  all  but  the  smaller  communi- 
ties, and  sometimes  even  there  it  is  felt  that  the  interests  of  the  public- 
will  be  best  conserved  by  having  a  special  officer  who  shall  be  the 
executive  of  the  board  and  do  all  but  its  legislative  and  judicial  work, 
and  oftentimes  some  of  the  latter.  As  a  general  thing  it  is  intended 
that  the  board  of  health  shall  make  rules,  issue  orders,  and  decide  on 
matters  of  general  policy,  but  that  the  actual  executive  and  adminis- 
trative work  shall  be  performed  by  one  or  more  appointees  or  employees. 
Such  an  officer,  if  there  is  only  one,  is  commonly  called  the  health 
officer,  and  in  most  counties,  townships,  villages,  and  small  cities 
suffices  to  carry  on  the  sanitary  work,  but  in  the  larger  cities  his 
labors  have  to  be  reinforced  by  that  of  others  until  in  our  largest 
cities  the  department  of  health  has  a  great  number  of  officers,  in- 
spectors, and  other  employees.  In  the  states  named  below1  it  is 
required  by  the  statute  that  there  shall  be  county  or  township  health 
officers ;  besides  these,  many  of  the  municipal  laws  and  charters  have 
this  requirement.  Almost  always  he  is  called  a  health  officer,  but 
sometimes  he  has  other  titles  as  shown  below.2  Usually  the  health 
officer  is  not  a  member  of  the  board,  but  this  is  not  always  the  case. 
In  North  Carolina,  North  Dakota,  and  West  Virginia,  the  health  officer 
is  a  member  of  the  county  board,  and  in  Wisconsin  he  is  ex-officio  mem- 
ber of  the  board  of  health  of  cities,  townships,  and  villages.  In  Ver- 
mont he  is  a  member  of  all  local  boards.  In  many  cities,  also,  the 
health  officer  or  commissioner  is  a  member  of  the  board.  Among  these 
may  be  mentioned  Buffalo,  Jersey  City.  Kansas  City,  Knoxville, 
Memphis,  Omaha,  Paterson,  St.  Louis,  San  Antonio,  and  Scranton. 

The  health   officer  is  usually   elected  by  the  board  of  health  as  is 
provided  by  the  statute  in  many  of  the  states.     But  sometimes  the 

1  Alabama,  Colorado,  Connecticut,  Iowa,  Indiana,  Kansas,  Kentucky,  Maryland, 
Michigan,  Minnesota,  North  Carolina,  North  Dakota,  Ohio,  Rhode  Island,  South 
Dakota,  Tennessee,  Texas,  Utah,  Vermont,  Virginia,  Washington,  West  Virginia, 
Wisconsin,  and  Wyoming. 

-  In  many  Massachusetts  cities  such  an  executive  is  known  as  the  agent  of  the 
hoard  of  health.  In  the  city  of  New  York  he  is  the  sanitary  superintendent.  In 
Providence,  North  Dakota  counties  and  in  North  Carolina,  he  is  the  superintendent 
of  health,  while  Newark  makes  use  of  the  English  term,  medical  officer  of  health. 
In  Newport,  and  Wilmington,  Del.,  he  is  the  executive  officer.  In  Knoxville  his 
duties  are  performed  by  the  secretary,  who  is  a  member  of  the  board  of  health.  He 
is  sometimes,  as  in  Buffalo,  Omaha,  and  Reading,  called  the  commissioner  of 
health.  He  is  the  superintendent  of  the  bureau  of  health  in  Allegheny  and  Pitts- 
burgh, and  city  sanitarian  in  Indianapolis.  In  Jersey  City  he  is  known  as  health 
inspector.     In  Worcester  the  clerk  of  the  board  of  health  is  the  executive  officer. 


*A  XI T A  R  ] '    OR  Q .  I XI  A.  J  7  ION. 

executive  officer  is  not  elected  by  the  board  of  health  which  he  serves. 
Thus  in  Buffalo  the  health  commissioner  is  appointed  by  the  mayor. 
In  Charleston  and  Providence  he  is  elected  by  the  city  council,  although 
in  the  latter  city  the  board  of  aldermen  is  the  hoard  of  health  and  in 
the  former  there  is  an  independent  hoard  of  health.  In  Maine  cities  he 
is  elected  by  the  "municipal  officers." 

The  qualifications  of  the  executive  officer  are  sometimes  prescribed 
by  statute.  Usually  he  must  he  a  physician  or  licensed  physician. 
The  Connecticut1  law  requires  that  he  must  be  "learned  in  medical  and 
sanitary  science."  In  Indiana2  he  shall  be  "a  graduate  of  a  reputable 
medical  college  recognized  by  the  State  Board  of  .Medical  Registration  and 
Examination  who  if  not  already  informed  in  hygiene  and  sanitary  science 
shall  immediately  inform  himself  according  to  the  requirements  of  the 
State  Board  of  Health."'  In  Buffalo  the  executive  officer  must  be  thirty 
years  of  age  and  have  been  a  practising  physician  for  five  years.  In 
the  City  of  New  York  the  sanitary  superintendent  must  have  been 
practising  ten  years  and  have  been  a  resident  of  the  city  three  years. 
Sometimes,  especially  in  the  smaller  communities,  it  is  not  possible  to 
secure  the  services  of  a  physician,  and  laymen  are  sometimes  appointed 
even  to  places  of  great  responsibility.  The  very  efficient  health  officer 
of  Pittsburgh  is  not  a  physician,  and  Worcester  and  Newton.  M 
Newark-  and  Montclair,  N.  .1..  have  non-medical  men  as  the* execu- 
tives of  the  health  department,  and  in  all  these  places  they  have  done 
nniisnalh   excellenl  sanitary  work. 

The  terms  of  office  for  the  executive  sanitary  officer  vary  as  do  the 
terms  of  office  of  the  other  sanitary  officials,  and  the  members  of  the 
board  of  health.  The  tendency  is  undoubtedly  towards  longer  terms  of 
service.  In  Buffalo  it  is  five  years;  in  Baltimore,  Charleston,  Con- 
necticut, and  Indiana,  four  years ;  in  Providence,  three  years.  In  Cin- 
cinnati, Newark,  and  New  York  cities  of  the  sec  >nd  class,  the  term  oi 
office  of  the  health  officer  is  indeterminate,  but  of  course  he  is  remov- 
able for  cause. 

A  great  many  health  officers  receive  no  compensation  at  all  but 
Berve  their  fellow-citizens  simplj  from  public  spirit.  Thus  in  Minne- 
sota in  1898,  of  214  health  officers,  eighty-three  received  no  pay, 
one  of  these  was  in  a  city  of  5,000  inhabitants.3  In  Alabama  none 
of  the  county  health  officers  and  their  assistants  receive  pay.-1  In 
Wisconsin,  of  li'.'l    health  officers,   342  had    no  salary,5  onh    two 

I  onnecticut,  Chapter  l  18  ol   1898,  See.  6. 
-  [ndiana,  A.  i  ol  L9  tfebruarj  .  1899,  Si 
■  Minnesota  Reporl  ot  State  Board  ol  Elealth,  1898,  p.  W2. 
1  Alabama  !:  ipori  ot  State  Medical  S  i.  p.  02. 

Wisconsin  Reporl  ol  the  State  Board  ol  Hi  all      '  • 


36 


n  I XTTA  R  3 r  Oil  GA  JSTIZA  TION. 


paid  over  #400  and  only  ten  over  $50.  In  Connecticut  the  health 
officer  receives  compensation  at  the  rate  of  $4  per  day  of  actual  service 
and  in  Michigan  of  'at  least  #2  per  day.'  In  North  Carolina  the 
superintendent  of  health  is  to  receive  the  usual  medical  fees  or  a  salary. 
In  Indiana  the  statute  fixes  the  compensation  as  follows  :i 

tl  The  health  officer  shall  receive  as  compensation,  from  the  county,  city  or  town 
treasury  hy  the  board  electing  him,  to  be  paid  quarterly  on  the  first  Monday  in  March, 
July,  September,  and  December,  the  sum  of  li  cents  per  capita  up  to  and  including 
100,000  people,  but  his  compensation  shall  not  exceed  $1,500  per  annum  ;  the  popula- 
tion to  be  determined  from  the  school  census  of  the  year  of  the  appointment,  by 
multiplying  the  number  of  school  children  as  determined  by  the  school  census  by 
Si  ;  Provided,  That  no  incorporated  town  or  city  shall  pay  its  secretary  less  than 
$  10  per  annum." 


Below  are  shown  the  salaries  paid  the  executive  sanitary  officers  in 
a  number  of  cities.2 


1  Indiana,  Act  of  28  April,  1800,  Sec.  8. 

2 Allegheny,  Supt.  of   Bureau....  $1,200 

Asbury  Park,  N.  J.,  Chief  Insp'r.  1,000 

Ashland,  Wis.,  Health  Officer.  ...  800 

Atlanta,  Chief  Inspector 1,500 

Baltimore,  Health  Commissioner.  3,500 

Boston,  Secretary 4,500 

Bradford,  Pa.,  Health  Officer.  .  .  .  840 

Bridgeport,  Health  Officer 1,200 

Brockton,  Health  Officer 1,000 

Brookline,  Mass.,  Agent 1,000 

Buffalo,  Health  Commissioner...  4,000 

Cambridge,  Medical  Inspector...  3,000 

Charleston,  Health  Officer 1,800 

Chicago,  Health  Commissioner...  5,000 

Cleveland,  Health  Officer 2,700 

Colorado  Springs,  Health  Officer.  500 

Columbus,  O.,  Health  Officer. .  .  .  1,500 

Concord,  X.  II.,  Health  officer. . .  800 

Dayton,  Health  Officer 1,000 

Detroit,  Health  Officer 3,000 

Denver,  Health  Commissioner...  2,500 

Evansville.  Health  Officer 780 

Erie,  Health  ( >fficer 1,200 

Fall  River,  Agent sou 

Fitchburg,  Agent 1,000 

Grand  Rapids,  Health  Officer 1,500 

Hartford,  General  Inspector 1,800 

Haverhill,  Agent 1,000 

Eolyoke,  Agent 1,100 

Indianapolis,  City  Sanitarian 1,800 

Jersey  City,  Health  Inspector...  2,000 

Lawrence,  Agent 1 ,200 


Louisville,  Health  Officer $2,000 

Lowell,  Agent 1,800 

Lynn,  Chairman 500 

Milwaukee,  Health  Commissioner.  2,500 

Minneapolis,  Health  Commis'r.  .  .  2,250 

Mobile,  Health  Officer 1,200 

Montclair,  X.  J.,  Health  Officer..  1,500 

Nashville,  Health  Officer 1,500 

Newark,  Health  Officer 3,000 

Xew  Haven,  Health  Officer 1,500 

New  Orleans,  Health  Officer 5,000 

Newton,  Mass.,  Agent 2,000 

New  York  City,  Sanitary  Supt.. .  .  0,000 

Paterson,  Health  Officer 1,100 

Pittsburgh,  Supt.  of  Bureau 2,400 

Providence,  Supt.  of  Health 2,000 

Reading,  Health  Commissioner..  700 

Rochester,  Health  officer 2,600 

St.  Louis,  Health  Commissioner. .  3,000 

St.  Paul,  Health  Commissioner...  2,400 

Salt  Lake  City,  Health  Officer ....  1 ,200 

San  Antonio,  Health  Officer 1,800 

San  Francisco, .Health  Officer.  .  . .  3,0C0 

Scranton,  Health  officer S0O 

Seattle,  Health  Officer 1,420 

Somerville,  Mass.,  Agent .'.  1,200 

Spokane,  Health  Officer 1,200 

Springfield,  Mass.,  Agent 900 

Syracuse,  Health  Officer 700 

Toledo,  Health  Officer 1 ,500 

Trenton,  Health  Officer 1,500 

Wilmington,  Del.,  Health  Officer.  1,100 


6'.  1  XITAli  Y  ORGANIZA  TION.  :j; 

In  villages,  towns,  and  cities  of  small  or  moderate  size,  the  health 
officer  is  expected  to  do  nearly  all  of  the  sanitary  work  of  the  com- 
munity. He  acts  as  the  secretary  of  the  board  of  health,  attends  per- 
sonally to  communicable  diseases,  puts  up  placards,  gives  instructions, 
and  often  does  the  disinfection  himself.  He  investigates  nuisances  and 
prepares  the  orders  which  are  passed  by  the  board,  often  serves  them? 
and  sees  that  they  are  obe}'ed.  With  increase  in  tin-  size  of  tin-  city 
come  increased  duties,  the  collection  of  garbage,  the  care  of  sick  poor. 
a  communicable  disease  hospital.  the  registration  of  vital  statistics,  ami 
the  supervision  of  the  food  supply.  It  becomes  manifestly  impossible 
for  a  single  man.  even  if  he  devotes  his  whole  time  to  tin-  work,  to 
attend  to  all  the  sanitary  duties  pertaining  to  the  department.  The 
appointment  of  subordinates  becomes  necessary  and  the  health  officer 
then  does  less  of  the  detail  work  but  attends  chiefly  to  its  superin- 
tendence. In  cities  of  100,000  and  over,  if  the  department  of  health 
is  even  fairly  well  organized  and  supported,  the  duties  of  the  health 
officer  are  almost  exclusively  those  of  directing,  the  details  being  carried 
out  by  clerks  and  inspectors.  For  examples  of  rules  governing  health 
officers  of  cities  see  the  printed  ordinances  and  regulations  of  Charles- 
ton, Cincinnati.  Cleveland,  Denver,  Mobile,  and  St.  Louis. 

The  secretary  as  well  as  the  president  is  provided  for  in  ex-officio 
hoards,  but  otherwise  is  usually  elected,  though  not  always.  Thus 
Bridgeport  and  Qtica  which  have  an  independent  board,  have  the  citj 
clerk  for  clerk  of  the  hoard.  In  Jersey  City  the  clerk  of  the  hoard  of 
police  commissioners  is  clerk  of  the  hoard  of  health.  When  chosen, 
the  secretary,  unlike  the  health  officer,  is  more  often  a  member  of  the 
board.  In  small  communities  his  duties  would  be  light,  and  he  would 
serve  without  compensation  as  do  the  other  members.  In  larger  com- 
munities the  duties  are  often  performed  h\  the  health  officer,  and  often 
the  secretary  is  an  appointee  of  the  hoard  with  duties  sufficient  to 
require  ;i  salary.  In  such  cases  he  is  often  more  property  termed  a  clerk 
than  a  secretary. 

Among  important  assistants  of  the  health  officer  may  lie  mentioned 
sanitary  and  medical  inspectors,  inspectors  of  food  and  milk,  clerks  or 
registrars  of  vital  statistics,  chemists  and  bacteriologists. 

All  the  officials  that  have  been  mentioned  ma\  he  reasonablj  looked 
f«.r  in  cities  of   100,000  and   over,  and  they  are  often  found   in   much 
smaller  communities.     The  varying  development  of  different  phasi 
sanitary   work   in  different   cities   ha-  resulted   in  the  appointmeii 

officials    in  one  city    that    are  unknown  in  other   cities  of   nun  ] 

si/.'.     Moreover,  different  local  condition-  due  t"  geographical 
industries   and   character  of  population,  and    the  notions  of  tl 


38  S ANITA E  Y  OR  GA  NIZA  TION. 

in  regard  to  the  functions  of  municipal  government,  result  in  the  employ- 
ment in  isolated  instances  of  any  one  of  a  considerable  number  of 
officials  that  have  not  yet  been  mentioned. 

Thus  cities  which  are  ports  of  entry  for  foreign  commerce,  and 
where  the  state  does  not  control  quarantine,  require  a  port  physician  or 
similar  officer,  and  in  larger  ports  the  establishment  of  a  complete  system 
of  quarantine,  with  boarding  officers,  physicians,  hospital  attendants, 
disinfectors,  boatmen  and  the  like. 

Again,  some  cities  consolidate  sanitary  work  with  the  care  of  the 
sick  poor,  perhaps  putting  even  the  hospitals  and  almshouses  in  charge 
of  the  health  department,  and  thus  requiring  in  addition  to  physicians, 
the  employment  of  a  large  force  of  nurses,  stewards,  apothecaries,  maids, 
watchmen,  etc.  Brooklyn,  Colorado  Springs,  Indianapolis,  Jersey  City, 
St.  Louis,  San  Francisco,  and  Spokane  are  examples.  Other  cities 
which  do  not  have  their  general  hospitals  under  the  health  department 
may  yet  have  their  contagious  disease  hospitals  in  that  department.  In 
fact  this  is  almost  always  the  case,  and  in  large  cities  this  necessitates  a 
considerable  force  of  officers  and  employees. 

In  some  cities,  as  Atlanta,  Denver,  and  Raleigh,  the  street  cleaning, 
and  in  many  more  the  collection  and  disposal  of  garbage  and  ashes,  and 
in  some  of  night  soil,  is  carried  on  by  the  health  department. 

In  those  sections  of  the  country  where  much  bituminous  coal  is  con- 
sumed, the  smoke  nuisance  receives  attention,  and  the  duty  of  smoke 
inspection  may  belong  to  the  health  department. 

In  Augusta  and  Memphis  the  sewer  department  is  within  the  juris- 
diction of  the  board  of  health  which  has  charge  of  the  construction  as 
well  as  the  maintenance  of  the  sewers. 

The  legal  adviser  for  most  health  departments  is  the  city,  town,  or 
county  attorney.  The  amount  of  legal  work  in  some  of  the  largest 
cities,  however,  renders  it  necessary  that  one  or  more  special  attorneys 
be  employed  for  this  department.  Such  special  attorneys  are  found  in 
Cincinnati,  New  York,  Newark,  Paterson,  Hoboken,  and  other  New 
Jersey  cities,  and  in  even  as  small  a  place  as  Montclair,  N.  J.  Occasion- 
ally it  happens  that  a  board  of  health  in  smaller  places  employs  its  own 
attorney  for  each  case  as  the  necessity  arises.  Such  is  the  policy  in 
Cambridge.  The  law  department  in  most  cities  usually  has  plenty  of 
work,  and  its  time  is  largely  taken  up  with  the  defence  of  suits,  the 
preparation  of  legal  papers  and  similar  matters,  and  prosecutions 
usually  receive  only  such  attention  as  can  be  spared  from  other  work. 
As  the  health  department  is  usually  on  the  offensive  rather  than  the 
defensive,  better  results  can  be  expected  when  the  department  has  its 
own  attorney.     Thus  the  executive  force  of  the  health  department  may 


SA  XITAR  Y  OB  GANIZ.  1  TION.  39 

consist  of  a  single  health  officer  who  -performs  all  the  duties  of  his 
department.  This  is  the  rule  in  the  vast  number  of  smaller  com- 
munities throughout  the  county;  but  as  we  pass  to  larger  aggregations 
of  people  we  find  that  the  work  of  sanitary  administration  increases 
until  in  the  large  cities  it  necessitates  quite  an  army  of  officials. 

In  the  city  of  Xew  York  since  consolidation,  a  unique  division  of 
the  health  department  has  been  made,  necessitated  by  the  great  size  and 
peculiar  geography  of  the  city.  There  are  two  bureaus  in  the  depart- 
ment, one  to  be  presided  over  by  the  registrar  of  records,  and  which 
is  virtually  a  bureau  of  vital  statistics,  and  the  other  presided  over  by 
a  sanitary  superintendent,  and  which  bureau  is  to  perform  all  other 
sanitary  functions  than  those  relating  to  registration.  For  cadi  of  the 
five  boroughs  the  board  of  health  is  to  establish  borough  offices,  for 
each  of  which  is  appointed  an  assistant  sanitary  superintendent  and 
assistant  registrar  of  records.  These  local  officers  transact  the  business 
and  keep  the  records  for  their  respective  buroughs,  but  all  act  under  the 
direction  of  the  central  board  of  health  which  has  its  office  in  .Manhat- 
tan. The  sanitary  superintendent  and  his  live  assistants  arc  the  executive 
officers  of  the  board  of  health. 

Officers  and  employees  other  than  the  health  officer  are  almosl  always 
appointed  by  the  board  of  health  if  there  is  a  board  of  health.  When 
there  is  a  single  head  to  the  department  he  sometimes  has  the  entire 
appointing  power,  as  in  Buffalo,1  or  more  often  exercises  this  power  con- 
jointly. In  St.  Louis  the  appointments  of  the  health  commissioner  are 
to  be  confirmed  by  the  board  of  health,  and  in  Chicago  and  Denver  by 
the  mayor. 

Bonds.  Bonds  are  not  infrequently  required  of  the  officers  of  the 
health  department.  In  St.  bonis  the  health  commissioner  has  to  fur- 
nish bonds  in  the  sum  of  $10,000.  In  Chicago  the  amount  is  $5,000. 
Subordinate  officers  also  sometimes  have  to  give  bonds.  In  Cincinnati 
the  amount  required  of  the  registrar  of  vita]  statistics,  of  the  inspector 
of  meat,  of  the  milk  inspector,  ami  the  sanitar)  superintendent,  is 
$2,000.  [n  smaller  cities  health  officers'  ami  inspectors' bonds  in  the 
sum  of  $500  or  $1,000  are  sometimes  required. 

The  time  devoted  b\  the  health  officer  and  other  sanitary  officials  to 
the  duties  of  their  department  varies  very  much.  In  country  districts 
and  in  villages  and  small  cities,  the  health  officer  is  usually  engaged 
mosl  of  his  time  in  active  practice,  if  he  is  a   physician.     Excepl    in 

e rgencies,  he  is  able  to  satisfactorily    perform    his  duties    without 

materiall}  encroaching  on  the  time  devoted   to  his  privati  In 


New  V/ork,  Chapter  L05  oi  L891,  Sees. 


40  61  iNITA  K  Y  OK  GANIZA  TION. 

larger  towns  and  cities  public  sanitary  duties  are  more  exacting  and 
require  more  time,  perhaps  the  whole  time  of  one  man.  In  such  cases 
a  single  health  officer  may  be  employed  to  give  his  whole  time  to  pub- 
lic duties,  in  other  cases  he  will  exercise  only  a  general  supervision, 
giving  special  matters  his  personal  attention,  and  a  subordinate  at  a 
smaller  compensation,  may  be  employed  to  do  routine  work.  Occasion- 
ally, as  in  Woonsocket,  R.  L,  several  health  officers  are  engaged,  who 
shall  have  separate  districts,  and  thus  are  required  to  give  only  a  por- 
tion of  their  time  each  to  the  public  service.  In  large  cities  the  head 
of  the  department  is  sometimes  required  to  give  all  his  time  to  the  city, 
and  is  supposed  to  be  paid  a  corresponding  salary.  In  other  cases  it  is 
assumed  that  he  can,  by  the  expenditure  of  a  moderate  portion  of  time 
each  day,  successfully  direct  the  department :  but  in  such  a  case  it  is 
supposed  that  his  assistants  are  very  competent  persons. 

The  working  hours  for  the  other  officials  of  the  health  department 
vary  in  different  cities.  The  hours  for  beginning  work  are  from  7 
a.  .m.  to  9  A.  M.,  and  for  closing,  3  p.  M.  to  5  p.  m.,  with  Saturday 
afternoons,  Sundays,  and  holidays  free.  In  cities  of  over  100,000  the 
office  for  recording  deaths  is  usually  open  a  part  of.  Sunday  and  holi- 
days, and  an  officer  is  also  ready  to  receive  communicable  disease  calls 
at  any  hour. 

In  the  honest  endeavor  to  discharge  their  duties,  sanitary  officials 
must  often  incur  the  bitter  enmity  of  those  with  whom  they  have  to 
deal,  and  may  lie  subject  to  personal  suits  for  fancied  injuries.  The 
writer  was  subjected  to  three  such  suits  within  a  short  time  while  at- 
tempting to  check  the  spread  of  a  diphtheria  outbreak.  To  prevent 
such  personal  liability  the  section  given  below  Avas  enacted  in  the 
charter  of  the  city  of  New  York.1 

In  one  instance  at  least,  in  Charleston,  the  health  officer  is  liable  to 
a  fine  for  failure  to  perform  his  duties.  He  is  to  pay  $10  for  each 
failure  to  attend  to  a  complaint  of  a  nuisance,  and  the  amount  of  the 
fine  is  to  be  taken  out  of  his  salary.2 


1  New  York,  Chapter  378  of  1897  : 

"Sec.  1196.  No  member,  officer,  or  agents  of  said  department  of  health,  and  no 
person  or  persons  other  than  the  department  of  health  or  the  city  itself,  shall  be 
sued  or  held  to  liability,  for  any  act  done  or  omitted  by  either  person  aforesaid,  in 
good  faith,  and  with  ordinary  discretion,  on  behalf  of  or  under  said  department,  or 
pursuant  to  its  regulations,  ordinances  or  health  laws.  And  any  person  whose  prop- 
erty may  have  been  unjustly  or  illegally  destroyed  or  injured,  pursuant  to  any 
order,  regulation  or  ordinance,  or  action  of  said  department  of  health  or  its  officers, 
for  which  no  personal  liability  may  exist,  as  aforesaid,  may  maintain  a  proper  action 
against  the  city  for  the  recovery  of  the  proper  compensation  or  damage.  Every  such 
suit  must  be  brought  within  six  months  after  the  cause  of  action  arose,  and  the  re- 
covery shall  be  limited  to  the  damages  suffered.11 

2  Charleston,  Ordinances  of  1897,  Sec.  271. 


a.  1  NIT.  LRY   OR  GANIZA  TION.  4 1 

Civil  Service  Regulations.  The  principles  of  civil  service  reform  have 
been  crystallized  in  the  laws  of  several  states  and  cities.  These  laws 
are  made  to  apply  to  the  department  of  health  as  to  all  other  depart- 
ments, and  appointments  whether  made  by  commissioner,  health  officer, 
or  hoard  of  health,  must  be  in  accordance  with  these  rnles. 

Modern  civil  service  rnles  involve  a  certain  permanency  of  tenure  of 
office.  Permanency  in  office  should  imply  a  moderate  compensation, 
and  it  does  imply  ultimate  disability  fur  the  performance  of  duty. 
Hence  the  development  of  a  pension  idea  as  the  tenure  of  office  of  em- 
ployees becomes  more  secure.  A  pension  fund  is  provided  for  by  Sees. 
1331  to  1337  of  the  charter  of  the  city  of  New  York.  The  fund  con- 
sists of  the  moneys  received  for  searches  and  transcripts  of  births,  mar- 
riages, and  deaths,  and  from  lines.  The  board  of  health  is  the  trustee 
of  this  fund  and  reports  annually  to  the  mayor.  A  pension  consisting 
of  half  pay,  is  given  to  any  physician  or  other  person  employed  aboul 
communicable  disease,  who  shall  become  permanently  disabled  "while 
in  (In-  actual  performance  of  his  duty  and  without  fault  or  misconduct 
on  his  part."  In  case  of  death.  $300  per  annum  is  to  be  paid  to  his 
family.  Employees,  after  twenty  years'  service,  may  be  retired  on  half 
pay. 

('ivil  service  reform  requires  a  certain  degree  of  litmus  in  candi- 
dates for  official  positions,  and  this  fitness  is  to  be  determined  by  exam- 
ination. Unfortunately  most  appointees  to  official  sanitary  positions 
in  the  United  States,  an-  entirely  untrained  for  the  duties  they  are  to 
perform.  To  exhibit  some  degree  of  natural  ability  is  all  that  is  asked, 
and  often  this  is  nol  required,  the  sole  qualification  of  the  appointee 
being  bis  political  service  to  the  party  which  has  the  appointing  power. 
In  England,  considerable  attention  is  paid  to  the  education  of  sanitary 
officials,  ''in  it  is  only  just  beginning  t<>  he  thought  of  in  this  country. 
With  the  growth  of  the  reform  principle,  there  is  sure  to  come  in  the 
United  States  ;i  demand  lor  trained  officials.  Even  now  some  far- 
sighted  persons  are  preparing  for  this  demand.  Rutgers  College  and 
the  Ohio  State  University  offer  courses  of  instruction  lor  health  officers 
ami  sanitary  inspectors,  and  give  certificates  to  candidates  on  bu< 
fully  piissiiiL;  examination.  Lafayette  College  has  ;>  coin-.-  in  hygiene, 
and  the  Universitj  of  Pennsylvania  has  for  some  years  offered  a  most 
excellent  course.  Unfortunatel}  these  courses  are  not  taken  l»\  men 
who  intend  in  till  sanitary  positions,  and  they  will  not  be  so  long 
is  known  that  the  successful  candidate  needs  no  other  recoinnu  ml 
than  thai  of  "  influential  "  friends. 

Among  other  rules  con nly  found  in  sanitary  end.-.  1-  one  which 

forbids  the  offering  of  an}  obstruction  to  the  health  officer  or  oth<  1 


42  SANITARY  ORGANIZATION. 

ployees  of  the  sanitary  department.  As  we  shall  see,  the  proper  offi- 
cers are  frequently,  by  statute,  given  authority  to  enter  upon  private 
property  in  the  performance  of  their  sanitary  duties,  and  all  persons  are 
warned  not  to  obstruct  them.  Often  this  provision  is  extended  so  as 
to  forbid  interference  with  any  of  the  authorized  functions  of  this  de- 
partment of  municipal  administration.1 

One  of  the  duties  of  the  local  sanitary  authority  is  to  make  reports 
to  the  local  government  and  to  the  state  government.  The  local  ordi- 
nances usually  provide  that  the  board  of  health,  like  all  other  depart- 
ments, shall  report  annually  to  the  trustees,  council,  mayor,  or  some 
other  body  or  officer.  Reports  to  the  state  board  of  health  are  also 
usually  required.  Sometimes  this  requirement  is  found  in  the  act  es- 
tablishing the  local  board,  but  more  often  in  the  act  establishing  the 
state  board.  Most  of  the  laws  require  annual  reports  and  some  require 
them  more  frequently,  and  others  prescribe  that  special  reports  shall  be 
made  when  demanded  by  the  state  authorities.  For  the  annual  reports 
to  the  state  board,  printed  schedules  are  often  furnished.  The  one 
used  in  Pennsylvania  is  given  in  Appendix  1.  This  subject  will  be 
further  considered  in  the  chapter  on  registration,  and  in  the  last 
chapter. 

II.     Legislative  Functions. 

Most  local  sanitary  authorities  are  given  legislative  powers.  Some- 
times such  legislative  power  is  very  broad  and  extensive,  and  sometimes 
it  is  very  limited.  Sometimes  it  is  conferred  upon  the  state  board  of 
health  rather  than  upon  local  boards,  and  sometimes  both  the  state  and 
local  boards  hold  it,  each  to  exercise  it  under  certain  conditions.  Some 
of  the  states  in  which  the  state  board  has  legislative  power  are  men- 
tioned below.2  The  power  thus  given  is  often  limited,  frequently  to. 
the  management  of  contagious  disease.  In  other  cases,  as  in  Florida, 
Louisiana,  Mississippi,  New  Hampshire,  North  Dakota,  and  South 
Dakota,  it  is  very  general.     In  Virginia  it  can  be  exercised   only  in 


1  Denver,  Ordinances,  44  of  1893,  Sec.  12 : 

11  Sec.  12.  It  shall  be  unlawful  for  any  person  or  persons  to  molest,  hinder,  inter- 
fere with  or  in  any  manner  prevent  the  said  health  commissioner,  or  any  individual 
engaged  in  the  bureau  of  health  of  the  city,  from  performing  any  duty  imposed 
upon  him  or  made  by  any  law  of  the  city  or  state  or  any  rule  of  the  said  commis- 
sioner ;  nor  shall  anyone  interfere  with  him  in  any  acts  done  to  prevent  the  spread 
of  contagious  diseases,  or  with  any  employee  of  the  bureau  of  health  in  carrying  out 
any  direction  of  the  health  commissioner  in  enforcing  any  of  the  laws  and  ordi- 
nances of  the  city  in  reference  to  health." 

2  Florida,  Illinois,  Indiana,  Iowa,  Kentucky,  Louisiana,  Maryland,  Minnesota, 
Mississippi,  Missouri,  New  Hampshire,  New  York,  North  Carolina,  North  Dakota, 
Ohio,  Pennsylvania,  South  Dakota,  Tennessee,  Vermont,  Virginia,  Wisconsin. 


& 1  NIT,  iJRY   Oil  GA  XIZA  TIOX.  4  3 

epidemics  :  in  Pennsylvania  only  where  there  is  no  local  board  :  in  North 
and  South  Dakota  the  local  board  can  make  rules  only  under  the  super- 
vision of  the  state  board,  and  in  North  Carolina  the  state  board  can 
make  rules  only  during  epidemics  or  where  there  is  no  local  board.  In 
New  York  and  Virginia  the  state  board  of  health  may  modify  or  amend 
a  local  regulation  if  in  its  opinion  it  affects  other  communities. 

A  recent  decision  of  the  supreme  court  of  Wisconsin  has,  however, 
affirmed  that  the  state  board  of  health  being  appointive  and  not  a 
representative  body,  cannot  be  clothed  with  legislative  power.* 

Most  states,  in  the  laws  establishing  local  sanitary  authority",  provide 
for  the  exercise  by  that  authority  of  legislative  powers,  and  the  same 
provision  is  found  in  most  special  charters.  Whenever  an  independent 
board  of  health  is  established,  power  to  legislate  is  generally  conferred 
upon  it :  but  this  is  not  always  the  case.  In  some  localities,  even  where 
the  principle  of  local  independence  in  sanitary  affairs  is  admitted,  legis- 
lative power  in  such  affairs  is  given  to  a  branch  of  the  city  government 
other  than  the  board  of  health  or  health  officer  on  whom  is  conferred 
the  executive  powers.  Tints  at  Bridgeport,  although  there  is  an  estal>- 
lished  board  of  health,  the  city  council  alone  is  competent  to  legislate 
on  sanitary  affairs.  In  Richmond  it  is  the  city  council,  in  Memphis  the 
Legislative  council,  and  in  San  Francisco  the  board  of  supervisors,  and 
in  Baltimore  it  is  the  mayor  and  city  council  that  are  invested  with  legis- 
lative powers,  although  in  each  of  these  cities  there  is  a  separate  board 
of  health.  Besides  these  and  other  cities  provided  tor  by  special 
charter,  there  are  a  number  of  states  in  which  legislative  power  in 
regard  to  sanitary  matters  is  conferred  on  the  proper  legislative  depart- 
ment of  the  cities.  This  is  true  in  Illinois,  Indiana.  Kansas.  Kentucky, 
Missouri,  Nebraska.  North  Carolina,  and  Texas,  though  there  arc  special 
charters  in  some  of  these  states  making  other  provisions.  Where  there 
is  no  local  board  of  health,  and  only  a  single  health  commissioner 
or  health  officer,  such  officer  is  not  usually  given  legislative  powei 
if  bo,  only  to  a  limited  extent.  Tims  in  the  District  of  Columbia  the 
health    officer   can  only  make    rules    in  regard    to  the    protection    of    the 

milk  supply.  The  commissioners  of  the  District  of  Columbia  have 
some  legislative  authority  in  regard  to  plumbing,  garbage,  communica- 
ble disease  and  sanitary  affairs  generally,  bul  Congress  has  not  given 
them  a  \en  free  rein. 

In  Chicago  the  commissioner  of  health  has  no  legislal  ive  power,  nor 
have  the  superintendents  of  the  bureaus  in  Pittsburg  and  Allegheny,  or 

1  Wisconsin  Supreme  Court,  23   February,  L897,  State  ex  rel.     Ida 
etal.,  School   Board.    See  also  tllinoia  Suprem<  Court,  10   May,   1807,   Potts 
rs.  Breen  ei  <<i..  and  Illinois  Supreme  Court,    it    February,    I 
Labangh  vs.  Board  of  Education  "t  District  No.  2. 


44  SANITARY  ORGANIZATION. 

the  health  officer  in  Cleveland.  In  other  cities  the  health  officer  acts 
in  conjunction  with  the  proper  legislative  branch  of  the  city  govern- 
ment. In  Buffalo,'  where  there  is  nominally  a  board  of  health,  but 
practically  a  single  head,  the  health  commissioner  is  to  make  rules  for 
carrying  out  ordinances  and 

"  To  propose  such  ordinances  as  he  shall  deem  to  he  required  for  the  protection 
of  the  public  health  and  for  securing  the  proper  registration  of  births,  marriages 
and  deaths,  and  such  other  statistical  material  as  may  he  necessary  for  the  efficient 
-working  of  the  department  with  penalties  for  their  violation,  which  ordinances, 
when  approved  by  the  board,  shall  be  by  him  submitted  to  the  council,  and  when 
approved  by  said  council,  shall  have  the  same  force  and  effect  as  other  ordinances 
of  the  city.  Xo  ordinance  so  prepared  and  approved  by  said  common  council  shall 
be  repealed  and  annulled  without  the  approval  of  the  health  commissioner  and  board 
of  health,  and  the  common  council  shall  adopt  no  ordinance  relating  to  governing 
the  matters  and  things  contained  in  this  title,  unless  the  same  shall  be  recommended 
by  the  health  commissioner  and  board  of  health.11 

In  Wisconsin2 

"The  commissioner  of  public  health  shall  have  all  the  power  or  authority  here- 
tofore given,  or  which  may  hereafter  be  given,  to  boards  of  health  by  any  general 
law  of  the  state,  and  it  shall  be  his  duty  to  provide  such  additional  rules  and  regu- 
lations as  shall  be  requisite  and  necessary  for  the  preservation  of  the  health  of  the 
people  of  the  city  to  prevent  the  spread  of  contagious  diseases,  and  to  cause  the 
removal  of  all  objects  detrimental  to  the  health  of  the  people  of  the  city,  and  to 
enforce  such  rules  and  regulations  as  are  hereinafter  provided,  etc.1' 

In  Connecticut3  also  the  health  officer  has  legislative  power  granted 
by  the  following : 

"It  shall  be  sufficient  notice  to  all  persons  of  any  regulation  of  the  health  officer 
of  any  town,  if  it  be  published  in  a  newspaper  published  in  the  town,  if  there  be 
one,  and  posted  for  three  days  on  each  sign  post  in  said  town  ;  and  if  any  person 
shall  willfully  violate  such  rules  after  they  have  been  so  published  and  posted,  or 
after  actual  notice  thereof  shall  have  been  given  to  him,  he  shall  be  fined  not  more 
than  one  hundred  dollars." 

It  is  thus  seen  that  often,  perhaps  usually,  the  legislative  power 
granted  to  a  single  health  officer  is  subject  to  limitations  by  other 
branches  of  the  local  government.  Even  in  the  case  of  regularly 
established  boards  of  health  of  several  members,  its  legislative  acts  often 
have  to  be  subjected  to  revision  and  approval  before  they  may  have  the 
force  of  laws.     Thus  in  Maine4  the  board  of  health  has  power 

"  To  make,  alter  or  amend  such  orders  and  by-laws  as  they  shall  think  necessary 
and  proper  for  the  preservation  of  life  and  health  and  the  successful  operation  of 
the  health  laws  of  the  state,  subject  to  the  approval  of  any  justice  of  the  supreme 
judicial  court." 


1  New  York,  Chapter  105  of  1891,  Sec.  233. 
-Wisconsin,  .Statutes  (1898),  Sec.  925  (-108). 

3  Connecticut,  Chapter  164  of  1895. 

4  Maine,  Supplement  Laws  (1895),  Chapter  14  (2),  Sec.  7. 


&  I XITAE  } "   OH  <3L  I XIZ.  I  TION.  4  5 

In  New  Hampshire  the  rules  of  the  local  health  organization  must 
be  approved  by  the  selectmen.  A  similar  provision  is  made  in  the  laws 
of  Pennsylvania  and  South  Carolina. 

In  North  Dakota1  the  hoard  of  health  is  empowered 

"  To  make  and  enforce  any  and  all  needful  rules  and  regulations  for  the  preven- 
tion and  cure,  and  to  prevent  the  spread  of  any  contagious,  infectious  or  malarial 
diseases  among  persons  and  domestic  animals,"*  "...  subject  to  the  super- 
visory control  of  the  state  board  of  health  and  the  superintendent  of  public 
health." 

Usually  the  legislative  power  granted  to  local  sanitary  organizations 
is  very  great,  though  occasionally  it  is  limited,  especially  in  single- 
headed  departments.  Instances  of  this  have  just  been  given,  but  true 
boards  of  health  also  sometimes  have  circumscribed  powers.  Thus  in 
West  Virginia,  the  county  board  of  health  is  empowered  to  legislate 
only  in  regard  to  contagious  diseases.  In  Louisiana2,  the  local  board  of 
health  can  pass  ordinances 

••For  the  exclusion  and  repression  of  contagious  and  infectious  diseases;  for 
defining  and  abating  nuisances  dangerous  to  the  public  health:  for  regulating  drain- 
age and  ventilation  with  reference  to  human  habitations  and  places  of  business  and 
public  resort;  for  the  collection  and  recording  of  vital  statistics." 

Sometimes   the  phraseology   of    the   statutes  conferring    legislative 

power   is    very  broad  and  general,  and  sometimes  it  is  most  specific  and 

limited.     Sometimes  the  power  is  conferred  by  almost  a  single  line,  and 

sometimes  several  pages  are   required   for  the   specific  enumeration   of 

powers  conferred.     The  tendency   is  rather  towards  the  briefer  form, 

and  some  id'  the  most  important  cities  are  governed  by  such.     The  suc- 

of  such  cities   as   Brooklyn   and    Baltimore   in   maintaining  in   the 

Courts    their    authority    to    Legislate  <>n  sanitan   affairs  shows  that   greal 

powers  can  he  conferred  by  a  very  concise  act.     As  examples   of  state 

laws  of  ;j  similar  character  the  following  ma\  he  cited  : 3 

"  The  board  of  health  of  a  town  shall  make  such  regulations  as  it  judges  m 
sarv  for  the  public  health   ami  safety    respecting  nuisances,  sources  of  tilth  and 
causes  of  sickness." 

i'his  Massachusetts  law    was  enacted   in    IT'.'T  and   has  thus  for  a  full 

century   been    maintained   against    all   attacks  as  a  c petent  authority 

for  sanitary  legislation  mi  the  part  of  the  towns  and  cities  of  the  com- 
monwealth, and  it  has  been  copied  almosl  verbatim  in  the  laws  of  man\ 
other  state.     Broad   provisions  therefor  are  amphj  sutncienl  to  give  to 

the  local  sanitary  authority  all   the  power  neccss;n\    for    the    exi 

its  proper  functions.     It  would  seem  then  that  when  the  various  powers 


1  North  Dakota,  Rei  ised  Code  (18fl  it. 

-  Louisiana.  Chapter  192  of  L898,  Sec.  7. 
Massachusetts,  Public  Statutes,  Chapti 


46  SANITARY  ORGANIZATION. 

conferred  are  specified  by  the  statute,  the  law  makers  had  in  mind  to 
limit  the  powers  of  the  local  board!;  but  an  examination  of  the  various 
laws  shows  that  this  is  not  so.  It  is  only  rarely  that  any  indication  is 
seen  of  chariness  in  conferring  power  when  local  boards  of  health  are 
established.  It  is  generally  felt,  and  correctly  so,  that  a  local  board  of 
health  to  be  anything  else  than  a  farce  must  have  very  great  powers. 
Unless  such  are  granted  it  was  worse  than  foolish  to  establish  the 
board.  Law  makers  would  appear  then,  in  specifying  the  powers  of  the 
local  sanitary  authority,  to  be  desirous  of  making  sure  that  all  neces- 
sary powers  are  granted,  rather  than  of  attempting  to  limit  them. 
Hence  it  happens  that  when  specific  powers  are  enumerated,  they 
usually  include  all  that  an  efficient  board  of  health  need  to  exercise. 
As  examples  of  a  somewhat  extended  enumeration  of  powers  may  be 
cited  Chapter  68  of  the  laws  of  New  Jerse}',  1887,  Sec.  12  (General 
Statutes  (1895),  p.  1644),  and  Sec  4134  of  the  Revised  Statutes  of 
Indiana,  1897,  giving  the  powers  of  cities  of  the  first  class. 

The  rules  and  regulations  of  boards  of  health  cannot  conflict  with 
state  constitutions  or  be  in  any  wa}~  contrary  to  the  statute  law  of  the 
state.  This  is  true  whether  or  not  such  conflict  be  specifically  forbid- 
den. Though  not  usually  the  case,  this  conflict  is  sometimes  forbidden, 
as  in  Rhode  Island.1  In  Iowa  the  regulations  of  the  local  board  of 
health  must  not  be  in  conflict  with  the  regulations  made  by  the  state 
board  of  health,2  and  in  California  they  must  be  "necessary  and  proper 
and  not  contrary  to  law."3 

Minnesota  requires  that  notice  of  rules  shall  be  given  when  no 
newspaper  is  published  in  the  town,  "  by  posting  up  such  notice  in  five 
(•"))  public  places  therein."  A  similar  provision  is  found  in  the  Wis- 
consin law,  and  in  New  Jersey.  In  Hartford  and  New  Haven  it  is 
specified  that  the  rules  must  be  published  in  a  newspaper  four  times ; 
in  New  Jersey  for  two  weeks  once  in  each  week.  In  New  Jersey4  also 
it  is  required  that  every  sanitary 

"  Ordinance  shall  have  three  readings  before  its  final  passage,  and  at  least  one 
week  shall  intervene  between  the  second  and  third  readings  of  said  ordinance,  and 
a  notice  stating  the  title  of  said  ordinance  and  the  date  when  it  passed  its  second 
reading  shall  be  published  at  least  one  week  prior  to  its  final  passage  in  at  least  one 
newspaper  published  in  the  township,  city,  town,  borough  or  other  local  municipal 
government,  if  any  newspaper  is  published  therein,  and  if  there  be  no  newspaper 
published  therein,  then  in  some  newspaper  of  the  county  circulating  in  such  town- 
ship, city,  town,  borough  or  other  local  municipal  government." 

1  Rhode  Island,  General  Laws  (1896),  Chapter  40,  Sec.  29. 

2  Iowa,  Code  (1897),  Chapter  16,  Title  12,  Sec.  5. 

3  California,  Political  Code  (1SSG),  Sec.  3061. 

4 New  Jersey,  General  Statutes  (1895),  p.  1644,  Sec.  4'.t. 


SAX  IT.  illY  OR  GAJSTIZ.  J  TION.  \  7 

In  Connecticut  if  there  is  no  newspaper  in  the  town  the  rules  nrav 
be  posted  on  sign  posts  and  entered  in  the  town  records. 

The  board  or  officer  legislating  must,  of  course,  have  the  authority  to 
impose  penalties,  otherwise  the  rules  and  regulations  would  be  useless. 
Sometimes,  as  in  Rhode  Island,  the  penalty  is  fixed  by  the  statute  author. 
izing  the  legislation.  In  many  cases  it  is  fixed  by  other  general  statutes 
regulating  the  legislative  functions  of  local  government.  When  local 
boards  fix  the  penalties  the  maximum  and  sometimes  the  minimum  is 
fixed  by  the  statute.  The  smallest  maximum  that  the  writer  has  noticed 
is  $10  in  New  Hampshire.  Usually  the  maximum  penalty  allowed  for 
violations  of  local  sanitary  regulations  i-  $100,  hut  sometimes  it  i-  •^■".,' 
and  more  rarely  $25;  in  Albany,  until  1900  it  was  $1,000.  Jn  some 
cities  the  lines  go  into  the  general  treasury,  hut  in  others  they  go  to  the 
health  department.  The  alternative  of  imprisonment  for  periods  up  to 
one  year  is  often  allowed. 

Ill     Judicial  Functions. 

The  power  and  duty  of  sanitary  officials  to  investigate  and  abate 
nuisances  is  an  important  part  of  their  functions  and  implies  the  exer- 
cise of  quasi  judicial  powers.  If  a  nuisance  is  to  lie  abated  through  the 
action  of  a  board  of  health,  it  must  first  of  all  he  determined  to  1.,'  ;i 
nuisance,  and  this  question  of  fact  must  he  decided  by  the  hoard. 
Sometimes  the  question  is  very  easily  settled,  hut  often  it  is  not,  and 
occasionally  a  set  1  lenient  can  only  he  arrived  at  after  a  Long  and  patient 
investigation.  In  most  of  the  statutes  establishing  hoards  of  health 
this  power  is  only  granted  by  implication  in  the  general  granl  of  powers 
or  in  the  special  provisions  for  the  abatement  of  nuisances.  Sometimes, 
however,  il  is  specifically  recognized  and  its  exercise  provided  for.  The 
laws  0!'  Connecticut l  and  New  Vork 2  furnish  examples  of  this.  The 
New   Fork  law  provides  in  regard  to  the  hoard  of  health  that 

'•  It  may  issue  subpoenas,  compel  the  attendance  of  witnesses,  administer  oaths 
to  witnesses  ami  compel  them  to  testify,  and  for  such  purposes  it  shall  have  the 
same  powers  as  a  justice  of  the  peace  of  the  state  in  a  civil  action  of  which  he  has 
jurisdiction.  It  may  designate  bj  resolution  one  of  iis  members  to  sign  anil  issue 
such  subpoenas.     No  subpoenas  shall  be  served  outside  the  jurisdii  tion  -■(  tin 

Issuing  it.  and  no  witness  shall  be  interrogated  or  compelled  t"  testify  ii] ii 

in- 1  related  to  the  public  health." 

The  powers  conferred  upon  aboard  of  health  h\  statute  01  ordi- 
nance  cannot     usually    be   delegated    h\     it.       Thc\    cannot    unless    the 


1  Connecticut,  Chapter  248  of  1898,  S<  - ,  3. 

'  \.u  fork,  General  Laws  (1896),  p.  2422,  Sec.  1. 


48  SANITARY  ORGANIZATION. 

authority  to  do  so  is  expressly  granted.  Sometimes,  as  in  Rhode  Island 
and  Massachusetts,  certain  executive  powers  belonging  to  the  board  of 
health  are  exercised  by  the  health  officer,  a  subordinate  official ;  but 
this  is  provided  for  in  the  statute.  The  powers  are  not  delegated  by 
the  board.  Occasionally  the  law  provides  that  the  powers  of  the  board 
of  health  may  be  delegated.  Such  authority  is  given  in  New  Jersey,1 
and  in  Detroit2,  and  in  the  City  of  New  York3. 

In  pursuance  of  the  power  to  legislate  which  has  been  granted  them, 
most  boards  of  health  adopt  more  or  less  extensive  rules  for  the  better- 
ment of  the  communities  under  their  jurisdiction,  and  sanitary  codes, 
ordinances,  or  rules  and  regulations,  are  found  in  almost  every  com- 
munity. In  the  great  cities  these  are  often  very  extensive  and  cover  a 
wide  range  of  subjects.  Almost  all  legislation,  statutory  as  well  as 
municipal,  shows  more  or  less  legal  and  technical  ignorance  on  the  part 
of  the  framers.  It  might  be  expected  that  boards  of  health  would  ex- 
hibit such  failings  in  a  marked  degree,  and  it  is  to  be  feared  that  they 
often  do.  Sanitary  ordinances,  like  all  laws,  should  first  of  all  be  reason- 
able. They  should  also  be  strong,  so  that  the  result  aimed  at  may  really 
be  accomplished.  It  is  for  the  board  of  health  under  the  constitution 
and  the  statutes  to  determine  what  -the  regulations  should  be.  In  draw- 
ing up  the  rules  it  is  very  necessary  to  have  them  express  exactly  what 
is  intended.  There  must  be  no  ambiguity.  The  thing  forbidden  must 
be  clearly  denned  and  it  must  also  be  clear  upon  whom  the  penalty  must 
fall.  These  regulations  should  be  made  so  that  Warrants  can  be  readily 
drawn  and  so  that  proof  of  violation  shall  be  made  as  easy  as  possible 
for  the  prosecution.  To  improve  the  quality  of  local  legislation,  a  num- 
ber of  state  boards  of  health  have  prepared  model  rules  for  the  guidance 
of  the  local  boards  within  their  jurisdictions.  Such  laws  are  usually 
prepared  after  a  study  of  those  which  have  been  in  successful  operation, 
and  as  they  are  revised  with  care  by  the  state  board  of  health,  are  very 
suitable,  with  perhaps  a  few  local  modifications,  for  adoption  by  the 
majority  of  local  health  authorities  in  the  state,  and  such  rules  are  very 
often  so  adopted.  Among  the  states  which  have  prepared  model  ordi- 
nances may  be  mentioned;  Connecticut,  Illinois,  Indiana,  Iowa,  Kansas, 
Maine,  Michigan,  New  Jersey,  North  Carolina,  New  York,  New  Hainp- 


JNew  Jersey,  (ieneral  Statutes.  (1895),  p.  1642,  See.  40. 

-  Michigan,  Chapter  10  of   1895,  Sec.  26. 

3  New  York,  Chapter  378  of  1897 : 

"  Sec.  1182.  The  board  of  health  may  from  time  to  time  delegate  any  portion  of 
its  powers  to  the  sanitary  superintendent  or  an  assistant  sanitary  superintendent,  to 
be  exercised  by  such  delegate  from  the  time  and  in  manner,  and  to  the  extent  speci- 
fied in  such  delegation  in  writing.11 


x.  1  Nil \ IRT  0 11 G A XI Z.  1  TION.  4 j | 

shire,  and  Pennsylvania.  Those  of  Maine  are  very  brief  indeed.  ( )n 
the  other  hand  those  of  Iowa  are  very  numerous  and  include  matters 
covered  by  the  statutes  and  by  the  regulations  of  the  state  board  of 
health.  The  Pennsylvania  rules  also  are  very  elaborate  and  would  suf- 
fice for  a  great  city.  They  deal  very  largely  with  the  duties  of  the 
board  of  health  and  its  employees.  Among  the  best  of  these  model 
codes  is  that  of  New  York  shown  in  Appendix  2. 

Statutes  Providing  for  the    Establishment   of   Sanitary  Authority, 
sulted  in"  the  preparation  of  this  chapter. 

Alabama.     Code  (1896),  Sees.  2423-2437. 

Arkansas.     Cities  of  the  first  and  second  classes.     Statutes  (1894),  Sec.  5203. 

California.     Counties,  Political  Code  (1886),  Sec.  3059. 

Municipalities,  Political  Code  (1886),  Sec.  3061-::. 
Colorado.     Act  of  IT  April,  1893. 
Connecticut.     Chapter  248  of  1893. 

Chapter  144  of  1S95. 
Delaware.     Counties.  Revised  Code  (1893),  Chapter  46. 

Municipalities,  Laws  of  Delaware,  Vol.  16,  Chapter  345. 
Florida.     Revised  Statutes  (1892),  Sees.  ~~-  785. 

Chapter  27  of  1897. 
Idaho.     Revised  Statutes  (1887),  Sees.  1150  et  seq. 

Illinois.     Municipalities.   Annotated  Statutes  (1896),  Chapter  24,  Sec.  63,  seventy- 
jin  to  eighty-four. 

Townships.     Annotated  Statutes  (1896),  Chapter  139,  Sec.  L28  130. 
Indiana.     Counties  and  Municipalities,  Act  of  28  April,  1899. 

Cities  of  the  flrsl  class,  Revised  Statutes  1 1897),  Sees.  1134,  1225. 

Cities  of  the  second  class,  Revised  Statutes  (1897),  Sees  3984,  1072. 

Cities  of  the  third  class,  Revised  statutes  |  1897),  Sees.  3959  60. 
Iowa,     (ode  |  1897),  Sec.  2568  -/  ■-"/. 
Kansas.     Counties,  '  reneral  Statutes  (1897),  Chapter  75,  Sec.  11. 

Cities  of  the  tit-si  class.  Statutes  (1897),  Chapter 32,  Sec.  8. 

Cities  of  the  second  class.  Statutes  (1897),  Chapter  35,  Sec.  95. 

Cities  of  the  third  class,  Statutes  (1897),  Chapter  38,  Sec.  52. 
K'i.n  it  (  kv.     Counties,  Statutes  (1894),  Arts.  2047,  2055. 

Municipalities,  statutes  (1894),   Sorts.  2059. 

Cities  of  the  first  class,  Statutes  (1894),  Art  -'71l'. 

Cities  of  thr  second  class.  Statutes  1 1894),  Art  3058. 

Cities. u  the  third  .lass.  Statutes  (1894),  An.  3290. 

3  Of   the  fourth  class.  Statutes  ,  1894),   Art.  3490. 

Louisiana.     Constitution  (1898),  Arts.  296-7. 

Chapter  192  "t   18 
Maine.    Suppleraeni  Laws  (1895),  Chapter  14. 
Maryland.     Counties.     Public  General  Laws  (1888),  Lrt  18,  Sec.  9. 
M  IlSsachi  -ins.     Townships,  Public  Statutes  (1882),  Chapfc 

Municipalities.  Chapter  332  of  1895 
Michigan.    Townships,  Compiled  Laws  (1897),  Si 

Municipalities,  Compiled  Laws  (1897),  Sec.  1459. 

Legislative  power,  Compiled  Laws  (1897)  1412. 
Minm.m.i  \.    Statutes  1 1894),  Set .  7048. 

Cities,  statutes  (1894),  Sec.  1 1">'.'. 

Villages,  Statutes  (1894),  Sec.  1224(28),  1299(80). 

4 


5  ( )  &  J  ATI  1  \  1 11 3 '   on  GA  XI Z  A  TIOX. 

Mississippi.     Chapter  15  <>f  1807. 

Municipalities,  Annotated  Code  (1892),  Sees.  2281-98. 
Missouri.     Cities  of  the  first  class,  Revised  Statutes  (1899),  Sec.  5460  et  seq. 

Cities  of  the  second  class,  Revised  Statutes  (1899),  Sec.  5508. 

Cities  of  the  third  class,  Revised  Statutes  (1800),  Sec.  5842. 
Montana.     Political  Code  (1895),  Sec.  2800. 
Nebraska.     Metropolitan  cities,  Compiled  Statutes  (1899),  Sec,  794. 

Cities  of  the  first  class  A,  Compiled  Statutes  (1899),  Sec.  1038. 

Cities  of  the  first  class  B,  Compiled  Statutes  (1899),  Sec.  1226. 

Cities  of  the  second  class  B,  Compiled  Statutes  (1899),  Sec.  1012. 
New  Hampshire.     Public  Statutes  (1891),  Chapter  108. 

Cities,  Public  Statutes  (1891),  Chapter  50,  Sec.  10. 

Townships,  Chapter  45  of  1897. 

Townships,  Chapter  65  of  1899. 
New  Jersey.     General  Statutes  (1805),  p.  1036  et  seq. 

Cities  of  the  first  class,  General  Statutes  (1895)  pp.  1047-49. 

Counties,  General  Statutes  (1805),  p.  1651. 
New  Mexico.     Cities,  Compiled  Laws  (1897),  Sec.  2446. 

Towns,  Compiled  Laws  (1807),  Sec.  3706. 
New  York.     Revised  Statutes  (1896),  p.  2422.  General  Laws,  Chapter  25,  Art.  2. 
North  Carolina.     Act  of  1  March,  1893. 
North  Dakota.     Counties,  Revised  Code  (1800),  Sees.  245-253. 

Cities,  Revised  Code  (1800),  Sees.  254-274. 
Ohio.     Municipalities,  Annotated  Statutes  (1000),  Sec.  2113  et  seq. 

Townships,  Annotated  Statutes  (1900),  Sec.  2121. 

Cities  of  the  first  class,  1st  grade,  Cincinnati.  Sec.  2231. 

Cities  of  the  first  class,  2d  grade,  Cleveland,  Sec  1545  (41,  45-7). 

Cities  of  the  first  class,  3d  grade,  Toledo,  Sec.  2141. 

Cities  of  the  second  class.  1st  grade.  Columbus,  Sec.  1545  (-05.  -134  et  seq). 

Cities  of  the  second  class,  3d  grade,  a  Springfield,  Sec.  2113. 

Cities  of  the  second  class,  3d  grade,  h  Hamilton,  Sec.  1545  (-200). 

Cities  of  the  second  class,  3d  grade,  c  Portsmouth,  Sec.  1707  (-12). 
Pennsylvania.     Cities  of  the  first  class,  Brightly's  Purdon's  Digest  (1804),  p.  1428, 
Sec.  02;  p.  1431,  Sees.  115-59. 

Cities  of  the  first  class,  Two  Acts  of  22  May,  1899. 

Cities  of  the  second  class,  Act  of  26  June,  1895. 

Cities  of  the  third  class,  Brightly's  Purdon's  Digest  (1894),  p.  1557,  Sees.  129-137. 

Boroughs,  Brightly's  Purdon's  Digest  (1804).  p.  250,  Sees.  240-7. 

Townships,  Act  of  4  April,  1899. 
Rhode  Island.     General  Laws  (1800),  Chapter  40,  Sees.  13,  14  and  29. 

General  Laws  (1800),  Chapter  91,  Sees.  20-22. 
South  Carolina.     Act  of  5  January,  1895. 

Act  of  19  February,  1808. 
South  Dakota.     Act  of  0  March,  1895. 
Tennessee.     Counties,  Code  (1800),  Sees.  3106-14. 

Municipalities,  Code  (1800),  3101-14. 
Texas.     Counties,  Revised  Statutes  (1895),  Sees.  418,  447-8. 

Municipalities,  Revised  Statutes,  (1805),  Sec.  4322  et  seq. 

Towns,  Chapter  100  of  1899. 
Utah.     Chapter  45  of  1899. 

Municipalities,  Revised  Statutes  ("1898),  Sees.  1105,  1109. 

Counties,  Revised  Statutes  (1898),  Sees.  1106,  1109. 
Vermont.     Statutes  (1804),  Sees.  4675-80. 
Virginia.     Act  of  7  March,  1000. 


&  I xrr. IBY  <> li (r. I XI Z. J  TION.  .-, i 

Washington.     Counties,  Code  and  Statutes  (1897),  Sec.  2972. 

Municipalities.  Code  and  Statutes  (1897),  Sec.  1237. 

Townships,  Code  and  Statutes  (1S97),  Sec.  629. 
Wisconsin.     Municipalities,  Statutes  (18  .  925(-107  to  ill  b). 

Townships,  villages  and  cities.  Statutes  (18!         5        .  1411-12. 
West   VIRGINIA.     Code  (1899),  Chapter  150. 
Wyoming.     Revised  Statutes  (1899),  Sec.  2226  et  seq. 

Charters  and  Special  Acts  fob  Cities. 

Atlanta.    Act  of  26  February,  1877;  23  August,  1879;  8   December,   1880;  3  Sep- 
tember, 1881. 

Augusta,  i.a.     Act  of26  February,  1877;  T  May.  1877;  29 August,  1879;  8  December, 
1880;  -  December,  1888. 

Baltimore.     Chapter  123  of  1898,  Sec.  31. 

Baton  Rouge  and  Shbevepobt.     Act  of  20  March,  1878. 

Bridgeport.    Aci  of  22  March.  1877. 

Bbooklyn.     Chapter  307  of  1890. 
on.     Chapter  448  of  1854. 

Bi  i'kai.o.     Chapter  105  of  1891,  Sees.  IT.  231  et  seq. 

Chicago.     Act  of  13  February,  1863;  16  February,  1865;  9  March,  1867. 

Denveb.     Ad  of  11  April.  1891,  Sec.  1. 

Di.i  boit.     Chapter  10  of  1895. 

I)i-i  kict  of  Columbia.     Act  of  Congress,  21  February,   1871;   11  June,   1878;  24 
April.  1880. 

Babtfobd.     Act  of  3  March.  1886,  "validating'1  Ordinance  ol  26  January,  i- 

Manchesteb,  X.  II.     Chapter  165  of  1885. 

Milwaukee.     Chapter  184  of  1874,  sub-chapter  XIII.     Chapter  36  of  187 

Minneapolis.     Chapter  413,  Special  Laws,  1889. 

Memphis.     Chapter  11  of  1879. 

Newbi  bgh,  n.  Y.     Chapter270of  1885. 

Nia\  Baven.     Chapter  418  of  1897. 

Xi:\\    Fobk  (The  City  of).     Chapter  378  ol   1897. 

Providence.     Chapter  598  of  1866,  Sec.  IX..  Clause  I. 

Reading.     Ac!  of  22  April,  1873. 

Richmond.     Chapter  101  of  1870,  Sub-Chapter  3,  XV   XIX. 

is.w   Fbancisco.     Concurrent  Resolutions,  Chapter  II,  26  Ji ary,  1899. 

Santa   Babbaba.      \<t  of 20  February,  1899. 

St.   Paul.     <  'barter  oi  1874,  <  lhapter  X  I. 

Sacbami  sto.     Aci  of  27  March,  I 

Si  i:  \n  io\.      An  of  23  May.  1874. 

Vallejo.     Aci  of  26  January,  1899 

Wilmington,  Del.     Laws  of  Delaware,  Vol.  17,  Chapter  207. 


CHAPTER  II. 

REGISTRATION   OF   VITAL   STATISTICS    AND   DISPOSAL  *OF 

THE   DEAD. 

THE  registration  of  vital  statistics  is  the  firm  basis  on  which  the 
whole  structure  of  sanitary  science  and  practice  must  rest.  In 
order  to  learn  the  laws  of  disease,  to  devise  remedies,  and  test  them,  we 
must  have  an  approximately  accurate  knowledge  of  the  movement  of 
population  and  of  the  causes  of  death.  Not  only  is  a  knowledge  of  these 
required,  but  also  an  accurate  census  si  lowing  the  distribution  of  the 
population  as  to  age,  sex,  civil  condition,  race,  etc.  Correct  knowledge 
of  population  and  its  movements  is  valuable,  not  alone  to  sanitary 
science,  but  to  the  economist,  the  educator,  the  penologist,  and  indeed 
to  the  student  of  every  branch  of  social  science.  A  subject  which  is 
of  such  vast  scientific  importance  should  receive  most  careful  govern- 
mental attention,  and  every  aid  should  be  given  in  assisting  its'  investi- 
gation. Unfortunately  scientific  considerations  have  little  weight  with 
politicians ;  but  fortunately  there  are  other  reasons  which  render  an 
accurate  record  of  the  movement  of  population  desirable.  The  main- 
tenance of  property  rights  requires  a  correct  record  of  family  relations, 
and  is  only  to  be  obtained  by  a  public  record  of  each  birth,  marriage, 
and  death.  The  advantage  of  such  a  record  was  very  early  felt  among 
the  colonies  and  was  manifested  in  appropriate  legislation.  In  Virginia 
on  24  February,  1631,1  it  was  enacted  that  ministers  and  church  wardens 
should  report  births,  marriages  and  deaths  to  the  midsummer  quarter 
court.  The  first  registration  law  in  Massachusetts  was  adopted  in 
1639,2  and  in  Plymouth  in  l<;4li.:> 

The  registration  of  vital  statistics  is  interesting  in  connection  with 
our  subject  because  of  its  great  value  in  aiding  the  progress  of  sanitary 
knowledge,  and  it  must  also  receive  our  attention  because  it  is  often 
one  of  the  functions  of  the  sanitary  department. 


1  Herring's  Statutes  at  Large,  Vol.  I.,  p.  155. 

2 Records  of  Massachusetts,  Vol.  I.,  p.  276. 

8  Plymouth  Colony  Records,  Vol.  I.,  p.  96  (3  March,  1G45-G). 


REGISTRATION   OF    VITAL    STATISTICS.  53 

There  are  several  reasons  for  this.  The  routine  work  of  the  health 
officer  requires  that  he  should  have  the  earliest  possible  knowledge  of 
recognized  dangerous  communicable  diseases,  and  hence  returns  of 
death  should  properly  be  made  directly  to  him.  It  is  of  great  impor- 
tance that  a  medical  man  should,  if  possible,  see  all  returns  of  death,  to 
scrutinize  the  causes,  and  usually  some  member  of  the  board  of  health 
is  the  most  available  medical  man  for  this  purpose  in  the  public  employ. 
Sanitary  officials  are  more  likely  than  any  others  to  make  a  good  use  of 
the  data  obtained,  and  to  record  and  tabulate  the  returns  properly. 
Sanitary  officials  are  more  likely  than  any  others  to  secure  complete 
and  correct  returns.  Hence  it  is  very  generally  the  custom  in  cities, 
even  of  moderate  size,  for  the  board  of  health  or  health  officer  to  be 
entrusted  with  the  duty  of  collecting  and  recording  the  deaths  in  the 
population  within  its  jurisdiction.  In  any  community  which  is  of  suffi- 
cient size  to  have  a  permanent  office  or  clerk  for  the  sanitary  depart- 
ment, there  can  be  no  doubt  that  this  department  should  have  charge 
of  the  registration  of  deaths.  The  records  of  births  should  be  in  the 
hands  of  such  a  department,  because  for  other  reasons  it  would  be  in 
touch  with  the  physicians  who  are  to  make  the  returns,  because  it  can 
check  returns  of  births  by  returns  of  deaths  of  infants,  and  because  it 
can  more  accurately  separate  still-births  from  deaths  than  could  any 
non-medical  recorder.  The  writer  also  believes  that  marriages  ought 
to  be  recorded  by  the  same  authority,  even  though  this  might  necessitate 
the  issuing  of  licenses  as  well.  The  issuing  of  marriage  licenses  and 
the  recording  of  marriages  may  no1  seem  to  be  properly  a  sanitary 
function,  bui  it  can  be  besl  performed  in  conjunction  with  the  recording 
of  births  and  deaths.  Marriage  i>  as  important  as  births  and  deaths  in 
the  movement  of  population,  and  under  present  social  conditions  all  ^i 
our  social  problems  require  a  knowledge  of  this  factor.  Births,  mar- 
riages and  deaths  are  best  collected  and  recorded-  by  the  same  officials, 
and  the  sanitary  official  in  cities  at  Least  is  the  best  fitted  to  have  con- 
trol of  it.  The  experience  of  the  New  England  townships,  and  many 
of  our  important  cities,  where  the  registration  of  all  of  these  three 
classes  of  vital  phenomena  is  done  by  the  same  officer,  shows  that  fuller 
and  better  returns  can  be  thus  obtained.  The  registration  of  births, 
marriages  and  deaths  is  a  desirable  function  to  have  performed  by  sani- 
tary officials  and  is  performed  by  them  in  many  communities.  It  is 
therefore  discussed  in  this  chapter.  The  methods  employed  for  obtaining 
the  data  necessary  for  making  a  full  and  complete  record  of  ' 
marriages,  and  deaths  varj  greatly  in  different  states  and  cit 
in  the   same  state  the   records  of  each  of  these  thn 

marriages  and  deaths,  may  be  collected  iii  different   w: 


54  REGISTRATION  OF    VITAL    STATISTICS. 

Deaths. 
Collection  of  Death  Records. 

Probably  the  most  unsatisfactory  method  of  obtaining  death  records 
is  by  an  annual  census.  This  enumeration  method  has  been  pursued  in 
the  United  States  censuses,  and,  as  is  well  known,  the  results  have  been 
very  unsatisfactory.  This  must  necessarily  be  the  case,  for  the  memory 
of  people  is  not  to  be  trusted  even  in  such  important  matters.  Moreover, 
even  the  most  skilled  enumerators  are  not  able  by  questioning  to  over- 
come the  stupidity  or  carelessness  of  many  of  the  persons  questioned, 
and  skilled  enumerators  are  hard  to  find.  Then,  too,  unless  the  census 
is  taken  on  a  single  day,  many  persons  will,  by  removal,  entirely  escape 
the  enumerators. 

This  census  method  is  provided  for  in  Iowa,  Kansas,  Ohio,  Penn- 
sylvania, and  Vermont,  except  in  certain  municipalities.  In  Ohio  the 
assessors  of  each  township  and  ward  collect  the  data  required  by  statute 
covering  all  births  and  deaths  that  have  occurred,  and  make  a  return  of 
the  same  to  the  probate  judge  of  the  county,  and  the  assessor  is  to 
state  upon  oath  that  "  he  has  made  diligent  enquiry  "  to  obtain  these 
facts,  and  he  is  not  to  be  paid  until  his  work  is  done  to  the  satisfaction 
of  the  probate  judge.  Provision  is  by  statute  made  for  other  methods 
in  cities  of  over  150,000  inhabitants,  and  all  municipalities  are,  through 
their  board  of  health,  to  have  power  to  register  births,  marriages,  and 
deaths,  and  are  required  to  register  births  and  deaths,  and  all  this  regis- 
tration work  is  under  the  supervision  of  the  state  board  of  health. 

In  Kansas  the  assessors  collect  the  data  for  recording  births,  mar- 
riages and  deaths  annually,  and  physicians  are  obliged  to  keep  a  register 
of  deaths  and  report  them  to  the  local  board  of  health  when  required  by 
the  state  board  of  health.  In  Pennsylvania  the  assessors  are  to  make 
the  enumeration  semi-annually,  "  and  it  shall  be  the  duty  of  parents, 
guardians  and  other  persons  to  furnish  to  such  assessors  the  information 
necessary."  The  assessors  make  semi-annual  returns  to  the  orphans' 
court  and  make  oath  as  to  their  correctness.  .  In  Vermont  the  clerk  of 
the  board  of  school  directors  and  the  clerks  of  incorporated  school  dis- 
tricts are  to  take  a  census  of  births,  marriages  and  deaths,  and  to  report 
to  the  town  clerk  by  February  first,  each  year.  They  are  to  receive  fifteen 
cents  for  each  birth  and  death  return,  to  be  paid  by  the  town.  In 
Iowa  the  assessor  makes  an  annual  enumeration  of  births  and  deaths. 

Another  and  more  satisfactory  method  is  to  require  certain  persons, 
such  as  physicians,  heads  of  families,  or  undertakers,  to  make  returns 
of  deaths,  either  directly  or  indirectly,  to  the  officer  who  is  to   record 


REGIS  TIL  1  TION   <  >F    VITAL    8  rJ\  i  TI&  TI(  '& 


.... 


them.  In  most  states1  physicians  are  required  to  certify  to  deaths.  In 
some  states  the  terms  doctor  or  surgeon  are  used.  In  Colorado  it  is 
provided  that  "when  two  or  more  surgeons,  physicians  or  midwives  may 
have  attended  professionally  at  any  birth  or  death,  that  surgeon,  physi- 
cian or  midwife  who  is  oldest  in  attendance  shall  make  the  registry." 
In  California  and  Kentucky,  if  two  doctors  attend,  the  eldest  of  the 
two  shall  sign.  Usually  it  is  -every  physician  who  shall  have  attended 
a  person  in  his  last  sickness"*  who  shall  give  a  certificate.  In  Minne- 
apolis2 it  is  "every  physician  who  shall  be  in  professional  attendance 
upon  any  person  at  the  time  or  within  twelve  hours  of  the  time  of 
death."  In  Rochester,'5  in  order  that  none  but  a  person  having  knowl- 
edge of  the  ease  shall  sign  a  certificate,  it  is  provided  that 

"No  physician  shall  issue  any  certificate  of  death  under  the  ordinance  of  this 
Board  or  the  laws  of  this  State,  unless  he  was  the  medical  attendant  on  the  person 
named  in  said  certificate  during  his  or  her  last  illness,  provided  said  person  died 
from  natural  causes." 

In  California  "clergymen  who  officiate  at  a  funeral"  are  obliged  to 
report  the  same.     In  most   of  the  states  mentioned  coroners  as  well  as 

physicians  are  obliged  to  make  returns,  and  in  those  states  which  have 
medical  examiners,  as  Massachusetts,  Connecticut,  and  Rhode  Island. 
officers  also  are  obliged  to  make  special  reports  of  all  deaths  which 
they  investigate.  In  California.  Delaware.  Maine,  Massachusetts,  Michi- 
gan, New  Hampshire,  New  Jersey,  New  York,  and  Rhode  Island  under- 
takers are  made  responsible  for  all  deaths  coming  under  their  charge; 
also  in  a  number  of  cities  outside  of  these  states.1  In  ( 'alifornia  sextons 
as  well  as  undertakers  are  to  make  returns  of  deaths,  and  in  many  cities 
in  other  states  this  is  found  as  a  municipal  requirement.  The  form  of 
undertaker's  return  \\^r<\  in  Milwaukee  is  shown  in  Appendix  ;>>. 

Other  persons  than  those  above  mentioned  are  sometimes  required 
to  make  reports  of  deaths.  Tims  in  Alabama  it  is  any  " other  person 
having  at  the  time  of  death  charge  of  a  sick  person,"  and  iii  New  York 
City  it  is  the  duty  of  ■•each  person  being  with  such  deceased  person  at 
his  nr  hei'  death,  and  of  the  persons  occupying  or  living  in  an\  bouse  01 
premises  in  or  on  which  an\    person  \  die."     The   family  is  required 

1  Alabama,  California,  ( lolorado,  Connecticut,  Delaware,  Florida,  Illinois,  [nd 
Kansas.    Kentucky,    Maine,    Maryland,    Massachusetts,    Michigan,   Minnesota,    Ne^ 
Hampshire,    \cw   Jersey,    N<  \\    Sfork,    North   Dakota,    Ohio,    Rhode  Island,   liaji. 
Vermont,  Virginia,  Washington,  Wesl  Virginia,  and  Wisconsin. 

'Minneapolis,  Rules  and  Regulations,  Department  of  Health  (1880),  Sec.  28. 
Rochester,  Ordinances,  Board  of  Health,  ber6,  Sec.  2. 

'Allegheny,  Charleston,   Cincinnati,   Cleveland,   Districl  of    Colu 
Minneapolis,  Mobile,  Philadelphia,  Pittsburg,  Reading,  St.  Loui     Scranton. 


56  REGISTRATION  OF    VITAL   STATISTICS. 

to  make  a  report  of  a  death  in  Connecticut,  Delaware,  Illinois,  Indiana, 
Maine,  Maryland,  Massachusetts,  Michigan,  Minnesota,  Missouri,  North 
Dakota,  Vermont,  Washington,  and  West  Virginia,  and  in  Pennsylvania 
the  family  is  to  give  information  to  the  assessors.  In  Massachusetts 
"  every  householder  —  the  eldest  next  of  kin  —  the  keeper  of  a  work- 
house, house  of  correction,  prison,  hospital  or  almshouse  —  and  the 
master  or  other  commanding  officer  of  a  ship "  shall  give  notice  of 
deaths  among  persons  under  his  charge.  The  law  has  been  adopted  in 
much  the  same  form  by  several  other  states.  In  New  Orleans1  if  there 
is  no  relative  in  the  parish  the  report  of  a  death  is  to  be  made  by  the 
executor  if  designated  or  by  the  landlord. 

A  number  of  states,  as  California,  Maine,  Maryland,  Massachusetts, 
and  Rhode  Island,  require  reports  from  the  different  classes  of  persons 
mentioned  above,  independent  of  one  another,  so  that  in  case  of  failure 
each  is  equally  liable.  In  other  states,  as  Connecticut,  Illinois,  Indiana, 
Missouri,  Vermont,  Washington,  and  West  Virginia,  the  physician  is 
required  to  report  deaths,  and  the  next  of  kin  or  householder  only  when 
there  is  no  physician  in  attendance.  In  many  states  it  is  intended  and 
is  provided  by  statute,  that  the  physician  and  undertaker  and  sometimes 
the  family  also  shall  act  together,  and  this  is  doubtless  the  practice  in 
certain  places  where  it  is  not  prescribed.  Thus  in  Maine  and  New 
York  the  undertaker  is  to  obtain  from  the  physician  the  certificate  of 
death  and  present  it  to  the  local  board  of  health.  In  Delaware,  Massa- 
chusetts, New  Hampshire,  New  Jersey,  Rhode  Island,  Vermont,  and 
Wisconsin,  and  in  certain  cities,  as  Atlanta  and  Cleveland,  it  is  the  duty 
of  the  physician  in  attendance  at  the  last  sickness  to  furnish  the  certifi- 
cate of  death  to  the  undertaker,  but  in  Massachusetts  and  Wisconsin  he 
is  to  do  so  when  requested.  Nevertheless  in  practice  in  Rhode  Island 
the  undertaker  obtains  it  from  the  physician.  The  best  provision  is 
that  of  the  Michigan2  law  : 

"  Whenever  any  person  shall  die,  the  undertaker,  householder,  relative,  friend 
manager  of  institution,  sexton  or  other  person  superintending  the  burial  of  said 
deceased  person  shall  cause  a  certificate  of  death  to  be  filled  out  with  all  of  the  per- 
sonal and  family  particulars  required  in  section  three  of  this  act,  and  attested  by 
the  signature  of  a  relative  or  some  competent  person  acquainted  with  the  facts. 
The  physician  who  attended  the  deceased  person  during  his  last  illness  shall  fill 
out  the  medical  certificate  of  cause  of  death.11 

In  Denver  and  St.  Louis  the  physician  is  to  furnish  two  certificates, 
one  to  the  undertaker  and  one  to  the  commissioner  of  health.  The 
blanks  for  both  of  these  are  furnished  attached  to  one  stub.     In  Omaha 


1  New  Orleans,  Act  number  80,  approved  20  April,  1877,  Sec.  10. 

2  Michigan,  Compiled  Laws  (1897),  Sec.  4615. 


REGISTRATION  OF    VITAL    STATISTICS.  :,; 

the  physician  reports  upon  a  postal  card  directly  to  the  board  of  health 
the  facts  as  shown  below1  and  the  undertaker  obtains  the  rest  of  the 
items  before  a  permit  is  given. 

In  order  to  insure  that  physicians  shall  report  all  the  deaths  which 
occur  in  their  practice,  it  is  advisable  that  they  keep  a  current  record  of 
the  same.  A  number  of  states  and  cities  require  this.  Thus  in  the 
City  of  New  York2 

"  Every  physician  and  professional  adviser  who  has  attended  any  person  during  a 
last  illness  or  has  been  present  by  request  at  the  death  of  any  person,  shall  make 
and  preserve  a  registry  of  such  death,  stating  the  cause  thereof,  and  specifying  the 
date,  hour,  place,  and  street  number  of  the  place  of  such  death.'1 

This  rule  has  been  copied  in  Chicago,  Omaha,  and  other  cities. 
Even  where  it  is  not  the  law  it  is  sometimes  the  custom,  as  when  blank 
certificates  in  book  form  with  stubs  are  furnished  to  the  physicians  b\ 
the  state  or  city. 

The  interval  of  time  after  a  death  during  which  the  return  must  be 
made  is  important.  It  is  necessary  that  births,  marriages  and  deaths 
should  be  reported  promptly,  otherwise  they  are  forgotten  and  fail  of 
record  altogether.  In  those  states  and  cities  in  which  a  permit  is 
required  before  burial  or  removal,  it  is  scarcely  necessary  to  li\  this 
limit.  A  very  short  limit  is  sometimes  set  for  reporting  deaths  from 
certain  contagious  diseases.  Thus  in  Philadelphia  physicians  are 
obliged  to  sign  certificates  of  death  from  contagious  diseases  in  twenty- 
loiir  hours,  all  others  in  forty-eight  hours.3  In  Maine4  the  certificate 
shall  be  madeand  forwarded  immediately.     Such  a  regulation  is  hardly 

Physicians  are  subject  to  prosecution  ami  fine  for  failure  to  return  Certificate  ol  Death 
to  Commissioners  ol   Health  within  241 re. 


Certificate  ok  Death— Omaha,    Neb. 

Name 

Sea 

Married,  Single  or  Widowed  [Jf^^*]   A-                 V,.. 

Mo 

Residence  No.                                           street 

Date  "*l  l >« -: » t ii                                         Duration  of  last  illness 

Cause  ol    Death      primary 

"       "        "     —  secondary 

When  no  I  »octor,  in  he  i 
signed  bj  «  on r.     i 

M.     I). 

I '  adertaker 
-city  of  \rw  Fork,  Sanitary  Code  (1809),  Sec.  I7'.». 
:1  Philadelphia,  Rules  of  Board  of  Bealth  i  L8  206. 

1  Maine.  Chapter  lis  .a  1891,  amended  by  Chapter  154  of  1895,  S< 


58  BEGISTRATION  OF    VITAL    STATISTICS. 

necesssary  now  that  reports  of  cases  of  contagious  disease  are  required, 
and  the  local  board  of  health  is  thus  supposed  to  have  a  knowledge  of  all 
cases,  alive  or  dead.  The  limit  for  reporting  deaths  from  other  diseases 
varies  very  much.  In  Illinois,  Missouri,  Washington,  West  Virginia, 
and  in  certain  cities,  as  Camden  and  Newark,  N.  J.,  reports  of  deaths 
are  to  be  made  within  thirty  days.  In  Ohio  cities  physicians  are  to  send 
in  their  returns  by  the  second  Monday  of  each  month,  and  in  Denver 
by  the  fifth  day  of  each  month.  In  Minnesota  deaths  are  to  be  reported 
within  ten  days.  In  New  York  City  the  family  and  friends  are  liable 
to  a  fine  if  death  is  not  reported  in  five  days.  In  North  Dakota  the 
time  is  five  days.  In  Denver  coroners  must  make  their  reports  in 
three  days.  In  Charleston  the  doctor  must  report  in  three  days.  In 
Philadelphia  and  Rhode  Island  physicians  must  sign  the  certificates  of 
death  in  forty-eight  hours,  and  in  Yonkers  coroners  must  report  within 
the  same  time.  In  Vermont  and  in  Brooklyn,  Chicago,  Erie,  Mil- 
waukee, Memphis,  Omaha,  and  Rochester,  deaths  must  be  reported  in 
thirty-six  hours.  In  Buffalo,  Detroit,  the  District  of  Columbia,  Flor- 
ence,  S.  ('.,  Newburg,  X.  Y.,  Omaha,  and  Reading,  the  returns  of  deaths 
must  be  made  within  twenty-four  hours.  In  Portland,  Ore.,  the  time  is 
twelve  hours.  In  Scranton  and  Albany  the  certificate  of  death  must  be 
presented  to  the  board  of  health  twenty-four  hours  before  burial.  In 
Xew  York  City  coroners  are  obliged  to  report  to  the  board  of  health  as 
soon  as  they  are  called  to  a  death.  In  Milwaukee  where  the  physician 
is  to  report  direct  to  the  health  department  and  not  through  the  under- 
taker, stamped  envelopes  are  furnished  on  application,  and  in  Omaha 
postal  cards. 

The  best  method  that  can  be  devised  to  secure  prompt  and  certain 
returns  of  deaths  is  to  require  a  permit  from  the  board  of  health  or  some 
official  before  burial  or  removal  can  take  place.  Burial  and  transit  per- 
mits are  the  first  requisite  of  correct  death  registration,  at  least  under 
such  conditions  as  exist  in  the  United  States.  They  are  required  by 
statute  in  fifteen  states,1  and  in  many  cities  outside  of  these  states.2 
In  California.  Massachusetts,  Michigan,  Xew  York,  in  Xew  Hampshire 
cities,  and  in  Wisconsin,  and  in  most  cities  having  local  rules  of  their 
own,  the  certificate  of  death  is  to  be  presented,  and  the  permit  obtained 


California,  Connecticut,  Delaware.  Florida,  Indiana,  Maine,  MassachnsKs. 
Michigan.  Ohio,  New  Hampshire,  Xew  Jersey,  except  in  unincorporated  districts. 
Xew  York,  Utah,  Vermont,  and  Wisconsin, 

-Atlanta,  Baltimore,  Denver,  District  of  Columbia,  Charleston,  Chicago,  Cincin- 
nati, Cleveland,    Erie,   Florence.  S.   C,  Minneapolis,  Mobile,  New  Orleans,  Omaha, 

Pennsylvania  cities  of  the  second  class,    Philadelphia,   Providence,  Reading,  Scran- 
ton and  .St.  Lot i is. 


REGISTRATION    OF    VITAL    STATISTICS.  59 

from  the  local  sanitary  authorities  when  such  have  been  established ; 
but  in  Connecticut,  Maine,  New  Hampshire  and  New  Jersey  the  permit 
for  burial  is  to  be  issued  by  the  town  clerk  or  city  clerk,  and  in  Ver- 
mont by  thf  town  clerk,  except  in  cases  of  communicable  diseases.  In 
California,  if  there  is  no  board  of  health,  the  permit  is  issued  by  a 
justice  of  the  peace.  In  Cleveland  the  permit  is  to  be  obtained  from 
the  health  officer  or  from  a  police  station.  In  New  Jersey1  when  it  is 
impossible  to  obtain  a  permit  from  the  town  clerk  it  may  he  obtained 
from  a  judge  or  justice. 

In  Delaware  a  permit  is  not  required,  but  undertakers  are  forbidden 
to  inter  until  a  certificate  lias  been  obtained  from  the  physician.  There 
seems  to  be  no  valid  reason  why  permits  should  not  he  required  in  all 
cities,  and  the  only  objection  to  this  requirement  elsewhere  —  the  diffi- 
culty of  obtaining  a  permit  in  sparsely  settled  regions  —  may  he  met  as 
in  Connecticut,  Maine  and  New  Hampshire,  by  the  appointment  of  sub- 
registrars  to  issue  permits.     The  Maine  law  is  given  below.2 


1  New  Jersey,  General  Statutes  (1895),  p.  2008,  Si 

"That  in  case  where,  on  account  of  the  absence  of  the  registrar  of  vital  statistics 
or  the  clerk  of  any  city,  borough,  town  or  local  municipal  government,  or  for  any 
other  sufficient  reason,  it  may  he  impossible  to  obtain  from  such  registrar  or  clerk  a 
permit  in  time  for  burial,  it  shall  he  lawful  for  any  judge  of  the  court  of  common 
pleas  or  any  justice  of  the  peace  of  the  county  in  which  the  deatb  occurred,  on 
presentation  of  the  certificate  of  deatb  to  him,  ami  being  satisfied  that  such  certifi- 
cate is  genuine,  ami  that  no  permit  can  he  obtained  in  time  for  burial  from  the 
clerk  aforesaid,  t"  issue  a  special  permit  for  burial  in  the  following  form:  li 
being  impossible  to  obtain  a  burial  permit  from  the  registrar  of  vital  statistics 
or  the  clerk  of  i  he  [stating  here  t  lie  name  of  the  city,  borough,  town  or  other  local 
municipal  government],  on  accounl  of  state  here  the  reason],  I .  a  judge  of  the  court 
of  common  pleas   or  a  justice  of  the  peace],  of  the  county  of  ,  do  hereby 

grant  this  special  permit   for  the  burial  of  .  whose  death  has  been 

duly  certified  to  me."  which  permit  shall  he  dated  and  signed  by  such  judg 
justice;  the  said  judge  or  justice  shall  transcribe  a  copy  of  said  permit  upon  the 

back  of  the  certificate  of  death,  shall  give  th iginal  permit   to  the  person  deliver 

ing  to  him  the  certificate  of  death,  and  shall  transmit  the  certificate  with  the  trans- 
cription theron  indorsed,  by  mail,  in  an  envelope  marked  "burial  permit.'"  to  the 
state  in i tea u  of  vital  statistics,  at  Trenton;  the  judge  or  justice  who  shall  issue  anj 
such  permit  shall  be  entitled  to  charge  and  receive  from  the  person  presenting  to 
him  such  certificate  of  death  the  sum  of  fifteen  cents." 

2 Maine,  Chapter  118  of  1891,  a-  amended  by  Chapter  i">  I  of  Ifi 
"Se(  rios  8.     The  town  or  city  clerk  shall  appoint  two  suitable  and  propei 
sons,  in  each  town  or  city,  as  sub-regist  tars,  who  shall  be  authorized  to  issue  b 
permits  based  upon  a  death  certificate,  as  hereinbefore  provided,  in  the  same  man- 

mi  as  is  required  of  the  town  or  city  clerk;  and  t  he  said  record  of  death  upon 

the    permit    is    issued    shall    be    forwarded    to    the    town   clerk    within 

receiving  the  same,  and  all  permits  by  whomsoever  iss 1  shall  be  returned  I 

town  clerk  as  re.pt  i  red  bj  section  seven  of  this  act.     The  appointniei 

t  rats  shall  he  made  with  reference  to  locality,  BO  as  to   best    suit    t  he 


60  REGISTRATION  OF    VITAL    STATISTICS. 

To  provide  for  unincorporated  regions  it  was  enacted  in  Maine  that 
the  death,  marriage  or  birth  should  be  reported  to  the  nearest  town 
clerk  and  recorded  by  him.1  In  Michigan  permits  are  not  required  in 
sparsely  settled  townships  having  an  average  density  of  population  of 
less  than  five  (5)  persons  per  square  mile  at  the  time  of  the  last  pre- 
ceding United  States  or  State  Census ;  but  when  that  density  of  popu- 
lation is  reached,  the  law  is  to  go  into  effect.  In  New  Jersey  for  the 
convenience  of  undertakers  it  is  provided  that  when  a  burial  is  to  be  in 
a  place  other  than  the  township  where  the  death  took  place  the  under- 
taker may  present  the  certificate  of  death  in  the  town  of  burial  or  in  his 
own  town,  and  there  receive  the  permit,  but  he  must  deposit  with  the 
certificate  two  cents  for  postage,  and  the  registrar  must  send  the  certifi- 
cate by  mail  to  the  township  where  the  death  occurred. 

Trouble  has  arisen  in  Pennsylvania  where  a  cemetery  lies  in  two 
municipalities,  so  that  a  statute  was  necessary  which  declared  that  a 
burial  permit  issued  by  either  is  valid. 

As  an  example  of  statutory  provisions  requiring  burial  permits,  the 
following  from  the  Michigan2  law  may  be  cited : 

"  The  body  of  no  person  whose  death  occurs  in  the  state  shall  be  interred, 
deposited  in  a  vault  or  tomb  or  otherwise,  or  removed  from  the  township,  village  or 
city  in  which  the  death  occurred,  until  a  permit  for  burial  or  removal  shall  have 
been  properly  issued  by  the  clerk  of  the  township,  village  or  city  in  which  the  death 
occurs." 

Various  forms  of  burial  permits  are  used.  A  very  simple  form  has 
been  used  in  Providence  for  over  forty  years  and  has  been  entirely  sat- 
isfactory. Indeed,  if  the  permit  is  merely  to  be  kept  by  the  undertaker, 
or  presented  at  a  local  cemetery,  a  simpler  form  giving  merely  the  date 
of  issuing  the  permit,  date  of  death,  name  of  deceased,  place  of  burial, 
and  undertakers  name  might  do  just  as  well.  If  it  is  desired  to 
keep  a  record  of  permits  issued,  as  is  the  custom  in  many  places,  the 
permits  may  be  attached  to  a  stub  and  bound  in  book  form  as  in 
Michigan.  If  it  is  required  that  the  undertaker  leave  the  permit  with 
the  keeper  of  the  cemetery,  it  is  well  to  have  a  voucher  attached  for  the 
undertaker  to  keep,  as  in  the  form  recommended  in  Maine.     The  rules 


the  inhabitants  of  the  town,  and  such  appointment  shall  be  in  writing  and  recorded 
in  the  office  of  the  town  or  city  clerk. 

"  Section  9.  Town  clerks  and  sub-registrars  may  issue  burial  permits  to  persons 
in  contiguous  towns,  when  by  so  doing  it  would  be  more  convenient  for  those  seek- 
ing a  permit,  but  in  all  cases  the  permit  shall  be  made  returnable  to  the  town  clerk 
of  the  town  in  which  the  death  occurred.'" 

1  Maine,  Chapter  118  of  1891,  as  amended  by  Chapter  154  of  1895,  Sec.  20. 
2 Michigan,  Compiled  Laws  (1897),  Sec.  4614. 


REGISTRATION  OF    VITAL    STATISTICS.  61 

recommended  by  the  American  Association  of  General  Baggage  Agents 
and  adopted  by  a  large  number  of  states,  require  that  every  body  ship- 
ped by  a  common  carrier  shall  be  accompanied  by  a  transit  permit  and 
"the  transit  permit  must  be  made  in  duplicate  with  the  signatures  of 
all  attesting  parties.  The  duplicate  copies  shall  be  sent  to  the  secre- 
tary of  state  or  provincial  board  of  health  of  the  state  or  province  from 
which  the  shipment  was  made. 

When  dead  bodies  are  shipped  by  express  the  whole  original  transit 
permit  shall  be  pasted  upon  the  outside  box,  and  the  duplicate  for- 
warded by  the  express  agent  to  the  secretary  of  the  state  or  provincial 
board  of  health  of  the  state  or  province  from  which  such  shipment  was 
made." 

Examples  of  different  forms  of  permit  are  shown  in  Appendices 
4  to  7.  In  Denver  and  St.  Louis  two  certificates  are  furnished  by  the 
physician,  one  of  which  is  taken  by  the  undertaker  to  the  health  depart- 
ment and  endorsed  on  the  back.  It  then  serves  as  a  permit  and  is  left 
at  the  cemetery. 

The  object  of  requiring  permits  before  burial  is  to  secure  the  report- 
ing of  all  deaths  that  occur,  and  therefore  failure  to  obtain  such  a  per- 
mit is  punished  by  fine.  In  addition  to  such  requirement  and  its  pen- 
alty, a  second  safeguard  is  sometimes  made  use  of.  \.>t  only  is  the 
undertaker  required  to  obtain  a  permit  before  the  burial  of  the  body, 
but  he  is  obliged  to  deliver  it,  together  with  the  body,  to  the  keeper  of 
the  cemetery,  who  in  turn  is  required  to  return  it  to  the  officer  by  whom 
it  was  originally  issued.  By  this  means  the  chance  of  a  death  occurring 
without  a  record  of  the  same  is  very  much  lessened. 

To  secure  the  greatest  value  from  such  a  regulation  it  should  be 
part  of  the  statute  law  as  it  is  in  Maim-.  If  it  is  merely  a  local  regula- 
tion no  control  is  had  of  burials  in  out  of  town  cemeteries,  and  espe- 
cially when  the  body  is  removed  by  out  of  town  undertakers,  as  may 
easily  be  done  without  the  knowledge  of  the  local  registrar.  Local 
regulations  of  this  kind  are  found  in  Charleston,  Cleveland,  District  of 
Columbia,  Memphis,  Minneapolis,  New  burgh.  New  York,  Omaha,  Phil- 
adelphia, St.  Louis,  Scranton,  and  honkers.     In  Buffalo  the  sextons 

nd   in  the  permits  annually;   in  Newburgh  every  three  months:  in 
Yonkers  on  the  first  of  every  month;   in  Omaha   within  five  days ;  but 

in  most    cities  they  arc  returned    weekly.      In   Maine  the    permits  are  to 

be  returned   to  the  clerk  of  the  town  within  six  days  after  the  da 

burial. 

In  Cambridge,  Mass.,  permits  are  to  lie  returned  if  nol  used. 
In  certain  other  cities,  n-  Atlanta,  Augusta,  Lowell,  Milwaukee,  and 
New    Orleans,  sextons  arc  required   to  keep  a  complete  i 


62 


REGISTRATION  OF    VITAL    STATISTICS. 


burials,  and  in  some  cities  to  report  the  in  to  the  health  department. 
The  form  used  for  this  in  Milwaukee  is  given  below.1 

Sometimes  a  permit  is  required  when  a  body  is  to  pass  through  a 
city  as  in  Cleveland,  the  District  of  Columbia,  Minneapolis,  Newark, 
and  New  York.  Occasionally,  as  in  St.  Louis,  it  is  specified  that  it 
shall  not  be  required. 

Whenever  a  body  is  brought  into  a  township  for  burial  it  is  advis- 
able that  that  fact  should  be  recorded.  Permits  for  burial  are  in  such 
cases  required  in  many  cities,  as  Atlanta,  Buffalo,  Cambridge,  Mobile, 
Newark,  Paterson,  Philadelphia,  Reading,  St.  Louis,  Wilmington,  Del., 
and  Yonkers.  In  Philadelphia  the  transit  permit  in  such  cases  must 
also  have  the  local  undertaker's  certificate  which  must  state  the  place 
from  which  the  burial  is  to  take  place.  If  an  out  of  town  body  in  St. 
Louis  is  not  accompanied  by  a  certificate  of  death,  it  must  be  referred 
to  the  coroner.  In  Wilmington,  Del.,  a  body  dead  of  contagious  dis- 
ease cannot  be  brought  into  the  city  for  six  months  after  death.  In  New 
Jersey2  it  is  provided  that  when  a  body  is  brought  into  the  state  for 
burial  it  must  be  accompanied  by  a  certificate  of  death,  or  else  one  mast 
be  obtained  from  some  physician  in  the  town  or  city  where  the  burial 
is  to  take  place,  and  a  permit  for  burial  must  then  be  obtained.  In 
Connecticut3  the  permit  in  such  cases  must  be  obtained  of  the  registrar 
of  the  town  where  the  burial  is  to  take  place.  The  Maine  law  is  very 
similar.  In  Providence  permits  for  burial  of  bodies  brought  to  the  city 
are  not  required,  but  undertakers  must  in  all  cases  return  certificates 
of  death  within  ten  days  after  the  body  has  been  brought  into  the 
city. 

In  California,  Delaware,  and  New  York,  undertakers  are  forbidden  to 
bury  a  body  until  a  permit  is  obtained,  and  if  this  is  strictly  enforced  it 


Milwaukee,  Wis.. 


189. 


To 


Registrar  of  Vital  Statistics. 
Sir:  Following  is  a  list  of  burial  permits  received  at  the 
for  the  month  of 189- 


Cemetery 


Secretary. 


Permit 
No. 


NAME. 


Date 
of 

Burial. 


Permit 
No. 


NAME. 


Date 

of 
Burial. 


2  New  Jersey,  General  Statutes  (1895),  p.  2008,  Sec.  7. 

3  Connecticut,  Chapter  155  of  1893,  Sec.  3. 


REGISTRATION  OF    VITAL    STATISTICS.  63 

would  apply  to  bodies  brought  into  the  town  for  burial  as  well  as  those 
of  persons  who  died  there. 

The  laws  which  require  permits  generally  specify  that  no  body 
shall  be  ''buried,  removed  from  the  city  or  otherwise  disposed  of" 
without  the  permit,  and  in  the  California  law  is  added  the  word 
cremated.  In  Wisconsin  no  undertaker  is  to  prepare  a  body  tor  incinera- 
tion without  a  permit. 

For  legal,  genealogical  and  other  purposes,  it  is  very  desirable  thai 
the  deaths,  births,  and  marriages  of  members  of  resident  families  should 
be  recorded  in  the  place  of  residence,  even  if  the  birth,  marriage,  or 
death  takes  place  elsewhere.  In  the  case  of  deaths,  if  the  body  is 
returned  to  the  place  of  residence  for  burial,  as  frequently  happens,  and 
if  such  burials  are  reported,  the  facts  may  go  on  record.  The  .Maine, 
Massachusetts,  NVw  Hampshire,  and  Rhode  Island  laws  contemplate  the 
record  of  the  births,  marriages,  and  deaths  in  the  place  of  residence,  and 
the  provisions  in  Rhode  Island  are  given  below.1 

If  a  similar  law  should  be  adopted  in  all  states,  records  of  this  kind 
could  be  made  very  complete.  It  is  sometimes  objected  that  in  regard 
to  births  and  marriages  it  is  an  unwise  provision.  It  is  said  that  a 
certainty  of  the. publicity  of  a  marriage  or  birth  at  home  will  often  deter 
a  man  from  marrying  the  woman  with  whom  he  has  had  improper  rela- 
tions, while  if  secrecy  for  the  time  could  lie  secured  he  would  be  read} 
to  enter  into  marriage  Whether  such  a  view  of  the  law  is  warranted 
it  is  perhaps  not  easy  to  determine. 

Items  required  "/>  Death  Returns. 

The  information  concerning  deaths  required  for  record  varies  very 
much  in  different  cities  and  states.  There  has  been  a  progressive  in- 
crease   in    the    number    of    facts  to  be  recorded.       Ill  the  earliest  colonial 

1  Rhode  Island.  General  Laws.  Chapter  LOO,  Sec.  IT.  as  amended  by  Chapter  L262 
ef  the  Public  Laws: 

"Tlie  clerk  or  regis!  rar  of  each  town  and  citj  shall  on  the  flrsl  daj  "i  cadi  and 
every  month  make  a  certified  copy  of  all  births,  marriages,  and  deaths  recorded  in 

the  books  of    sail  I    tOWD   OT  city  during   (lie   |'le\  in  I  Is   111'  ail  li.    \\  he never  the     |  'ale  Ills  ,.| 

the  child  born,  or  the  bride  or  the  groom,  or  the  deceased  person,  were  resident  in 
: 1 1 1 >  other  town  or  city  in  i  his  state  or  in  anj  other  state  ai  the  time  of  said  birth, 
marriage  or  death ;  and  shall  I  ransmii  such  certified  copies  to  the  clerk  or  regisl  rar 
of  the  town,  city  or  state  in  which  such  parents  of  the  child  born,  the  bride  or  the 

gr or  the  deceased,  wen-  resident  al   the  time  of  said  birth,  marriage,  or  death, 

stating  in  case  oi  a  birth,  the  name  of  the  streel  and  number  of  the  house,  if  anj 
where  such  parents  resided,  the  place  of  birth  of  such  parents  and  the  maiden  name 
of  t  he  1 1 km  her.  whenever  the  same  can  be  ascertained ;  and  the  clerk  or  i 
receiving  such  certified  copies  shall  record  the  same  in  the  books  kepi  for  recording 
births,  marriages,  and  deaths.     Such  certified  copies  shall  be  made  upon  blanks  to 
be  furnished  for  thai  purpose  h.v  the  secretary  of  the  -cue  board  of  health." 


64  REGISTRATION  OF    VITAL   STATISTICS. 

records  it  was  customary  to  record  in  most  cases  merely  the  name  and 
date  of  death,  though  the  age  or  parents*  or  husband's  name  was  some- 
times given.  It  is  only  during  the  present  century  that  additions  have 
been  made  to  those  simple  records.  About  the  beginning  of  the  cen- 
tury the  cause  of  death  began  to  be  recorded  in  Boston  and  Philadel- 
phia, but  it  was  not  for  many  years  and  until  after  the  development  of 
interest  in  public  sanitation,  that  this  became  general.  With  the  in- 
crease of  population  better  means  of  identification  were  needed,  and  age, 
names  of  parents,  etc.,  came  to  be  added.  With  the  great  interest 
which  has  been  aroused  during  the  last  half  of  the  century  in  sanita- 
tion, in  social  science,  and  in  statistics,  a  large  number  of  items  have 
been  considered  desirable  in  death  returns.  Undoubtedly  the  more 
facts  that  can  be  recorded  accurately,  the  better  will  it  be  for  the  prog- 
ress of  science ;  but  there  must  be  a  limit.  If  too  many  data  are  re- 
quired, or  data  which  it  is  not  easy  for  the  reporter  to  ascertain,  care- 
fully made  returns  cannot  be  expected,  and  inaccuracies  will  result  which 
will  be  anything  but  helpful  to  science. 

Much  care  should  be  used  in  devising  a  schedule  of  items  for  death 
returns,  and  probably  the  value  of  any  form  can  be  fully  tested  only  by 
experience.  It  seems  to  the  writer  that  in  order  to  satisfy  sanitary  and 
social  requirements  a  return  of  death  should  contain 

Name, 

Date  of  death, 

Place  of  death, 

Usual  residence, 

Age, 

Sex, 

Color  or  race, 

Civil  condition, 

Husband's  name,  if  wife  or  widow, 

Occupation, 

Place  of  burial, 

Cause  of  death. 

These  should  be  certified  to  by  the  physician  and  undertaker  if  such 
were  in  attendance.     The  above  are  essential  and  are  required  wherever 
registration  is  at  all  satisfactory.     Other  items  which  are  often  required 
and  are  very  useful  are 
Birthplace, 
Names  of  parents, 
Birthplaces  of  parents, 
Duration  of  disease. 


REGISTRATION  OF    VITAL    STATISTICS.  ,;;, 

Some  of  the  above  items  require  explanation. 

Place  of  death. 

The  Massachusetts,  Michigan,  Pennsylvania  and  other  laws  specify 
that  if  in  a  city,  the  ward,  street,  and  number  of  the  house  must  be 
given.  In  Charleston  if  the  death  occurs  in  an  institution  the  name 
of  the  institution  must  be  given.  In  Buffalo  and  Brooklyn  the  floor  of 
the  house  must  be  given  and  the  number  of  families  in  the  house.  In 
Connecticut  the  number  of  families  must  be  given  in  the  usual  resi- 
dence, if  the  deceased  resided  in  a  tenement  house. 
Age. 

In  Massachusetts  one  of  the  requirements  of  the  death  certificate  is 
"the  supposed  age,"'  presumably  to  indicate  that  if  the  exact  age  is  not 
known  the  approximate  age  should  be  given.  In  Wisconsin  and 
Michigan  it  is  specified  that  the  age  shall  be  given  in  years,  months  and 
days.  In  New  Jersey  and  Buffalo  a  blank  for  hours  is  left.  The  Wis- 
consin law  and  the  blanks  used  in  Rhode  Island  require  the  date  of 
birth  of  the  deceased,  and  it  would  appear  that  fewer  errors  would 
occur  if  this  were  given.  Relatives  remember  the  date  of  birth,  not 
the  age  in  years,  months  and  days,  and  for  them  or  the  undertaker  to 
calculate  the  latter  is  not  a  particularly  easy  arithmetical    problem. 

Color. 

The  color  distinctions  usually  made  are  White  and  Colored,  though 
distinctions  in  the  latter  as  Mulatto  and  Quadroon  arc  sometimes  asked 
for.  This  distinction  of  Black  and  Mulatto  would  be  very  valuable  if 
it  could  be  obtained,  but  attempts  to  obtain  it  do  not  seem  to  be  suc- 
cessful. Indian  and  Chinese  are  racial  distinctions,  but  are  sometimes 
noted  under  this  heading.  In  California  and  Milwaukee  race  is  to  he 
Specified,  the  intention  doubtleS8  being  to  require  a  distinction  to  be 
made  between  Caucasian  so-called,  Indian  and  Chinese.  I'rohabb  it 
WOUld   be  best   to  have  one  item,  Ibice  or  (  lolor,  and   the  individual  Would 

then  be  designated  as  White,  Colored,  Indian,  or  Mongolian,  which 
would  meet  all  conditions  now  commonly  existing  in  the  United  States. 
( Occupation. 

In  Wisconsin  it  is  to  be  reported  "  whether  the  deceased  was  ever  a 
soldier  or  sailor  in  the  service  of  the  United  States. 

Place  of  Burial. 

The   Michigan   Law   requires   "  the  proposed  place  of  burial  or  place 

and  route  of  removal." 
(  'anse  of   I  )eath. 

Mosl  forms  for  returns  of  death  ash  for  Cause  of  death.'     Prii 
Secondary?    and   a etimes  a   line   is  given   for  complications. 


66  B.EG  is  TEA  TION  OF    I Y  7\  I  L    S  T.  I  TIS  TIC  1S. 

writer  has  found  that  much  confusion  exists  in  the  minds  of  physicians 
as  to  whether  Primary  ?  refers  to  time  or  to  the  importance  of  the  dis- 
eased condition.  Furthermore  many  feel  obliged  to  write  in  two  causes 
instead  of  one  in  every  case.  It  lias  been  found  possible  to  obtain  a 
better  picture  of  disease  conditions  by  dropping  the  words  primary  and 
secondary,  and  adding  several  blank  lines  to  encourage  a  detailed  ac- 
count of  the  case.  This  appears  to  be  quite  important.  It  is  utterly 
impossible  in  many  cases  to  give  a  correct  explanation  of  a  death  in  a 
single  line,  and  the  attempt  to  do  so  is  quite  likely  to  be  misleading. 
If  the  physician  can  be  induced  to  tell  the  story  at  some  length,  greater 
accuracy  is  more  likely  to  be  obtained.  The  Massachusetts  law  only 
requires  the  primary  and  secondary  causes  if  "  the  deceased  was  a 
soldier  or  sailor  who  served  in  the  War  of  the  Rebellion.*' 

Accuracy  in  stating  the  cause  or  causes  of  death  is  of  the  utmost 
importance  and  every  registrar  knows  that  a  considerable  proportion  of 
the  returns  coming  to  him  are  valueless  in  this  respect.  How  to  get 
better  results  is  one  of  the  most  important  problems  in  registration. 
Intelligence  and  education  on  the  part  of  the  medical  attendant  is  the 
chief  factor  in  correct  diagnosis,  and  whatever  tends  to  raise  the  stand- 
ard of  the  profession  in  these  respects  makes  for  more  perfect  registra- 
tion. Progress  must  be  slow,  but  the  adoption  of  the  practice  of  licens- 
ing physicians,  and  establishing  a  high  educational  qualification,  will  do 
much  for  registration,  as  it  will  also  for  sanitation  proper.  With  the 
licensing  of  a  physician  must  go  a  rule  forbidding  all  but  licensed  medi- 
cal men  signing  a  death  return.  Such  a  rule  is  now  in  force  in  a  few 
cities  as  the  District  of  Columbia,  Charleston,  Rochester,  and  St.  Louis. 
Even  the  best  educated  physician  at  times  cannot  arrive  at  the  true 
cause  of  death  without  an  autopsy.  We  cannot  expect  to  see  the  power 
to  make  autopsies  conferred  by  law,  but  it  is  easily  observed  that  the 
higher  the  education  and  abilities  of  the  physician  the  more  often  are 
autopsies  performed.  The  higher  the  intelligence  the  more  sensibly  are 
the  limitations  of  diagnosis  perceived,  and  the  more  urgently  and  suc- 
cessfully are  post  mortem  examinations  sought.  In  Denver1  the  health 
commissioner  is  authorized  to  order  an  autopsy  in  obscure  cases. 

I  Denver  Ordinances,  No.  44  of  1893,  Sec.  152 : 

II  Whenever,  in  the  opinion  of  the  health  commissioner  the  canse  of  death  of  any 
person  as  given  in  the  certificate  of  the  physician,  coroner  or  other  professional  at- 
tendant of  the  deceased  person  is  incorrect,  obscure  or  false,  and  it  is  in  the  health 
commissioner's  judgment  in  the  interest  of  the  public  health  that  such  cause  of 
death  shall  more  accurately,  truthfully  and  correctly  be  ascertained,  it  shall  be  the 
duty  of  the  health  commissioner  to  make,  or  cause  to  be  made,  a  post  mortem  exam- 
ination of  the  body  of  such  deceased  person,  and  to  this  end  he  is  hereby  empowered 
to  enter  upon  any  premises  in  order  to  discover  and  properly  examine  such  dead  body, 
or  to  cause  such  dead  body  to  be  disinterred,  if  it  has  been  already  buried.1' 


REGIS  TJL 1  TION   OF    VITA  I    S  T.  I  TIS  Tit  <S.  \  j  7 

It  is  not,  however,  likely  that  in  American  communities,  public 
opinion  would  permit  of  such  a  procedure  other  than  in  very  excep- 
tional cases. 

One  of  the  most  effectual  methods  of  improving-  the  character  of 
physicians'  returns  of  the  cause  of  death  is  by  letters  of  inquiry  sent  out 
by  the  registrar  who  receives  the  returns.  Busy  practitioners  arc  often 
careless  in  filling  out  returns,  and  frequently  they  do  not  appreciate 
the  importance  of  certain  points  which  are  of  the  greatest  value  in 
compiling  statistics.  Mistakes  and  ommissions  in  returns  of  death  can 
be  largely  overcome  by  correspondence  between  the  registrar  and  the 
physicians.  In  Providence  a  blank  form  is  used  for  convenience  in 
sending  out  these  inquiries,  a  stamped  return  envelope  is  enclosed,  and 
it  is  seldom  that  such  a  communication  fails  to  elicit  a  courteous  and 
satisfactory  response.  The  following  by-laws  are  enforced  by  the  board 
of  health  of  the  City  of  New  York: 

"  Certificates  of  death  willb<  returned  for  additional  information,  which  give  any 
<>f  the  following  diseases,  without  explanation,  as  the  sole  cause  <>f  death  : 
Abortion,  Erysipelas,  Meningitis,  Phlebitis, 

Cellulitis.  Gangrene.  .Metritis.  Py»mia, 

Childbirth,  Gastritis,  Miscarriage,  Septicaemia, 

Convulsions,  Hemorrhage,  Peritonitis,  Tetanus. 

(Am  one  of  these  may  be  t  he  result  of  an  injury,  and  thus  lie  a  subject  for 
investigation  by  a  coroner.     If  it  is  ma.  the  certificate  should  make  that  facl  plain.  1 

No  certificate  will  be  accepted  which  gives  a  mere  symptom  as  the  sole  <-;ei^c  of 
death  (such  as  'asphyxia,'  'debility,1  'dropsy,1  'heart failure,1  etc'.  1.  unless  accom- 
panied by  a  satisfactory  written  explanation." 

To  prevent  ;t  common  form  of  unsatisfactory  and  careless  return  it 
is  provided  in  Maine  and  Connecticut  l>\  statute,  and  in  Philadelphia 
by  regulation,  that  death  certificates  with  -heart  failure"  as  a  can-'  oi 
death  will  not  be  received  :  and  in  Wisconsin  and  Iowa  this  cause  will 
not  l»e  received  on  a  transportation  permit.  In  the  latter  state  the 
reason  is  given  that  it  was  used  by  unscrupulous  persons  to  conceal 
death  from  contagious  disease.1 

Another  difficulty  in  the  wa\  of  obtaining  a  satisfactory  legist  ration 

of  causes  is  the  fact  that  a  ceil  a  in  number  of  deal  lis  occur  w  it  ho  ill  the 
attendance  of    a  medical     man.       It   is  necessary  that   all    such  should    be 

Investigated  l>\  some  competent  person.  Of  course  if  violence  is  sus- 
pected, it  is  a  proper  case  for  the  medical  examiner  or  coroner  whose 
report  will  he  returned  in  due  season,  as  is  provided  for  l>\  the  laws 
governing  such  cases ;  bul  often  persons  die  suddenl}  when  there  is  no 
suspicion  id'  violence,  and  it  is  these  that  need  special  investigation. 
In    Alabama   the  count}  health   officer  is   to  "make  such   1  irtifi 

1  [owa,  hep, ,n  of  the  State  Board  of  Health  1801,  p.  104. 


68  REGISTRATION  OF    VITAL    STATISTICS. 

otherwise  a  proper  certificate  cannot  be  obtained/'  In  Connecticut,1 
"in  case  no  physician  attended  such  deceased  person,  or  in  case  of  the 
inability  of  the  attending  physician,  by  reason  of  sickness,  death,  or 
absence,  to  make  out  said  certificate,  the  nearest  of  kin  shall  procure 
such  certificate  from  some  other  reputable  physician  or  member  of  the 
board  of  health  of  the  town  in  which  such  person  died." 

In  California  and  Utah  when  there  is  no  physician,  the  cause  of 
death  must  be  sworn  to  by  two  reputable  citizens  (except  that  in  Utah 
cities  the  case  is  to  be  investigated  by  the  health  officer)  and  in  New 
York  in  non-medico-legal  cases,  it  must  be  "  sworn  to  by  some  credible 
person  known  to  the  officer  granting  the  permit."  In  Atlanta  and  Buf- 
falo the  city  physician  is  to  certify  to  all  deaths  without  a  medical 
attendant,  and  in  Cleveland  it  is  a  similar  officer  known  as  the  district 
physician.  In  New  York  when  no  physician  is  in  attendance,  an  affi- 
davit must  be  attached  to  the  certificate  stating  the  circumstances  of 
death.  In  Massachusetts  the  chairman  of  the  board  of  health  or  any 
physician  employed  by  any  city  or  town  for  that  purpose  shall  sign  the 
certificate.  In  Michigan  the  registrar  is  to  refer  such  returns  to  the 
health  officer,  except  that  when  the  health  officer  is  not  a  physician  the 
registrar  is  to  fill  the  return  to  the  best  of  his  ability.  In  New  Hamp- 
shire the  town  clerk  is  to  get  the  facts  from  relatives.  In  Wisconsin 
any  physician  or  justice  of  the  peace  may  be  employed  to  sign  the 
return  where  there  has  been  no  physician  in  attendance.  In  New 
Jersey  if  no  physician  attended  such  deceased  person,  or  if  the  attend- 
ing physician  is  absent  or  sick  any  physician  may  view  the  body  and 
sign  the  certificate.  The  best  provision  appears  to  be  that  of  the 
Rhode  Island  law:2 

"  Whenever  the  body  of  a  person  is  lying  dead  in  any  town  or  city  who  has  been 
unattended  by  a  physician  in  his  or  her  last  sickness,  the  town  or  city  clerk,  or  in 
the  city  of  Providence  the  city  registrar,  shall  call  upon  a  registered  physician  or  the 
medical  examiner  of  the  district  in  which  the  remains  are  lying,  to  inquire  into  and 
to  certify  as  to  the  cause  and  manner  of  death,  and  shall  allow  to  said  physician  or 
medical  examiner  the  fee  of  two  dollars  which  shall  be  paid  out  of  the  town  or  city 
treasury  of  said  town  or  city  upon  the  order  of  said  town  or  city  clerk  or  registrar.'1 

In  Providence  the  registrar  has  under  this  law  requested  the  chief 
of  police  to  instruct  his  officers  to  promptly  report  all  sudden  deaths  or 
deaths  without  medical  attendance  to  the  medical  examiner.  If  the 
latter  decides  that  there  is  a  suspicion  of  violence  he  makes  it  a  medical 
examiner's  case  and  receives  his  fee,  four  dollars  from  the  state.     If  it 


1  Connecticut,  Chapter  155  of  1893,  Sec.  1. 

2  Rhode  Island,  Chapter  452  of  the  Public  Laws,  amending  Sec.  9  of  Chapter  100 
of  the  General  Paws. 


REG  IS  TEA  TION  0  F    VI T.  i  I    s  r.  1  77  8  77  C&  69 

is  not  a  medical  examiner's  case  he  reports  the  probable  cause  of  death 
to  the  registrar  and  receives  two  dollars  from  the  city.  By  this  method 
satisfactory  returns  are  promptly  obtained.  If  cases  without  suspicion 
of  violence  are  reported  to  the  registrar  by  undertakers  or  any  others 
than  the  police,  the  registrar  sends  the  medical  inspector  of  the  depart- 
ment to  investigate  the  case. 
Undertaker's  Name  and  Address. 

Wherever  the  undertaker  is  wholly  or  partially  responsible  for  returns 
of  death  he  is  required  to  sign  the  same,  and  sometimes  as  in  Michigan 
his  address  is  to  be  given.  In  Massachusetts,  New  Jersey,  Denver, 
the  City  of  New  York,  and  Pennsylvania  cities  of  the  second  class,  the 
place  of  business  of  the  undertaker  is  to  be  given  and  in  Cleveland  his 
office  or  residence. 
Physician's  Name  and  Address. 

Usually  it  is  deemed  sufficient  for  the  physician  to  certify  as  to  the 
cause   of  death,  but   sometimes    as    in    Michigan,    Massachusetts,    New 
Jersey.  New  York,  Buffalo,  Detroit,   Denver,   and    Pennsylvania  cities 
of  the  second  class  his  address  is  to  be  given. 
Birthplace. 

The  Pennsylvania  law  requires  the  "street  and  number  if  possible,'' 
and'the  Michigan  law  the  "  state  or  county  if  not  born  in  Michigan.'1 
It  is  often  impossible  to  determine  the  exact  place  of  birth,  but  it  is 
usually  possible  to  ascertain  whether  or  no1  it  was  in  the  United  Slates. 
As  this  is  of  great  importance  for  statistical  purposes  it  is  necessary 
for  the  registrars  to  instruct  undertakers  and  other  reporters  concern- 
ing it.  Sometimes  nativity  is  required  instead  of  birthplace,  in  which 
case  the  country  of  birth  or  nationality  is  intended. 
Names  of  Parents. 

In  Pennsylvania  tins  is  only  required  in  case  of  minors,  and  in 
Charleston  in  the  case  of  unnamed  infants.  By  name  of  mother  is 
usually  meant  and  often  specified   the  maiden  name. 

Birthplaces  of  Parents. 

It  is  highPj  desirable  that  theseshould  be  given  it  possible,  ami  the] 
are  asked  lor  on  the  returns  of  .Maine,  Massachusetts,  Michigan,  New 
Hampshire,  and  Rhode  [sland.  In  Delaware  the  "name  and  nation  of 
the  parents"is  asked  for.  Here  again  the  distinction  between  the 
United  States  and  foreign  countries  can  usually  be  made  even  when 
more  accurate  data  are   Lacking,  and  should  always  be  insisted  on.     It 

is  probably  this  distinction  of  native  and   foreign  that   is  intended  where 
merely  nativity  of  parents  is  asked  lor  as  in  the  I  Ynnsyh  ania  ■•ltd 

but  full  information  should  be  (riven  if  it  can  be  obtained. 


7()  REGISTRATION   OF    VITAL    STATISTICS. 

Duration  of  the  Disease. 

Usually  the  duration  of  both  primary  and  secondary  causes  of  death 
is  asked  for,  and  in  Providence  this  distinction  is  retained  under  dura- 
tion although  it  is  omitted  from  cause. 

Other  items  are  occasionally  noted  on  death  returns. 
The  Date  when  Physician  last  saw  Patient. 

This  is  required  in  Charleston,  where  the  physician  is  to  subscribe 
to  the  following :     "  I   hereby  certify   that   I  attended  deceased  from 

18 to  18  that  I  last  saw  alive   on  the 

day  of 18 " 

A  similar  form  is  used  in  Michigan,  New  Jersey,  and  New  York. 

Place  where  Disease  was  Contracted. 

Among  the  items  required  by  the  Colorado  law  are  -when  and 
where  the  disease  was  contracted,"  and  the  same  phrase  with  the 
proviso,  "  if  known.*'  is  found  in  the  rules  of  the  Omaha  department  of 
health  and  upon  the  certificate  in  Mobile. 

Term  of  Residence. 

In  Buffalo,  Charleston,  the  District  of  Columbia,  Minneapolis,  and 
Pennsylvania  cities  of  the  second  class,  the  time  of  residence  in  the 
place  of  decease  is  to  be  given.  In  Buffalo,  Charleston,  and  the  City 
of  New  York,  if  the  deceased  was  of  foreign  birth,  the  duration  of  resi- 
dence in  the  United  States  as  well  as  in  the  city  must  be  given.  In 
Minneapolis,  New  Jersey,  and  Iowa,  the  time  of  residence  in  the  state 
is  asked  for. 
Place  of  Previous  Residence. 

In  Pennsylvania  cities  of  the  second  class,  the  place  of  previous 
residence  is  required,  and  also  in  Cincinnati,  but  only  -in  case  of  non- 
residents"; this  is  practically  the  same  as  -  usual  residence."  So  also 
in  Charleston  the  returns  from  institutions  must  give  the  residence 
before  admission. 

Date  of  Burial. 

This  is  required  in  Maine,  New  Hampshire,  Pennsylvania,  Cleve- 
land: and  in  Buffalo,  Cincinnati,  and  Detroit,  the  day  and  hour  of  the 
funeral. 

Name  of  Wife. 

In  the  case  of  married  women  and  widows  the  name  of  the  husband 
is  usually  required.  .  In  the  case  of  a  married  man  the  name  of  the  wife 
is  required  in  Rhode  Island.  Virginia.  Wisconsin,  and  Detroit. 

Age  at  First  Marriage. 

This  is  one  of  the  questions  to  be  answered  on  returns  of  death  in 
Michigan. 


REGISTRATION  OF    VITAL    STATISTICS.  ~\ 

Parent  of  how  many  Children,  of  whom  how  many  are  living. 

It  is  evident  that  if  these  questions  could  be  truthfully  answered 
we  could  speedily  reach  conclusions  as  to  the  absolute  fertility  of  our 
population,  and  the  relative  fertility  of  different  classes.  We  have  as 
yet  nowhere  in  the  United  States  been  able  to  settle  these  questions  by 
an  enumeration  or  registration  of  births.  The  results  of  the  experi- 
ments in  .Michigan  will  he  awaited  with  much  interest.  Their  value 
must  depend  entirely  upon  the  degree  of  accuracy  with  which  the 
answers  to  these  queries  can  lie  obtained. 

The  number  and  date  of  the  burial  permit  must  he  noted  on  the 
death  return  in  Wisconsin.  The  Michigan  law  requires  that  the  return 
he  numbered,  and  the  blanks  furnished  in  New  York,  have  ;i  place 
for  a  serial  number.  The  Minnesota  blanks  have  a  place  for  date  of 
return.  In  Connecticut  the  date  when  the  certificate  is  received  is  en- 
dorsed on  the  back,  and  in  Massachusetts  the  date  of  filing  is  noted  on 
the  back. 
Name  of  Informant. 

The  personal  and  family  particulars  required  for  a  return  of  a  death 
must  usually  he  furnished  by  some  one  other  than  the  undertaker  or  the 
physician.  The  Michigan  law  prescribes  that  the  person  who  gives  the 
information  shall  sign  the  return  and  append  his  address.  Iii  Rhode 
[sland  the  name  of  the  informant  is  required  (but  not  the  signature). 
and  in  New  Orleans  the  ••name,  age  and  residence  of  the  declarant  and 

his  relationship,  if  any.  to  the  deceased.*"       It   is  of  great  convenience  to 

the  recording  officer  and  conduces  to  accuracy  if  the  items  on  the  return 

arc  arranged  as  nearly  as  possible  in  the  same  order  that  they  are  on  the 
permanent  record  if  such  record  is  to  he  made.  Forms  of  death  returns 
arc  shown  in  Appendices  8  to  1  -1. 

Births. 

Records  of  births  like  records  of  deaths  are  obtained  in  various 
ways.  One  method  is  1>\  enumeration.  This  method  is  vm  unsatis- 
factory, but    is  employed  in  Michigan,  Ohio  (excepl  in  cities  of  the  firsl 

class),  and  Pennsylvania,  and    Iowa   in  1898  went  back  to  this  thod. 

Until  1896  ii  was  the  onlj   thod  in  Rhode  Island.     Besides  the  above 

states,  Kansas,   Maine.    Massachusetts,   New    Jersey  and    Rhode   Island 
supplement  the  reports  of  physicians   l>\    an    annual   enumeration.     In 
Michigan    the   township  supervisors  between    1"  April   and    1  Jun 
each   year  make  an  enumeration  of  all  births  occurring  during  the  year 
ending  on  the  ;Mst  of  the  preceding  December,  and  forward  the  returns 

to  the  count}  clerk:  except  thai    in  Detroil   the  comn :ounci] 

appoint  persons  especiall}  for  this  work.     In  Pennsylvania  the 


72  REGISTRATION   OF    VITAL   STATISTICS. 

make  the  enumeration  semi-annually.  In  Kansas,  Maine,  New  Jersey, 
and  Ohio  the  assessors  make  the  enumeration  annually,  and  in  Massa- 
schusetts  and  Rhode  Island  the  town  clerks  make  the  enumeration  in 
January  of  each  year ;  but  in  Providence  the  city  registrar  makes  the 
enumeration  semi-annually.  This  method  is  very  unsatisfactory,  and  in 
the  city  of  the  writer  skilled  enumerators  fail  to  obtain  nearly  forty  per 
cent,  of  the  births. 

The  usual  method  of  securing  birth  records  in  the  United  States  is 
to  require  reports  from  the  attending  physician  or  midwife.1 

Usually  it  is  the  physician  or  midwife  or  accoucheur  who  is  to  re- 
port, and  sometimes  it  is  "  any  other  person  in  charge,"  as  in  Maine. 
In  Delaware2  it  is  the  "physician  present  at  the  birth  of  any  child,  or  (if 
not  present  at  the  birth  of  the  child)  who  attends  the  case  of  any  mother 
during  her  lying-in  period,"  ..."  and  every  midwife  present  at 
the  time  of,  or  within  five  days  after  the  birth  of  any  child,  where  no 
physician  is  attending  said  case."  In  Alabama,  California,  and  in  a  few 
cities,  as  Brooklyn,  New  York,  Chicago,  Cleveland,  Denver,  Omaha,  and 
the  Pennsylvania  cities  of  the  second  class,  the  physicians  are  to  keep 
registers  of  all  births  attended. 

Another  method  is  to  require  the  parents  or  householder  to  report 
the  births  of  their  children  or  such  as  occur  in  their  families.  Wiscon- 
sin is  the  only  state  which  relies  upon  this  method  alone,  and  as  the  law 
only  went  into  effect  1  July,  1897,  it  has  never  as  yet  had  a  fair  trial 
in  this  country.3  There  are,  however,  a  number  of  states  in  which  the 
parents  and  head  of  the  family  are  made  equally  responsible  with  the 
physician  in  reporting  births,  the  same  persons  usually  being  specifically 
mentioned  that  are  named  in  the  corresponding  sections  of  the  law- 
requiring  reports  of  deaths.  Sometimes  the  responsibility  rests  on  both 
parent  and  physician,  and  sometimes  the  parent  is  required  to  report 
only  when  there  is  no  physician  or  midwife  in  attendance.  In  New 
Orleans4  "it  shall  be  the  duty  of  the  father,  or,  in  his  default,  of  any 
person  present   at   the   birth  of  any  child,  to  report  within  twenty-four 


1  The  following  states  have  such  laws  upon  their  statute  books:  Alabama,  Cali- 
fornia. Colorado,  Connecticut,  Delaware,  Florida,  Illinois,  Indiana,  Kansas,  Ken- 
tucky, Maine,  Maryland,  Massachusetts,  Minnesota,  New  Hampshire,  New  Jersey, 
New  York,  North  Dakota,  Rhode  Island,  Utah,  Vermont,  Washington  and  Wis- 
consin. It  is  also  required  in  the  cities  of  Atlanta,  Florence,  S.  C,  Memphis, 
Mobile,  Omaha,  Philadelphia,  the  Pennsylvania  cities  of  the  second  class,  and 
Scranton. 

2 Delaware  Revised  Code  (1893),  p.  405  (Chapter  381,  Vol.  16,  Laws  of  Delaware.) 

3  This  law  was  repealed  in  1899,  and  reports  are  now  required  from  physicians  and 
midwives,  as  well  as  from  parents. 

*  Louisiana,  Chapter  80  of  1877,  Sec.  9. 


REGISTRATION   OF    VITAL    STATISTICS. 


i  •> 


hours  from  the  date  of  said  birth,  at  the  office  of  the  board  of  health, 
such  birth,  which  report  shall  be  recorded  in  presence  of  two  witnesses." 

In  Providence  for  a  year  or  two  before  the  enactment  of  the  statute 
requiring  physicians  and  mid  wives  to  report,  physicians  were  requested 
to  report  births,  and  clergymen  baptisms,  and  they  were  paid  ten  cents 
for  each  birth  and  baptism  reported.  With  a  little  urging,  reports  were 
obtained  from  most  of  the  Catholic  and  Episcopal  churches  and  from 
many  of  the  physicians.  After  the  statute  went  into  effect  requiring 
reports  from  physicians,  the  report  of  baptisms  was  no  longer  sought, 
except  from  the  French,  Italian,  and  Portuguese  churches.  It  is  found 
that  the  reports  from  these  churches  are  still  needed  to  complete  and 
correct  returns  received  from  other  sources. 

The  Vermont  statute  provides  that  the  head  of  a  family  moving  into 
the  state  may  have  the  births  of  his  children  recorded. 

Examples  of  forms  for  birth  returns  are  shown   in  Appendices  12 
and  13. 
Time  Limit  for  Reports. 

In  California,  Colorado,  Delaware,  and  Utah  the  returns  of  births 
must  be  made  by  doctors  and  midwives  quarterly.  In  Massachusetts 
parents  must  report  in  forty  days.  In  Connecticut,  Maryland,  Massa- 
chusetts, and  Rhode  Island  physicians  must  report  monthly.  In  Con- 
necticut and  Rhode  Island  physicians  and  midwives  must  report  during 
the  first  week  of  the  next  month,  and  in  Maryland  and  Massachusetts 
during  the  lirst  five  days  of  the  succeeding  month.  In  Illinois.  New 
Jersey,  New  York,  Washington,  and  Wisconsin  the  time  is  thirty  days: 
in  Minnesota,  Vermont,  Cincinnati,  Cleveland,  the  Citj  of  New  Y^ork, 
Paterson,  Pennsylvania  cities  of  the  second  class,  and  Scranton,  ten 
days,  in  St.  Louis  and  Mobile,  seven  days,  ami  in  Maine.  New  Hamp- 
shire,   and    the     District     of    Columbia,    six    days:     in     North      Dakota, 

Chicago,  St.  Paul,  and  Memphis,  five  days,  for  midwives  in  Maryland 
four  days:  in  Buffalo  and  Charleston,  three  days,  and  in  Omaha  and 
New  Orleans,  twenty-four  hours.  Promptness  is  evidently  desired,  but 
it  is  to  be  feared  that  it  is  frequently  not  obtained.  Physicians,  left  to 
their  own  devices,  are  apt  to  he  dilatory.  Sometimes  efforts  are  made 
to  secure  promptness  otherwise  than  by  the  threat  of  penalties.  In 
New-  Jersey  the  Law  requires  that  the  assessors  shall  annually,  in  April, 

send  to  the  physicians  twelve  stamped  and  addressed  envelopes  in  which 

the\  shall  semi  in  their  returns  monthly.  In  Providence  physicians 
are  furnished  with  return  envelopes,  and  doubtless  this  practice  is  fol- 
Lowed  in  other  cities,  In  Cincinnati  the  sanitarj  police  keep  a  list  ot 
clergymen,  doctors,  and  midwives,  and  call  on  them  monthly  lor  then 
returns.     In  Philadelphia  there  are  two  collectors  of  vital  statistics  who 


74  REGISTRATION  OF    VITAL    STATISTICS. 

visit  practitioners  of  midwifery  monthly  to  collect  returns  of  births. 
Nevertheless  the  number  of  births  recorded  in  these  two  cities  is  doubt- 
less much  less  than  the  number  which  actually  occurs.  In  Chicago, 
where  the  Illinois  law  has  for  twenty  years  required  that  doctors  and 
midwives  shall  report  births  without  compensation,  the  returns  were 
very  defective.  Physicians  would  not  take  the  trouble  to  make  out  a 
long  report  and  send  it  in  at  their  own  expense  without  compensation. 
To  lessen  their"  labor  the  commissioner  of  health  now  distributes  postal 
cards  on  which  only  the  items  necessary  for  identification  are  to  be 
given.     The  form  of  card  used  is  shown  below.1 

On  receipt  of  this  card  the  registrar  proceeds  to  obtain  from  the 
parents  the  rest  of  the  required  information  ;  by  this  means  the  commis- 
sioner. Dr.  Arthur  K.  Reynolds,  succeeded  in  a  few  months  in  securing 
a  twelvefold  increase  in  the  number  of  births  reported.  Another 
method  of  securing  an  interest  in  the  subject  and  consequently  better 
returns  may  be  described  in  the  commissioner's  words: 


1  Report  of  a  Birth. 

"Sections  1485,  1486,  of  the  Laws  and  Ordinances  of  the  City  of  Chicago,  require 
that  any  Physician,  Midwife  or  other  person  who  attends  upon  a  birth  shall  report 
the  same  to  the  Department  of  Health  within  five  (5)  days  after  its  occurrence. 

Filling  out  this  Card  and  its  deposit  in  a  letter  box  will  fulfill  the  requirement 
and  avoid  the  penalty  for  neglect. 

The  Recorder  of  Births  will  furnish  these  Carols  on  request. 

To  the  Recorder  of  Births :  Chicago, 189 ... . 

Doctor  :     A  living child  was  horn  to 

(1.     Male  or  female.     Parentage,  if  other  than  White.) 

(2.     Full  name  of  one  Parent. ) 

at Ward 

(3.     Exact  address  of  place  of  birth.) 

on  the day  of 189 .... 

(4)  (4) 


Attendant : 


Address: 


Carefully  Follow  These  Instructions:  Wbite  in  the  numbered  blank  spaces 
above  — 

1.  Male  or  female,  as  the  case  may  be.  If  the  child  is  not  of  white  parentage, 
add.  after  the  word  'male1  or  -female,'  the  word  African,  Indian.  Chinese,  etc. ^ 
as  the  case  may  be.  If  a  still-birth,  strike  out  the  word  'living.1  2.  Full  name  of 
Mother  or  Father.  :!.  Number  of  House,  name  of  Street,  and  number  of  Ward. 
4.  Day  and  Month  of  Birth.  5.  Name  and  address  of  Attendant;  if  a  Physician,  add 
the  letters,  M.  D. 


REGISTRATION  OF    VITAL    STATISTICS.  75 

'•  With  a  view  to  increasing  interest,  and  so  to  securing  fuller  returns,  the  Com- 
missioner obtained  the  publication  in  some  of  the  city  evening  papers  of  all  births 
reported,  on  representing  to  the  editors  that  birth  notices  should  he  as  interesting 
to  their  readers  as  'death  notices,1  to  which  space  is  readily  given.  Sneh  hesita- 
tion as  was  met  with  at  once  yielded  when  it  was  urged  that  a  knowledge  of  the 
city's  birth  rate  was  important  for  various  reasons,  that  the  publication  of  births 
would  aid  in  securing  such  knowledge,  and  that  it  was  a  recognized  function  of  the 
public  press  to  secure  and  publish  information  of  service  to  the  public  interests  as 
well  as  to  the  individual. 

Publication  was  begun  on  August  12th,  and  the  results  were  at  once  apparent. 
During  the  TO  days  prior  to  August  15th  there  were  5,122  births  reported  —  an  aver- 
age of  67  per  day.     During  the  succeeding  70  days,  up  to  the  close  of  <  ►ctober 
births  were  reported  — an  average  of  90  per  day,  and  an  increase  of  34  per  cent. 

The  publication  embraces  the  name  of  mother  and  her  residence,  sex  of  child 
(son  or  daughter),  and  name  of  attendant.  To  meet  the  objection  of  some  physicians 
to  the  alleged  quasi-advertising  flavor  of  this  publication  it  was  found  necessary  to 
furnish  a  special  card  for  the  exclusive  use  of  physicians;  and  the  raid  tirsi  pre- 
pared—  copy  above  given  —  is  now  used  by  midwives  only. 

This  Physician's  Eeport  of  a  Birth  card  has  the  letters  lM.  I>."  added  to  the  line 
for  the  attendant's  name  and  the  following  note  at  the  bottom  of  the  raid: 

'If  the  Physician  notes  an  objection  to  the  publication  of  this  birth, 
or  of  uis  Name  as  Attendant,  the  objection   wtli    be  respected."1 

It'  physicians  report  births  promptly,  they  certainly  cannot,  in  manj 

5,  give  the  name  of  the  child.     To  obtain  this  for  the  record  it   is 
accessary  for  the  recording  officer  to  communicate   with   the   parents. 
For  this  purpose  special  blanks  arc  often  provided.     The  form  used   in 
Maine  is  shown  in  Appendix  15. 
Items  required  for  Birth  Records. 

For  purposes  of  identification  a  birth  record  should  have  the 
Name, 
Sex, 

I  >ate  of  Birth, 
Place  of  Birth, 
Parents'  Names  and  Parents'  Residence. 

A  considerable  number  of  other  items  are  desirable   both  for  identifi- 
cation and  for  scientific  purposes. 
I  >ate  of  birth. 

Under  this  heading  it   is  often  specified   that  the  hour  id'  birth  shall 
be  given,  and   sometimes,  as  in  Wisconsin,  the  da\  oi   the  week  us  well 
as  i he  day  of  t he  month. 
.Maiden  Name  of  Mother  is  required   in    almost  all  records  oi  births. 

Father's  Occupation   is  also   very   useful   for  identificati md   is   fre 

quently  required. 

Name  of  Physician  or  other  Reporter  is  always  to  be  signed  to  returns 
of  lpirth  made  by  them,  and  in  Connecticut  and  a  few  other  places  the 
physician's  address  is  to  be  given  also. 


76  REGISTRATION  OF    VITAL   STATISTICS. 

Date  of  Certificate  is  often  required,  as  is  also  the 
Date  of  Return. 

Sometimes,  as  in  Massachusetts,  the  date  of  return  or  of  filing  the 
return  is  to  be  noted  on  the  back. 

A  serial  number  is  often  placed  on  returns  beginning  with  the  first 
return  of  each  year. 

A  number  of  other  items  are  sometimes  added  for  the  sake  of  their 
scientific  interest.     Among  them  are 
Color,  which  is  required  in  most  returns. 
Race  is  required  in  Alabama  and  California, 

■Color  of  Parents  is  required  in  Connecticut,  Maine,  New  Hampshire  and 
Rhode  Island. 

Nativity  of  Parents  is  required  in   Connecticut,  Michigan,  Minnesota, 
New  Jersey,  and  the  District  of  Columbia. 
Birthplace  of  Parents. 

Instead  of  nativity,  birthplace  is  required  in  Maine,  Massachusetts, 
New  Hampshire,  Pennsylvania  cities  of  the  second  class,  Rhode  Island, 
Wisconsin,  Cleveland,  and  the  City  of  New  York. 

Parents'  Age  is  required  in  Delaware,  Connecticut,  Minnesota,  New 
Hampshire,  Rhode  Island,  Cleveland,  and  the  City  of  New  York. 
Number  of  the  Child  of  the  Mother,  that  is  the  number  of  children 
the  mother  has  had,  including  the  one  named  in  the  return.  This  as 
well  as  the  preceding  is  useful  for  identification,  but  it  is  chiefly  for 
its  scientific  value  that  it  should  be  recorded.  It  is  required  in  Con- 
necticut, Delaware,  Iowa  under  the  old  law,  Maine,  Minnesota,  New 
Hampshire,  New  York,  and  Rhode  Island.  In  New  Jersey  the  num- 
ber of  children  by  this  marriage  are  required,  and  in  Wisconsin  "the 
names  of  other  issue  living  (born  of  the  same  parents)."  In  New 
York  in  addition  to  the  number  of  children  born  the  number  now 
living  is  required.  When  the  number  of  children  is  required  together 
with  the  age  of  the  mother,  valuable  information  can  be  obtained  in 
regard  to  fertility  at  different  ages.  When  the  number  of  the  child 
and  nativity  or  birthplace  of  the  parents  is  obtained  together  with  their 
ages,  much  may  be  learned  of  the  fertility  of  different  nationalities. 
Child's  Number  in  the  Family  is  required  in  Delaware  and  must  be 
of  value  from  a  sociological  point  of  view  as  showing  the  size  of  the 
family. 
Still-born. 

Whatever  is  done  with  still-births,  whether  they  are  recorded  with 
births,  with  deaths,  or  separately,  it  is  often  considered  advisable  to 
provide  on  birth  returns  opportunity  for  designating  whether  or  not  the 
child    is    still-born.       Such   an   item   is  found  in  Colorado,   Kentucky, 


REGISTRATION  OF    VITAL    STATISTICS.  77 

Maine,  New  Hampshire,  and  the  District  of  Columbia,  and  special 
blanks  for  still-births  are  used  in  New  Jersey,  New  York,  in  Iowa  under 
the  old  law,  and  in  Pennsylvania.  In  Rhode  Island  and  Wisconsin  the 
fact  of  still-birth  is  to  be  noted  under  -remarks"  as  it  doubtless  is  in 
other  places. 
Illegitimacy. 

This  condition  has  received  little  recognition  in  American  registra- 
tion laws.  In  Virginia  the  law  requires  the  name,  occupation  and 
residence  of  the  father  "if  the  child  be  bora  in  wedlock"  and  presum- 
ably they  are  to  be  omitted,  if  not  so  born.  In  New  -Jersey  and  New 
York  if  the  child  is  born  out  of  wedlock  and  the  father's  name  is  not 
given  the  letters  ( ).  W.  are  to  appear  on  the  return.  In  Iowa,  under 
the  old  law,  it  was  to  be  stated  whether  the  child  was  born  in  wedlock 
or  not. 

The  Massachusetts  law  is  as  follows  r1 

"  In  the  record  of  the  birth  of  an  illegitmate  child  the  name  and  other  facts  re- 
lating to  the  father  shall  not  be  recorded  unless  at  the  joint  request  in  wiitiny  of 
both  father  and  mother.  The  term  '  illegitimate,1  shall  not  be  used  in  the  record 
of  a  birth  unless  the  fact  has  been  legally  determined  or  upon  the  sworn  statement 
of  both  the  father  and  mother." 

In    Rhode    Island   and  Wisconsin   illegitimacy  is  to  be  noted   in  the 
space  on  the  return  left  for  remarks. 
Part  Presenting  is  to  be  noted  on  returns  of  births  in    Mobile. 

STILL-BIRTHS. 

Still-births  may  be  recorded  as  births,  or  as  deaths,  or  as  both,  in 
Massachusetts,  Rhode  Island.  Vermont,  and  sometimes  in  Connecticut, 
and  in  each  event  the  usual  blank  for  returning  births  and  deaths  is 
employed.  In  Massachusetts  it  is  required  thai  the  word  still-born 
shall  be  entered  in  the  record  of  both  birth  and  death.  But  in  some 
states  and  cities  special  blanks  are  used  which  differ  somewhal  from 
those  used  for  either  births  or  deaths.  The  form  used  in  New  Jerse} 
is  shown  in  Appendix  L6  and  is  substantially  the  same  as  that  used  in 
other  places. 

MARRIAGES. 

While  the  registration  of  marriages  bears  no  immediate  relation  to 
sanitary  science  or  practice,  it  is  considered  in  this  connection  because 
the  registration  is  usually  performed  bj  the  same  officer  who  registers 
births  and  deaths,  and  because  ii  seems  to  the  writer  that  there  is  no 
question  thai  these  latter  should  be  registered  b\    the  sanitary  offi 

1  Massachusetts,  Chapter  444,  of  1887,  Sec.  1. 


78  REGISTRATION  OF    VITAL    STATISTICS. 

at  least  in  all  municipalities  of  considerable  size,  and  perhaps  in  all 
communities. 

There  is  little  doubt  that  a  most  important  requisite  for  complete 
registration  is  a  requirement  that  a  license  shall  be  issued  to  the  con- 
tracting parties  before  the  marriage  is  solemnized.  Clergymen,  justices 
of  the  peace  and  others  authorized  to  solemnize  marriages  are  probably 
as  forgetful  and  careless  as  other  people.  Under  the  most  favorable 
circumstances  a  certain  number  of  certificates  of  marriage  are  not  re- 
turned by  the  officiating  parties  as  required.  If  complete  returns  are 
desired  everything  should  be  done  to  facilitate  the  return  of  the  certi- 
ficate. If  the  clergyman  has  a  blank  already  filled  except  for  one  or 
two  small  items,  he  is  less  likely  to  neglect  to  return  it  than  if  an  ex- 
tended form  has  to  be  filled  by  him.  It  is  also  important  that  the 
marriage  record  should  be  accurate  as  well  as  complete.  The  registra- 
tion officer  is  much  more  likely  to  feel  the  necessity  of  this  than  is  the 
person  who  officiates  at  the  marriage.  Experience  has  amply  proven 
that  records  of  marriage  are  much  more  nearly  accurate  when  they  are 
made  from  a  license  prepared  in  the  record  office  and  requiring  only  the 
signature  of  the  person  officiating  to  become  a  certificate  of  the 
marriage.  The  following  data  in  regard  to  marriages  are  largely  taken 
from  a  special  report  on  "  Marriage  and  Divorce  "  prepared  by  Hon. 
Carroll  D.  Wright,  United  States  Commissioner  of  Labor. 

The  following  is  a  list  of  the  states  and  territories  which  require  a 
license  as  a  preliminary  to  marriage,  also  the  officer  who  issues  the 
same  and  the  fee  required : 

State.                                                             Officer  Issuing.  Fees. 

Alabama Probate  Judge 81  50 

Arizona Probate  Judge 50 

Arkansas Clerk  of  County  Court 2  50 

California County  Clerk 2  50 

Colorado County  Clerk 1  00 

Connecticut Registrar,  Births,  Marriages,  Deaths 50 

I >elaware Clerk  or  Justice  of  Peace $2  33 — 2  83 

District  of  Columbia Clerk  of  Supreme  Court 1  00 

Florida Clerk  of  Circuit  Court 2  00 

■Georgia Ordinary,  or  Clerk  to  Ordinary 1  50 

Idaho County  Recorder 1  00 

Illinois County  Clerk 1  00—1  50 

Indiana Clerk  of  Circuit  Court 2  00 

Iowa Clerk  of  Circuit  Court 1  00 

Kansas Probate  Judge 2  00 

Kentucky County  Clerk 1  50 

Louisiana Clerk  of  District  Court -  00 

Maine Town  Clerk 50 

Maryland Clerk  of  Circuit  Court 1  00 

Massachusetts Town  Clerk  or  Registrar 50 

Michigan County  Clerk- 50 


1-2 

:; 

oo 

1 

00 

2 

mi 

1 

50 

2 

00 

1 

00 

50 

1 

50 

75 

1 1— ■_' 

67 

50 

1 

00 

1 

00 

1 

50 

50 

1 

mi 

■  • 

00 

1 

50 

3 

00 

RE(r  is  Til,  I  TION   0  F    I V  7\  I  L    8  7\  I  TIS  Tit  '& 

State.  Officer  Issuing. 

Minnesota Clerk  of  District  Court 

Mississippi Clerk  of  Circuit  Court 

Missouri County  Recorder 

Montana Probate  Judge 

Nebraska County  Judge 

Nevada County  Clerk 

New  Hampshire Tovrn  Clerk 

New  Jersey County  Clerk 

North  Carolina Registrar  of  Deeds 

Ohio Probate  Judge 

Oklahoma Probate  Judge 

< » regon County  Clerk •_'  i m i 

Pennsylvania Clerk  of  Orphans  Court 

Rhode  Island Town  or  City  Clerk 

Tennessee Clerk  of  County  Court 

Texas Clerk  of  County  Court 

Utah Clerk  of  Probate  Court 

Vermont Town  Clerk 

Virginia Clerk.  County.  City,  or  Corporation  Court. 

Washington County  Auditor 

West  Virginia Clerk  of  County  Court 

Wisconsin ( "ounty  Clerk 

Wy<  iming County  Clerk 

*A  license  is  required  only  when  both  parties  are  non-residents. 

In  Alabama.  Georgia,  Florida,  Kentucky.  Indiana,  Minnesota.  Mississippi, 
Ohio,  Oregon,  Virginia.  West  Virginia,  and  Wisconsin,  the  license  is  issued  in  the 
county  in  which  the  woman  resides.  In  Tennessee  it  is  to  issue  from  the  county 
where  the  woman  resides  <.r  where  the  marriage  is  solemnized.  In  Connecticut, 
Illinois,  Louisiana,  Maryland.  Montana.  Nebraska,  North  Carolina,  Pennsylvania, 
and  Wyoming,  it  is  issued  in  the  county  or  town  where  the  marriage  is  to  lake  place. 
In  Michigan  the  license  is  issued    in  the  county  in  which  either  party  resides,  and  in 

Nevada  in  the  county  in  which  both  or  one  of  the  parties  resides.     In  Massachusetts, 

Maine.  New  Hampshire,  and  Rhode  Island  a  license  must  l btained  from  the  town 

in  which  each  of  the  parties  resides,  and  in  Vermont  from  the  town  in  which  the 
groom  resides,  or  if  he  lives  oul  of  the  state  from  the  town  in  which  the  bride 
resides.  In  the  New  England  states  and  Minnesota,  if  the  parties  are  non-residents, 
and  in  Virginia,  if  the  bride  is  a  non-resident,  the  license  is  to  issue  from  the  town 
or  county  in  which  the  marriage  takes  place.  En  Nevada  if  the  parties  are  noi 
dents  the  license  may  issue  from  any  county.  In  Wisconsin  the  license  mils!  be 
obtained  five  days  before  the  ceremony.  This  is  the  only  state  with  such  a  require 
menl . 

Of  the  officers  who  issue  marriage  licenses  ;tll  but  ii\«'  record  t li«- 
certificates  utter  they  are  returned.  The  five  are  in  California,  Dela- 
ware, Nevada,  and  Wisconsin,  where  the  marriage  is  recorded  l>\  the 
recorder  of  deeds,  and  in  Washington,  where  il  is  recorded  l>\  the  probate 
judge.  In  the  Now  England  states  the  license  is  called  a  certifi 
winch  term  is  also  applied  toil  when  it  is  returned  with  the  clergyman  '* 
endorsement  upon  it.  Some  confusion  is  apl  to  arise  unless  this  unfor- 
i  unate  use  of  i  he  \\  "ids  is  kept  in  mind. 


80  REGISTRATION   OF    VITAL    STATISTICS. 

There  are  two  objects  to  be  secured  in  requiring  marriage  licenses. 
One,  which  has  been  considered,  is  to  secure  completeness  and  accuracy 
of  returns,  the  other  is  to  prevent  the  marriage  of  persons  whom  it  is 
unlawful  to  join  in  marriage.  Several  states  do  not  require  a  license 
when  public  notice  of  the  marriage  has  been  previously  given  by  the 
publication  of  "banns."  This  is  the  law  in  Delaware,  Georgia,  Mary- 
land, and  Ohio.  The  following  is  the  law  in  Maryland  :  "  The  name 
of  the  parties  intending  to  be  married  shall  be  thrice  published  in  some 
church  or  house  of  religious  worship  in  the  county  where  the  woman 
resides,  on  three  several  Sundays,  by  some  minister  residing  in  said 
county."  In  Delaware  this  is  not  required  in  the  case  of  a  marriage  of 
colored  persons.  In  Delaware  and  Ohio  the  banns  must  be  published  at 
least  ten  days  prior  to  the  marriage.  It  is  evident  that  in  the  minds  of 
the  framers  of  such  laws,  the  registration  of  the  marriage  was  a  minor 
matter. 
Contents  and  Form  of  Marriage  License. 

One  use  of  a  marriage  license  is  to  make  sure  an  accurate  return  of 
marriage  from  the  person  officiating.  The  data  necessary  for  record  are 
upon  it  and  all  the  clergyman  or  other  person  officiating  has  to  do  is  to 
certify  as  to  the  marriage.  The  marriage  license  is  a  basis  for  the  mar- 
riage record,  and  should  therefore  contain  all  the  data  necessary  for 
such  record.  There  is  rather  more  uniformity  in  regard  to  the  items 
required  for  records  of  marriages  than  for  the  records  of  either  births 
or  deaths.  The  most  essential  and  usual  items  to  be  found  on  marriage 
licenses  are  as  follows : 
Groom. 

Name, 

Occupation, 

Residence, 

Birthplace, 

Color. 
Bride. 

Name, 

Maiden  name  if  previously  married, 

Residence, 

Birthplace, 

Age, 

Color. 

Civil  Condition  of  the  Groom  and  Bride. 

A  statement  as  to  whether  single,  widowed  or  divorced  is  almost 
always  required.  Most  laws  require  a  record  of  whether  the  marriage 
is  the  first,  second  or  other  marriage. 


REGISTRATION  OF    VITAL    STATISTICS.  SI 

Occupation  of  the  Bride. 

This  is  required  in   Maine,   Massachusetts,  New    Hampshire,  New 
Jersey,  and  Rhode  Island. 
Age  of  the  Parties. 

Sometimes  the  age  is  to  be  given  in  years,  months  and  days,  some- 
times the  age  at  the  next  birthday,  as  in  Iowa  and  Buffalo,  and  some- 
times the  age  at  the  nearest  birthday,  as  in  New  Jersey.  If  not  other- 
wise expressed,  the  age  in  years  at  the  last  birthday  is  intended.  In 
Providence  it  is  the  custom,  though  not  required  by  law,  to  state  the 
date  of  birth  as  well  as  the  age  in  years. 
Data  Concerning  Parents. 

The   names  of   the  parents  of  the  contracting  parties  are    in  most 
states  to  appear  on  the  license. 
Color  of  Parent-. 
<  Occupation  of  Parents. 
Birthplace  of  Parents. 

In  Connecticut  the  nationalty  of  the  parents  is  required   instead  of 
birth  places. 
\-e  of  Parents. 

This  is  required  in  New  Hampshire. 

The  marriage  license  must  also  have  the  date  and  place  of  issue. 
ami  must  have  the  written  and  signed  statement  of  the  licensing  officer 
that  the  license  has  been  duly  recorded  or  the  ••intention  declared." 

A  certificate  or  return  of  marriage  tnusl  of  course  have  other  items 
besides  tin-  family  history  required  for  the  license.  The  license,  in 
those  >iates  where  a  license  is  required,  becomes  a  certificate  by  the 
written  statemenl  upon  it  by  the  person  officiating  that  the  parties 
named  have  been  legally  joined  in  marriage.  The  items  required  on  a 
certificate  of  marriage  are  as  follows: 
Date  of  Marriage, 

Place  of  .Marriage, 

Signature  of  Person  officiating. 

( Other  items  are  often  required. 
Official  Position  or  Denomination  of  the  person  officiating. 

This    is  Usually  required,  and    in    Rochester  the  name  of    the  church 

to   which    the   clergyman    is   attached.      In    Delaware   the   "ceremon} 
employed  "  is  required.     The  following  is  t  he  Massachusetts  law  : ' 

"The   words  'official  station,1  as  used  oi  a  person  solemnizing  .1  mai 
chapter  three  hundred  ot  the  acts  of  the  year  eighteen  hundred  and   a 
shall  be  taken  and  deemed  to  mean  the  office  bj  1  Irtue  oi  \\  hich  said  pi  1 


1  Massachusetts,  Chapter  124  oi  L897,  Si 


82  REGISTRATION  OF    VITAL    STATISTICS. 

nizes  such  a  marriage;  and  to  describe  such  office  in  returns  of  marriages  the  words 
'  justice  of  the  peace.1  'minister  of  the  gospel,1  'clergyman,1  'priest,1  or  'rabbi,1 
only  shall  be  used.1' 

In  Rhode  Island,  where  the  term  "  official  station "  occurs  in  the 
law,  it  is  interpreted  to  mean  in  the  case  of  clergymen,  the  denomina- 
tion. 

( )ther  items  occasionally  noted  are 
Names  of  Witnesses  to  the  ceremony. 

These  are  often  required  to  appear  on  the  returns  of  marriage,  but 
they  are  not  so  required   in   Connecticut,  Delaware,  Maine,  Massachu- 
setts, and  Xew  Hampshire. 
Residence  of  Witnesses. 

This  is  required  in  Michigan,  Xew  Jersey,  and  Rochester. 
Residence  of  Person  Officiating. 

This  is  a  requirement  in  Maine,  Massachusetts,  Xew  Hampshire, 
and  Xew  York. 

A  form  of  marriage  license  may  be  found  in  Appendix  17. 

Most  states  have  a  considerable  number  of  regulations  as  to  who 
shall  marry,  such  as  the  prohibition  of  consanguineous  marriages, 
limitations  as  regards  the  marriage  of  minors  and  divorced  persons,  but 
these  have  no  special  interest  in  this  connection.  They  must  of  course 
be  followed  by  the  officers  who  issue  the  licenses,  and  means  are  often 
provided  by  law  for  ascertaining  the  facts,  such  as  administering  oaths, 
etc.  Limitations  as  to  the  marriageable  age  of  minors  are  very  com- 
mon and  vary  considerably  in  different  states.  Xearly  all  require  the 
consent  of  parents  or  guardian  and  the  following  states  require  a 
written  consent  which  is  presumably  filed  by  the  officer  issuing  the 
license  :  California,  Connecticut,  Georgia,  Iowa,  Maine,  Montana, 
Xew  Jersey,  North  Carolina,  Oregon,  Rhode  Island,  Tennessee,  Ver- 
mont, Washington,  and  Wisconsin. 

In  Alabama,  Arkansas,  Kentucky,  Maryland,  Massachusetts, 
Minnesota,  Mississippi,  Missouri,  Xebraska,  Nevada,  New  Jersey,  New 
Mexico,  ( )hio,  Pennsylvania,  Utah,  Virginia,  West  Virginia,  and 
Wyoming,  the  minor's  permit  may  be  either  verbal  or  written. 

In  the  states  named  below1  the  law  requires  that  the  person  solemn- 
izing a  marriage  shall  keep  a  record  thereof. 

In  Alabama  and  Mississippi,  when  a  marriage  is  solemnized  by  the 
pastor  of  an}'  religious   society,   the  clerk  or  keeper  of  the  minutes  of 


1  California,  Colorado,  Delaware,  Idaho,  Kentucky,  Maine,  Massachusetts,  Michi- 
gan, Minnesota,  Missouri,  Nevada,  New  Hampshire,  New  Mexico.  New  York,  South 
Dakota,  Wisconsin. 


B EGIS  TIL  i  TION   OF    I  1  T.  J  L    8  T  i  TIS  Tit  >. 


such  society  is  required  to  make  a  record  of  such  marriage  in  a  book 
to  be  kept  for  that  purpose. 

In  Maryland  the  certificate  of  agreement  of  the  parties  to  a  Quaker 

marriage,  signed  by  at  least  twelve  witnesses,  must  he  recorded  among 
the  records  of  the  society,  or  in  some  court  of  record  in  the  city  or 
county  where  the  marriage  occurred. 

In  Ohio,  in  cities  which  are  co-extensive  with  the  counties  in  which 
they  are  situated,  persons  authorized  to  solemnize  marriages  are  required 
to  keep  a  record  thereof. 

The  usual  way  of  keeping  such  a  register  is  by  means  of  stubs. 

Nearly  all  states  require  that  the  person  solemnizing  a  man 
shall  make  a  return  thereof  to  some  officer  who  is  to  record  the  same  : 
but  in  New  Jersey  there  is  no  provision  for  record  after  return. 
Below1  is  a  list  of  the  states  requiring  such  return  with  the  name  of 
the  officer  to  whom  the  return  is  made.  An  example  of  a  marriage 
return  is  shown  in  Appendix  18. 


1  In  those  states  marked  with  an  *  the  return   is  made  to  the  sai ficer  who 

issues  tii''  license. 


State  "i   territory- 


Return  made  to— 


*Aiabaina Fudge  of  probate,  cm 

A  rizona <  lounty  recorder.   |  a) 

•Arkansas  (6). .  Clerk  of  county  court. (a) 

<  lalifornia <  lounty  recorder.  |  c  i 

*(  lolorado    .  .  .  .  <  lounty  clerk. 
♦Connecticut...  Registrar  of  births,  mar- 
riages ami  <leatlis.  (a  i 
Dakota  (North).  City   or   town    clerk,    or 
register  of  deeds. 

Delaware   Recorder  of  deeds. 

*D.  of  Columbia  Clerk  of  supreme  court. 

Florida   <  llerk  of  circuit  court. 

*(  i-eorgia <  Ordinary,  (a) 

*idaln> County  recorder. 

•Illinois <  lounty  clerk.  |  c  I 

♦Indiana Clerk  of  circuil  court,  (r) 

•Iowa <  llerk  of  circuit  court. 

•  Kansas.. Probate  judge,  [a  i 

■  Kent  uckj  .       .  <  lounty  rink,  (a  I 

•Louisiana Clerk  of  district  court. (a) 

'  Maim- Town  clerk  - 

■  .Maty  la  in  I .  Clerk  of  circuit  court,  (a) 
"Massachusetts  Town  clerk  or  registrar. 

I",  c) 

•  M  ichigan.. .        <  lounty  clerk,  i"  > 
•Minnesota Clerk  of  district  court,  (c) 


State  or  territory 


•Mississippi  .. . 

*M  issouri 

•Montana 

'  Nebraska 

Nevada 

■  N>  \\   llani|i..  .  . 
New  Jersey .... 

\i\\    Mexico.   . . 
New  York 

•  Ni  >r1  bCarolina 
••<  >hio 

•  <  >regon 

■  Pennsj  l\ ania  . 

Rhode  Island . 

essee.. 

I.   :as       .  .    .. 

I'lah 

■  Ven t 

V  irginia 

Washington 

■  \\ '.  -i  v irginia. 
Wisconsin.. 

\\'\  oming 


Return  mai 


Clerk  of  circuit  couj  I 
County  recorder,  (c) 
Probate  judge,  (a  i 
County  judge,  (a,  c) 
Recorder  ol  deeds 
Town  rlerk.  («/) 
Local  board  of  health. 
( llerk  of  probate  court.(c  ' 
Local  board  of  dealt li. 
Regist  rar  of  ilmls. 
Probate  judge,  (a 
County  clerk 
( llerk  nt'  orphan's  court. 

I",  c) 
Tow  n   or    city    clei  i 

i -i  gist  rar.  (c) 
( llerk  of  county  court  i"  i 
( llerk  of  county  court,  (a) 

<  llerk  "t  probate  cou  i 
Town  clerk,  i"  i 

( llerk  of  count  j 

corpora)  ion  court. 
Probate  judge,  (c) 

<  llei  h  of  < ntj  cou  i 

ter  of  deeds,  i  u 
Co  intj  clerk 


a  Of  the  county,  town,  etc.,  whence  license  issued. 

b  The  return  must  be  made  bj  the  person  who  obtained  the  lic< 

c  Of  the  county,  town,  etc.,  wherein  the  marriage  is  solemn 


84  REGISTRATION   OF    VITAL    STATISTICS. 

In  South  Dakota  the  provisions  for  returns  of  marriage  are  not  com- 
pulsory. The  statutes  provide  that  a  certificate  may  be  obtained  from 
the  person  solemnizing  a  marriage  upon  the  request  of  either  of  the 
parties,  and  may  be  filed  with  the  clerk  of  the  city  or  town  where  the 
marriage  occurred,  or  where  either  of  the  parties  resides,  or  with  the 
registrar  of  deeds. 

In  Iowa,  when  the  services  of  a  clergyman  or  a  magistrate  are  dis- 
pensed with,  the  husband  must  make  the  return. 

In  New  York  such  return  shall  be  made  by  the  person  solemnizing 
or  by  the  "  groom." 

In  the  following  states  the  return  of  marriage  is  to  be  made  to  the 
town  or  county  where  the  license  is  issued :  Alabama,  Arizona,  Arkan- 
sas, Connecticut,  Georgia,  Kansas,  Kentucky,  Louisiana.  Maryland, 
Michigan,  Montana,  New  Hampshire,  North  Carolina,  Ohio,  Tennessee, 
Texas,  Utah,  Vermont,  Virginia,  and  West  Virginia.  The  return  is  to 
be  made  to  the  town  or  county  where  the  marriage  is  solemnized  in 
California,  Colorado,  Delaware,  Idaho,  Illinois,  Indiana,  Minnesota, 
Mississippi,  Missouri.  Nebraska,  New  Hampshire  (for  non-residents), 
Nevada,  New  Mexico,  Oregon,  Rhode  Island,  Washington,  and  Wyo- 
ming. In  Maine,  Massachusetts,  Nebraska,  Pennsylvania,  and  Wis- 
consin, a  return  must  be  made  by  the  person  solemnizing  the  marriage 
to  the  town  or  county  where  it  was  solemnized  and  also  to  the  town 
where  the  license  was  issued. 

The  time  within  which  marriage  returns  must  be  made  is  usually  a 
month  or  thirty  days,  but  in  the  District  of  Columbia  it  is  forty-eight 
hours;  Indiana  and  Memphis,  five  days  ;  Maine,  six  days ;  Wilmington, 
ten  days;  Pennsylvania  cities  of  the  second  class  on  the  third  day  of 
each  quarter.  In  Philadelphia  the  collectors  of  vital  statistics,  and  in 
Cincinnati  the  sanitary  police  call  upon  the  clergymen  for  them  at  regu- 
lar intervals. 

Sometimes,  as  in  Kansas,  in  addition  to  the  returns  of  clergymen  the 
assessors  make  an  annual  enumeration  of  marriages  together  with  births 
and  deaths. 

"  In  addition  to  the  requirements  of  the  territorial  statutes  on  the 
subject  of  marriage  records  it  is  provided  by  act  of  Congress,  Approved 
March  3,  1887  (24  Stat.,  636),  that  in  all  the  territories  a  certificate  of 
every  marriage  performed  therein,  signed  by  the  parties  and  by  the 
person  solemnizing,  be  filed  by  such  person  in  the  office  of  the  probate 
court,  or,  if  there  be  none,  in  the  office  of  a  court  having  probate  powers, 
in  the  county  or  district  where  the  marriage  occurred,  which  certificate 
shall  be  immediately  recorded/' 


r  eg  rs  rn.  1  nox  of  \  it,  i  l  s  r.  1  tis  Tit 's.        85 

In  a  few  states  provision  is  made  for  the  return  of  marriages  cele- 
brated beyond  the  limits  of  the  state. 

In  Maine  the  statutes  provide  that  when  residents  of  the  state  are 
married  in  another  state  and  return  to  the  state  to  reside  they  shall  file 
a  certificate  or  declaration  of  their  marriage  with  the  clerks  of  the 
towns  in  which  they  respectively  lived.  -In  Massachusetts  and  New 
Hampshire,  under  similar  circumstances,  it  is  provided  that  such  certifi- 
cate shall  be  filed  with  the  clerk  of  the  town  where  either  of  them  lived. 
In  Vermont,  when  a  male  resident  of  the  state  is  married  without  the 
state  the  statutes  require  that  he  shall  deposit  with  the  clerk  of  the 
town  where  he  resides  a  certificate  embracing  the  statistics  required  by 
law  in  marriage  certificates.  The  statutes  also  provide  that  the  head  of 
a  family  who  moves  into  and  becomes  a  permanent  resident  of  the  state 
may  cause  a  certificate  of  his  marriage  to  be  recorded  in  the  office  of 
the  clerk  of  the  town  where  he  resides. 

In  Virginia  and  West  Virginia  it  is  provided  that  if  either  or  both 
of  the  parties  to  a  marriage  celebrated  without  the  state  he  residents  of 
the  state,  a  certificate  or  statement  of  such  marriage,  verified  by  the 
aflidavit  of  a  witness  thereto,  may  be  returned  to  the  clerk  of  court  of 
the  county  or  corporatioE  where  the  husband  resides  (or  if  he  be  not  a 
resident  of  the  state,  where  the  wife  resides),  and  an  abstract  thereof 
shall  be  recorded  by  such  clerk  as  in  other  cases. 

In  Wisconsin,  where  any  marriage  celebrated  in  the  state  shall  not 
have  been  returned  and  registered  as  provided  by  law,  or  when  any 
person  may  have  married,  who  was  a  child  of  a  citizen  of  the  state,  or 
when  any  person  so  married  elsewhere  was  bef<  re  oral  the  time  of  such 
marriage,  or  subsequently  thereto  shall  have  become,  a  resilient  of  the 
state,  upon  presenting  and  filing  with  the  proper  register  of  deeds  proofs 
of  marriage,  either  b\  the  affidavit  of  the  person  performing  the  cere- 
mony, or  if  such  proof  can  not  be  made,  then  by  affidavit  of  a  witness 
or  witnesses  thereto,  such  register  shall  enter  the  facts  so  proved   upon 

his  marriage  register." 

It  is  not  at  all  likely  that  compulsory  laws  like  those  of  Maine. 
New  Hampshire,  Vermont,  and  Massachusetts  can  be  thoroughly  en- 
forced. It  is  possible  perhaps  in  towns  with  a  small  population  where 
mosl   of  the  inhabitants  are  known  to  the  register,  but   not   in  cities.      It 

certainly  is  not  enforced  in  the  large  Massachusetts  cities. 

RETURNS    A.ND    RECORDS. 

False    Returns. 

It  is  of  course  a  very  grave  matter  for  a  person  to  make  a   false 

turn  of  a  birth,  marriage  or  death.       Penalties  are  provided   lor   such  an 

offense   in    Maine,   Massachusetts,    Michigan,   New   Jersey,   Wisconsin, 


86  REGISTRATION  OF    VITAL    STATISTICS. 

and  in  the  City  of  New  York,  and  other  cities.     The  following  is  the 
New  Jersey  law  : l 

"  That  any  minister  of  the  gospel,  magistrate,  physician,  midwife  or  other  per- 
son, who  shall  knowingly  make  any  false  certificate  of  marriage,  birth  or  death, 
shall  he  deemed  guilty  of  a  misdemeanor,  and  on  conviction  thereof  shall  be  liable 
to  a  fine  not  exceeding  one  hundred  dollars  or  imprisonment  in  the  county  jail  for  a 
period  not  exceeding  three  months,  or  both,  at  the  discretion  of  the  court.1' 

The  Massachusetts  law  affixes  a  penalty  for  altering  a  marriage 
certificate. 

hi  Connecticut  a  penalty  is  imposed  upon  the  registrar  for  making  a 
false  entry. 

Original   Returns. 

It  is  frequently  prescribed  that  these  shall  be  written  legibly,  spelled 
correctly,  and  written  in  ink.  The  former  of  these  requirements  is 
difficult  to  have  fulfilled,  but  the  latter  certainly  should  be  insisted  on. 

The  time  of  receiving  or  filing  the  original  returns  by  the  town  or 
county  clerks  is  sometimes  to  be  endorsed  upon  the  return  as  in  Con- 
necticut, Massachusetts,  Michigan,  and  Wisconsin.  A  place  for  this 
endorsement  is  printed  on  the  back  as  on  the  Massachusetts  returns. 

Often  a  blank  is  left  for  a  number,  and  in  Michigan  the  registrar  is 
required  by  law  to  "  number  all  certificates  consecutively  in  the  order  in 
which  they  are  received,  beginning  with  number  1  for  the  first  death 
which  occurs  in  each  year.1'  This  is  doubtless  of  assistance  to  the  sec- 
retary of  state  to  whom  the  returns  are  sent,  and  who  has  to  certify  to 
the  county  auditors  the  amount  due  each  registrar  for  making  returns. 
Sometimes  the  number  of  the  burial  permit  is  to  be  stamped  upon 
the  return  of  a  death. 

The  original  returns  are  usually  filed  and  preserved  by  the  registrar 
who  receives  them.  This  is  the  rule  in  all  the  New  England  states. 
In  some  cases  these  originals  serve  as  the  permanent  record  and  are 
bound  and  indexed.  This  is  the  method  of  keeping  the  record  in  the 
City  of  New  York. 

In  New  York  state  and  in  Michigan  the  originals  are  at  once  re- 
corded by  the  local  registrar  and  returned  monthly  to  the  state  regis- 
trar by  whom  they  are  indexed,  bound  and  preserved. 

In  New  Jersey  there  is  no  provision  in  the  law  for  local  record, 
though  one  is  made  in  very  many  places,  but  the  returns  are  to  be 
sent  to  the  state  bureau  of  vital  statistics,  and  the  law  provides  that 
they  shall  be  arranged  according  to  political  divisions.  In  the  above 
states  exception  is  made  for  certain  cities  which   may   send   transcripts 

1  New  Jersey,  General  Statutes  (1895),  p.  2010,  Sec.  11. 


HE GTs  TRA  TION  OF    VITAL    S  T.  I  TIS  TI(  'S.  87 

to  the  state  registrar  and  preserve  the  originals.  In  Minnesota  the 
original  returns  are  to  be  sent  by  the  secretary  of  state  to  the  comity 
clerks.  In  Wisconsin  returns  are  received  by  the  board  of  health  or 
town  clerks  and  sent  to  the  registrar  of  deeds  for  the  county.  The 
law  does  not  require  local  record. 

The  preservation  of  original  papers,  like  returns  of  births,  mar- 
riages and  deaths,  presents  quite  an  important  problem.  These  must  in 
the  course  of  years  become  so  great  in  number  that  it  will  be  with 
difficulty  that  proper  storage  room  can  be  found  for  them.  It  is  a  ques- 
tion whether  it  is  not  best  to  record  in  books  every  item  contained  in 
them  and  then  destroy  them. 
Blanks  for  Returns. 

These  are  almost  always  furnished  by  the  state.  It  is  only  in  this 
way  that  uniformity  can  be  secured.  They  are  usually  distributed  to 
clergymen,  undertakers,  physicians,  and  the  like  by  the  town  or  county 
clerks  or  other  recording  officers.  Usually  the  blanks  are  furnished  by 
the  state  board  of  health,  as  in  Arkansas.  California,  Colorado.  Florida, 
Illinois,  Indiana,  Kansas,  Maine,  Maryland,  Missouri.  New  Hampshire, 
New  Jersey,  New-  York,  Rhode  island,  Vermont,  West  Virginia,  and 
low  a  for  marriages  ;  but  in  Massachusetts,  Michigan  and  Wisconsin 
they  are  furnished  by  the  secretary  of  state,  and  in  North  Dakota  and 
Virginia  by  the  state  auditor.  In  Pennsylvania,  except  in  the  Large 
cities,  blanks  are  to  be  furnished  by  the  county  commissioners;  but  in 
Delaware  the  county  recorder  is  to  furnish  the  blank  returns. 

In  some  states  in  which  there  are  no  general  registration  laws,  as 
Georgia,  South  Carolina,  Tennessee,  and  others  like  Pennsylvania 
where  the  laws  are  very  imperfect,  there  are  nevertheless  importanl 
cities  which  have  long  had  a  good  system  of  registration  and  which  tor 
their  blanks,  books  and  laws  have  to  depend  upon  themselves  alone. 

I!,  cording  Officers. 

In  nearly  every  instance  the  officer  to  whom  returns  of  births,  mar- 
riages, and  deaths  are  made  is  to  record  them.     This  record,  however, 

is  not  required   by  statute  in  si ■  states,  as  Florida,  New    Jersey,  and 

Wisconsin,  and  in  certain  cities.  The  following  is  a  list  of  the  officers 
who  are  ex-officio  charged  with  the  duty  of  recording  vital  statistics  in 
the  different  states  : 

State.  Receiver,  Recorder. 

Alabama Counts  Sealtb  ( (fficer.  <  ountj  Health  Offl 

California County  Recorder. . .  Countj  Recorder. 

Colorad Board  of  Bealth. 

Connecticut Town  Clerk Town  Clerk, 

Delaware Recorderof  Deeds  Recorder  of  Deeds. 


88  REGISTRATION  OF    VITAL    STATISTICS. 

State.  Receiver.  Recorder. 

Florida State  Board  of  Health.  

Illinois County  Clerk County  Clerk. 

Indiana Health  Officer Health  Officer  (undertakers 

are  registrars  in  unincor- 
porated places). 

Iowa Clerk  Dist.  Court Clerk  Dist.  Court. 

Kentucky County  Clerk County  Clerk. 

Maine Town  Clerk Town  Clerk. 

Maryland Health  Officer. Health  Officer. 

Massaclmsetts Town  Clerk Town  Clerk. 

Michigan Health  Officer Health  Officer. 

Minnesota Health  Officer Health  Officer. 

Mississippi County  Board  of  Health.  . .  .County  Board  of  Health. 

Montana County  Clerk County  Clerk. 

New  Hampshire Town   Clerk Town  Clerk. 

New  Jersey Town  Clerk  or  Assessor 

New  York Board  of  Health Board  of  Health. 

North  Carolina County  Supt.  of  Health ....  County  Supt.  of  Health. 

North  Dakota Health  Officer Health  Officer. 

Pennsylvania Clerk  Orphan's  Court Clerk  Orphan's  Court. 

'  Rhode  Island Town  Clerk Town  Clerk. 

Utah County  Clerk County  Clerk. 

Virginia County  Clerk County  Clerk. 

Vermont Town  Clerk Town  Clerk. 

Washington County  Auditor County  Auditor. 

West  Virginia County  Clerk County  Clerk. 

Wisconsin Health  Officer  or  Clerk County  Register  of  Deeds. 

In  place  of  the  above  mentioned  officers  other  persons  are  some- 
times to  perform  these  duties.  Thus  in  Ohio  in  villages  and  cities  the 
board  of  health,  and  in  New  Hampshire  the  board  of  health  of  cities, 
is  to  record  births  and  deaths.  In  New  Jersey  it  is  the  registrar  or 
clerk  of  cities  who  is  to  receive  returns,  and  such  may  record  the  same, 
and  the  registrars  of  Michigan  cities  may  keep  the  original  returns  and 
send  copies  to  the  secretary  of  state. 

In  many  cities  provision  is  made  by  charter  or  otherwise  for  the 
appointment  of  special  officers  to  be  registrars  of  vital  statistics. 
Among  such  cities  are  Atlanta,  Boston,  Buffalo,  Camden,  Chicago,  Cin- 
cinnati, the  District  of  Columbia,  Lowell,  Milwaukee,  New  York,  Phila- 
delphia, Paterson,  Providence,  Portland,  Me.,  Rochester,  Syracuse,  and 
Wilmington,  Del.  Among  the  smaller  communities  which  have  a 
registrar  is  Asbury  Park,  N.  J. 

Sometimes  as  in  Buffalo,  Memphis,  and  the  District  of  Columbia, 
the  registrars  are  merely  clerks  in  the  department  of  health.  Usually 
the  registrar  is  a  member  of  that  department,  but  in  Boston  and  Provi- 
dence he  is  an  independent  officer,  but  in  Providence  the  same  person 
has  usually  been  elected  registrar  and  executive  officer  of  the  health 
department. 


REGISTRATION   OF    VITAL    STATISTICS.  go, 

As  it  is  sometimes  necessary  for  registrars  to  administer  oaths,  to 
determine  the  truth  of  statements  made  to  them,  this  power  is  often 
granted  to  them  and  they  may  sometimes  have  a  seal  as  in  Connecticut 
and  in  Boston. 

Records. 

Most  laws  require  that  births,  marriages,  and  deaths  shall  he  recorded 
in  separate  books,  though  as  has  been  stated  in  a  few  instances  the 
original  returns  serve  as  the  record.  In  Pittsburgh  the  record  page  for 
deaths  has  space  for  only  two  records  which  are  fac-similies  of  the 
original  returns. 

When  any  considerable  number  of  items  are  to  be  entered,  a  single 
page  scarcely  gives  space  enough  without  making  the  record  hook  entirely 
too  cumbersome.  Hence  these  records  usually  extend  across  two  pages 
which  have  the  same  number.  The  folio  has  a  proper  heading  and  is 
ruled  into  columns  for  the  various  items  which  are  usually  prescribed 
by  statute  or  by  the  state  registration  officer.  The  record  books  them- 
selves are  also  of  ten  furnished  by  the  state,  as  in  .Massachusetts  and  Dela- 
ware, by  the  secretary  of  state:  Rhode  Island,  by  the  state  hoard  of 
health  :  Washington  and  .Minnesota,  by  the  county  auditor :  and  in  <  Miio 
by  the  county  judge.  In  this  way  uniformity  is  secured  and  a  better 
paper  and  printing  is  obtained. 

In  many  records  there  is  a  space  at  the  bottom  of  even  page  for 
the  signature  of  the  registrar  attesting  that  the  record  is  correct. 

In  some  states  as  Maim'.  New  Hampshire,  and  Rhode  Island  returns 
me  to  he  recorded  " chronologically."  In  Rhode  Island  this  is  inter- 
preted to  mean  in  the  order  in  which  the  events  occurred.  So  that  the 
record  tor  a  given  period  of  time  cannot  he  made  until  sufficienl  time 
has  elapsed  for  all  the  returns  to  he  in.  In  Delaware  the  returns  are  to 
he  recorded  "  under  the  letter  of  the  alphabel  t<>  which  they  respectively 
belong."  In  Virginia  they  are  to  he  alphabetical!}  arranged.  In  most 
regulations  concerning  this  point  records  are  to  he  made  in  the  order 
in  which  the  returns  are  received. 

Deaths  of    paupers  shall   he   especially    designated    as  siieh   ill    records 

in  Mobile. 

In  Rhode  Island  the  law  requires  that  births,  marriages,  and  deaths 
of  residents  and   non-residents  shall    be  recorded   separately.     This   is 

interpreted  to  mean  that   the  births,  marriages,  and  deaths  in  the  families 

of  the  residents  of  the  town,  but  occurring  out  of  the  town  shall  be 
recorded  separate!}  from  those  which  occur  in  the  town.  It  is  import- 
ant that  such  should  be  recorded',  bul  the}  Bhould  not  of  course  he 
reckoned  in  am  tables  of  vital  statistics.     In  Providence  deaths  in  the 


90  REGISTRATION   OF    VITAL    STATISTICS. 

city  of  persons  of  foreign  parentage,  are  recorded  separately  from  those 
of  American  parentage. 

The  problem  of  dealing  with  the  deaths  in  prisons,  hospitals,  and 
almshouses  is  a  difficult  one.     In  Massachusetts  1 

"The  superintendent  of  the  state  almshouse  shall  obtain,  record,  and  make 
return  of  the  facts  in  relation  to  the  births  and  deaths  which  occur  in  his  institution, 
in  like  manner  as  is  required  by  town  clerks.  The  clerk  of  a  town  in  which  such 
almshouse  is  located  shall,  in  relation  to  the  births  and  deaths  of  persons  in  said 
almshouse,  be  exempt  from  the  duties  otherwise  required  of  him  by  this  act." 

It  is  of  the  greatest  importance  that  records  should  be  as  permanent 
as  possible,  and  to  secure  this  only  the  most  durable  paper  and  ink 
should  be  employed.  If  the  state  furnishes  the  record  books  there  is 
no  reason  why  they  should  not  always  be  of  the  best,  but  it  is  feared 
that  this  is  far  from  the  case.  In  regard  to  paper  the  Massachusetts 
law  provides  as  follows  :  2 

"The  matters  of  public  record  in  any  office  shall  be  entered  or  recorded  on  paper 
made  wholly  of  linen,  of  a  firm  texture,  well  sized,  and  well  finished;  and  in  the 
selection  of  paper  for  such  records  a  preference  shall  be  given  to  linen  paper  of 
American  manufacture,  if  it  is  marked  in  water  line  with  the  word  '  linen,'  and  also 
with  the  name  of  the  manufacturer." 

Ink  is  very  apt  to  be  poor  in  quality,  to  injure  the  paper  and  fade 
rapidly.  Massachusetts  and  Connecticut  have  prescribed  what  ink  shall 
be  used.     The  following  is  the  law  in  those  states : 3 

"  Section  1.  No  person  having  the  care  or  custody  of  any  book  of  record  or 
registry  in  any  of  the  departments  or  offices  of  the  Commonwealth,  shall  use  or  allow 
to  be  used  upon  such  books  any  ink  excepting  such  as  is  furnished  by  the  secretary 
of  the  Commonwealth. 

"  Sec.  2.  The  secretary  of  the  Commonwealth  shall  from  time  to  time  advertise 
for  proposals  to  furnish  the  several  departments  and  offices  of  the  Commonwealth  in 
which  books  of  record  or  registry  are  kept  with  ink  of  a  standard  and  upon  condi- 
tions to  be  established  by  the  secretary  at  such  periods  and  in  such  quantities  as 
may  be  required,  and  may  contract  for  the  same. 

"Sec.  3.  The  ink  so  furnished  shall  be  examined  from  time  to  time  by  a  chemist 
to  be  designated  by  the  secretary  of  the  Commonwealth,  and  if  at  any  time  said  ink 
shall  be  found  to  be  inferior  to  the  established  standard  the  secretary  shall  have 
authority  to  cancel  any  contract  made  for  furnishing  said  ink,  and  the  quantity  so 
found  inferior  shall  not  be  paid  for." 

It  is  sometimes  prescribed  that  records  shall  be  written,  but  if  that 
is  intended  to  exclude  typewriting  it  is  not  a  wise  provision.  Type 
written  records  are  more  legible  and  take  up  considerable  less  space 
than  written  records.      Moreover,  a  black   carbon   ribbon  gives   a  more 


1  Massachusetts,  Chapter  44-1  of  1897,  Sec.  22. 

2  Massachusetts,  Public  Statutes  (1882),  Chapter  37,  Sec.  1. 

3  Massachusetts,  Chapter  378  of  1894. 


REGISTRATION  OF    VITAL    STATISTICS.  91 

permanent  and  unalterable  record  than  can  any  fluid  ink.  The  type 
writer  has  been  used  for  records  in  Providence  since  1890.  The  sheets 
are  written  separately  and  bound  in  temporary  covers  until  enough  have 
accumulated  for  permanent  landing. 

In  Michigan  towns  the  death  permits  are  furnished  the  towns  in 
books  with  stubs  and  the  stubs  are  to  be  kept  as  the  local  town  record. 
See  examples  of  forms  of  records  in  Appendices  11'  to  21. 

Index. 

A  record  without  an  index  loses  a  large  part  of  its  value.  Hence  the 
indexing  of  records  is  usually  required.  As  was  stated  above,  in  Dela- 
ware and  Virginia  the  returns  are  recorded  alphabetically,  but  in  Dela- 
ware there  must  besides  be  an  index  for  each  book.  Usually  in  the 
records  of  births,  marriages  and  deaths,  each  volume  is  indexed  separ- 
ately and  the  names  are  indexed  as  they  are  recorded  under  the  initial 
letter  only.  This  method  has  not  such  very  serious  defects  in  small 
places  where  one  book  serves  for  a  great  many  years;  but  for  large 
places  it  is  almost  valueless.  Even  when  an  index  is  strictly  alpha- 
betical and  vet  only  covers  a  year  or  other  brief  period,  the  labor  of 
searching  records  is  considerable.  In  New  York  City  until  recently,  and 
in  Buffalo  and  some  other  cities,  the  busk  system  of  index  is  in  use  : 
in  the  District  of  Columbia  and  Hartford,  the  Burr  index  :  in  Lynn, the 
Schlicht;  in  Rochester,  the  Graves;  and  in  Pittsburgh,  Stephens  and 
.Mckees  index  is  used.  All  of  these  are  book  indexes.  The  book 
which  is  used  as  an  index  has  margin  letters  which  are  so  arranged 
that  the  names  may  be  entered  in  small  groups  which  are  si  rid  1\  alpha- 
betical and  which  are  SO  small  that  il  is  easy  to  run  the  group  through 
for    :  in  \     particular     name.        It.   however,  takes    some    care    to    enter    the 

names  properly.  In  the  borough  of  .Manhattan,  a  temporary  card  index, 
which  is  strict!)  alphabetical  is  made,  and  from  it  an  index  is  printed 
each  month,  and  the  pages  are  SO  arranged  that  the  different  months  ot 
of  the  same  letter  are  bound  consecutively  in  the  annual  volume.  I'he 
cost  of  printing  the  annual  index  of  about   200,000  names  is  some  $6,000. 

In  .Manhattan  a  card  index  of  deaths  l>\  streets  is  kepi  to  facilitate  the 
search  for  foreign  names  which  are  so  often  spelled  erroneously. 

By  far  the  best  index  is  the  card  index,  and  there  is  no  good  reason 
why  this  should  not  be  universally  employed.  The  labor  of  making  a 
card  index  is  no  greater  than  that  of  making  an}  other  index;  in  fact, 
it  is  rather  less,  and  it  may  be  made  to  extend  over  an\  desired  period 
of  years.  The  only  limit  is  the  amount  of  space  available.  When  the 
index  becomes  too  huge  it  should  be  printed.  To  print  one  hundred 
copies   of    an    index    from    cards    ought     not     to    COSl    over   one    and    one- 


92  REGISTRATION   OF    VITAL    STATISTICS. 

half  cents  per  name,  and  some  return  could  be  had  from  sale  of  copies, 
and  in  many  places  a  larger  edition  would  be  profitable.  If  it  is  worth 
while  to  record  births,  marriages  and  deaths  at  a  cost  of  from  five  cents 
to  fifty  cents  per  name,  it  is  worth  while  to  make  a  compact  printed  index 
at  a  cost  of  one  and  one-half  cents.  A  card  index  has  been  used  in 
Providence  since  1890,  and  the  printing  of  the  index  of  names  previ- 
ously recorded,  from  1636  to  1890,  has  now  been  nearly  completed. 
In  all,  there  are  about  two  hundred  and  fifty  thousand  names  in  ten 
volumes. 

The  following  is  the  form  of  card  used  and  a  sample  of  the  printed 

index  : 

Size  2x5  Inches. 


Delfino,  Giovanni 

16  501 

s.  of  Guglielmo  &  Margherita 

June  8  1899 

o 

BIRTHS    RECORDED    IX    PROVIDENCE 

Vol.  Page. 

Fury  Maria  of  William  and  Catherine  Aug  20  1874 10: 

Fury  Mary  C  of  William  and  Catherine  June  9  1K73 10 

Fury  Mary  E  of  Bartholomew  and  Margaret  Mar  31  1872 9 

Fury  Mary  E  of  James  and  Bridget  Sept  14  1878 11 

Fury  Mary  J  of  Thomas  and  Ellen  July  22  1874 10 

Fury d  of  Thomas  and  Ellen  Sept  3  1879 11 


47 
24S 
156 
159 
23S 


Custody  of  Record*. 

In  some  states  the  law  requires  that  records  shall  be  open  to  the 
public,  but  in  others  there  are  restrictions.  Thus  in  Delaware  a  fee  of 
fifteen  cents  is  charged  for  searching  the  record,  but  "said  register 
shall  at  all  times  be  accessible  to  physicians,  clergymen,  and  lawyers 
without  charge,"  and  a  similar  rule  is  found  in  Pennsylvania.  In 
Cleveland  and  the  Pennsylvania  cities  of  the  second  class,  the  indexes 
"shall  at  all  reasonable  times  be  open  to  the  examination  of  persons 
interested  therein."  The  recording  officer  who  has  charge  of  records  is, 
of  course,  responsible  for  their  safe  keeping,  and  will  only  allow  them  to 
be  examined  when  he  considers  it  safe  to  do  so. 

Amendment  of  Records. 

Errors  and  omissions  frequently  occur  in  records,  altogether  too 
frequently  in  this  country.  Some  registrars  take  it  upon  themselves  to 
make  corrections,  but  in  the  absence  of  statutory  provisions  it  is  doubt- 
ful if  they  have  a  right  to  do  so.      In  a  few  states  changes  in  the  record 


REGISTRATION  OF    VITAL    STATISTICS.  93 

are  provided  for.  In  Connecticut  the  registrar  "  shall  amend  bis  records 
as  he  may  discover  mistakes  or  omissions  therein."  In  1895  registrars 
were  directed  to  complete  the  records  since  1850  from  the  records  of 
public  officials,  church  societies,  or  from  parents,  physicians,  and  mid- 
wives.  In  New  Orleans  a  marriage  may  he  recorded  on  "the  produc- 
tion of  the  affidavits  of  the  contracting  parties  ami  at  least  one  of  the 
witnesses  or  the  officer,  priest,  or  ecclesiastic  celebrating."  Tin-  Massa- 
chusetts law  requires  that  a  deposition  must  he  made  under  oath  by  a 
person  whose  duty  it  was  to  furnish  information  for  the  original  record 
and  the  registrar  is  to  record  these  additions  in  a  separate  hook. 

In  Maryland  the  registrar  "shall  amend  his  records  as  he  shall  dis- 
cover mistakes  and  omissions."  In  New  Hampshire  the  town  clerk  may 
record  facts  in  regard  to  births,  marriages,  and  deaths  ••  which  have  not 
been  officially  reported  to  him,"  and  he  may  insert  ••  in  the  records  and 
returns  the  name  of  any  child  which  may  have  been  omitted  from  the 
official  return  of  a  birth."  The  best  law  seems  to  he  that  of  Rhode 
Island  which  is  less  cumhersome  than  the  Massachusetts  law.  and  prob- 
ably protects  the  records  as  well.1 

( 'opies  of  Record. 

A  considerable  number  of  states  specify  that  copies  of  record  shall 
he  sufficient  evidence  in  legal  proceedings  of  the  facts  recorded.  In 
Massachusetts  a  copy  may  he  signed  by  the  city  or  town  clerk  or  as 
ant  clerk  for  the  time  being.  Sometimes  a  -duh  certified  copy  is 
required,"  and  the  use  of  a  town  or  <it\  seal  maj  serve  as  a  certifica- 
tion, [n  Connecticut  the  registrars  are  to  provide  seals  of  their  own. 
A  fee  is  usually  charged  for  such  copies  of  record.  Usually  the  copy 
is  an  exact  copy  of  the  original  record  representing  a  section  ,,t'  the 
page  with  the  rulings  and  headings  as  there  given.  An  example  is 
given  in  Appendix  22. 

1  Rhode  I  > la  1  ul.  Chapter  616  of  the  Public  Laws  (2  March,  1899),  amending  Chap 
ter  100  "i  1 1 1 « -  ( General  Laws: 

Sec.  25.     It"  ii   shall  come  to  the  knowledge  of  a  town  clerk,  or  anj    person, 
appointed  am  lei-  the  provisions  of  section  1  of  this  chapter,  thai  anj  birth,  marriage, 
or  death  which   has  occurred   in  his  town  or  city  has  nol  been  returned  i"  him  as 
required  by  this  chapter,  or  lias  nol  been  recorded,  such  town  clerk  or  person  sliall 
record  the  facts  called  for  bj  section  3  of  this  chapter,  to  the  extent  he  shall  n 
in  an]  way  anj  credible  information  of  the  same.     If  anj   error  shall  !><■  made  in 
the  return  of  any  birth,  marriage,  or  death,  or  shall  be  discovered  In  the  records  ol 
births,  marriages,  or  deaths,  such  error  shall  be  corrected  without  erasure.     1  n 
case  the  source  ol   information,  from  which  the  addition  01  correction  is  made,  and 
the  date  of  making  the  same  sliall  be  noted  on  the  face  of  the  record   and 
clerk  or  person  shall  attest  the  same  by  his  signature  then ." 


94  REGISTRATION  OF    VITAL    STATISTICS. 

State  Registration  of   Vital  Statistics. 

Some  sort  of  a  state  registration  of  vital  statistics  is  found  in  most 
of  the  more  populous  states.  In  the  majority  of  them  it  is  true  the 
results  are  of  very  little  value  owing  to  the  very  defective  returns,  par- 
ticularly the  returns  of  births.  According  to  Dr.  Cressy  Wilbur,1  the 
following  states  had  in  1895  an  approximately  correct  registration  of 
■deaths :  Connecticut,  Delaware,  Maine,  Massachusetts,  New  Hamp- 
shire, New  Jersey,  New  York,  Rhode  Island,  and  Vermont.  Since  then, 
by  the  exertions  of  Dr.  Wilbur  and  Dr.  Hurty,  Michigan  and  Indiana 
have  been  added  to  the  list.  The  registration  of  marriages  is  more 
defective  than  that  of  deaths,  and  the  registration  of  births  is  more 
defective  still,  and  probably  not  even  approximately  correct  in  any  state. 

The  following  is  a  list  of  states  in  which  there  is  an  attempt  at  state 
registration  together  with  the  officer  having  charge  of  it : 

Alabama State  board  of  health.  Minnesota State  board  of  health. 

Arkansas State  board  of  health.  Mississippi State  board  of  health. 

California State  board  of  health.  New  Hampshire  . .  State  board  of  health. 

Colorado State  board  of  health.  New  Jersey State  board  of  health. 

Connecticut State  board  of  health.  New  York State  board  of  health. 

Delaware State  board  of  health.  North   Carolina. .  .State  board  of  health. 

Florida State  board  of  health.  North  Dakota State  baard  of  heolth. 

Indiana State  board  of  health.  Rhode  Island State  board  of  health. 

Iowa State  board  of  health.  South   Carolina .  . .  State  board  of  health. 

Kansas State  board  of  health.  Utah State  board  of  health. 

Kentucky State  auditor Vermont State  board  of  health. 

Maine State  board  of  health.  Virginia State  auditor. 

Maryland State  board  of  health.  Washington State  board  of  health. 

Massachusetts. .  .  .Secretary  of  state. . . .  West  Virginia State  board  of  health. 

Michigan Secretary  of  state. .  . .  Wisconsin State  board  of  health. 

In  order  to  have  state  registration,  reports  must  be  made  by  the 
local  registrars  to  the  central  office.  As  has  been  shown,  the  original 
returns  are  sent  to  the  state  registrar  in  New  York,  New  Jersey,  and  in 
Michigan  so  far  as  deaths  are  concerned.  In  other  states  copies  of  the 
returns  are  sent,  as  in  Connecticut,  Maryland,  Maine,  and  New  Hamp- 
shire. In  Connecticut  the  copies  are  on  cards,  white,  for  births ;  blue, 
for  still-births  ;  brown,  for  marriages  ;  and  buff,  for  deaths,  so  that  they 
can  be  easiby  arranged  alphabetically  or  otherwise.  For  an  example  of 
these  cards  see  Appendix  23. 

In  most  states  a  copy  of  the  record  book  is  made  on  folios  of  the 
same  size  and  ruling,  and  then  is  sent  to  the  state  registration  office. 
In  Providence  the  original  record  and  the  copy  are  made  at  the  same 
time  on  a  typewriter.  The  Fisher  book-typewriter  is  at  present  used 
for  this.     In  other  states  the  copies  are  made  on  one  side  only.     Some- 


1  American  Public  Health  Association,  Reports  and  Papers,  1806,  p.  237. 


BEG  is  TEA  TION   0  F    I  rIT  1  L    S  7\  I  Tls  Til  \*  q  - 

times  the   state   registrar  requires  that   if  all  blanks  are  not  filled!  the 
reason  must  lie  given  in  a  letter  to  accompany  the  report. 

Envelopes  are  furnished  by  the  state  for  these  returns  and  often  a 
memorandum  of  the  number  of  births,  marriages,  and  deaths  reported 
is  to  accompany  the  returns. 

It  is  important  for  the  state  registrar  to  have  a  report  regularly  from 
each  local  registrar,  whether  any  records  are  made  or  not.  When  no 
returns  of  births,  marriages,  and  deaths  are  received  by  the  local  regis- 
trar, a  special  form  of  report  is  sent  in.  Tims  in  Connecticut,  where 
cards  of  different  colors  are  used  for  state  returns  of  births,  marriages, 
and  deaths,  a  special  card  of  another  color  still,  but  of  the  same  size,  is 
used  when  no  returns  have  been  received. 

In  certain  states,  besides  the  copies  of  returns  or  records,  which  are 
sent  annually  to  the  state  registrar,  monthly  summaries  of  births,  mar- 
riages, and  deaths  are  required  by  the  registrar,  and  perhaps  also  by  the 
state  board  of  health  if  that  body  does  not  have  charge  of  state  regis- 
tration. The  form  used  in  Rhode  Island  for  such  a  report  is  shown  in 
Appendix  24.  In  New  York  returns  are  to  be  sent  to  the  secretary 
of  the  state  board  of  health  promptly  after  record.  The  returns  are  to 
be  sent  to  the  state  registrar  monthly  in  New  Jersey  and  Michieran, 
Copies  of  record  are  to  be  sent  in  quarterly  in  California.  Connecticut, 
Delaware,  Washington,  and  Wisconsin.  In  most  states  such  reports  are 
made  annually. 

The  original  returns  or  copies  thereof  or  copies  of  record  which  are 
sen;  to  the  state  registrar  are  usually  to  be  preserved  b\  him,  and  he  is 
t'rei|  iicni  1\  required  to  bind  and  index  them  as  in  .Michigan  and  New  Jer- 
sey.    This  requirement  appears  to  be  due  to  a   mistake >tion   as  to 

the  functions  of  ;i  state  registrar.     His  duty  should  be  to  supervise  n 

tration  and  to  arrange  and  publish  statistical  <lat;i  obtained  thereby.  It 
i-  a  well  nigh  useless  expense  to  try  and  make  the  state  collections  of 
records  useful  as  ;i  storehouse  of  the  facts  of  personal  history.  Indi- 
vidual records  should  be  somdit  in  the  town  and  counts  records,  not  in 
the  state  records.  It  is  much  better  to  perfect  the  index  of  local 
records  than  to  go  to  the  expense  of  indexing  those  of  the  state. 

Reports  of  /,<»•,//  Registrars. 

The  publication    of   vital   statistics   is   most    useful   and   necessary. 

Such   publication   can    llsnall\    be   best     made   b\    the  state  ;    but     the    1' 

tration  of  vital  statistics  in  the  United  States  began  in  the  cities, 
attained  greater  perfection  there,  and  continued  for  man}  years  before 
it  became  general  throughoul    the  state.     The  cities  were  the  leaders  in 

this.     The\  also  published  reports  before  it  \\;i>  done  ly  the  Btute.      \~ 


96  REGISTRATION  OF    VITAL    STATISTICS. 

these  reports  date  back  earlier  than  state  reports,  and  as  the  statistics 
are  better  in  some  cases,  and  the  reports  more  extensive,  it  may  be 
advisable  to  continue  them  for  many  years  to  come ;  but  if  the  state 
treatment  of  this  subject  should  ever  become  as  perfect  as  it  is  hoped  it 
may,  it  will  become  possible  to  do  away  with  the  publishing  of  local 
reports.     The  ordinances  of  Providence1  require  that 

"  The  city  registrar  shall  cause  an  abstract  of  the  returns  of  death  made  to  him 
to  be  published  in  all  the  newspapers  which  contract  to  do  the  city  printing, 
monthly,  and  oftener  if  required  by  the  board  of  health.  He  shall  also  on  or  before 
the  first  day  of  April,  annually,  prepare  and  present  to  the  city  council  a  statement 
of  the  number  of  births,  marriages  and  deaths  which  occurred  in  the  city  during  the 
year  ending  with  the  thirty-first  day  of  December  next  preceding,  with  such  other 
information  and  suggestions  in  relation  thereto  as  he  may  deem  useful  for  the  pro- 
motion of  the  public  health,  and  other  interests  of  the  city.'" 

A  large  majority  of  the  cities  and  towns  which  publish  annual  health 
reports  publish  in  them  quite  a  full  account  of  the  deaths  which  have 
occurred  during  the  year,  and  a  few  report  births  and  marriages  as  well. 
Besides  these  a  considerable  number  of  cities  publish  monthly  and  some 
few  weekly  abstracts  of  births,  marriages  and  deaths.  This  subject  will 
be  again  considered  in  Chapter  XIII. 

Registration  of  Physicians  and  Others. 

in  order  to  secure  the  best  control  of  the  returns  of  births,  marriages, 
and  deaths  it  is  necessary  for  the  recording  officer  to  have  a  knowledge 
of  the  names  and  addresses  of  all  persons  who  are  required  to  make 
such  returns.  At  the  present  time  nearly  all  the  states  have  laws  for 
the  licensing  of  physicians,  and  some  of  them  for  the  licensing  of  mid- 
wives.  Many  of  these  laws  regulating  the  practice  of  medicine  require 
the  registration  of  the  name  and  address  of  the  physician  or  midwife 
with  the  local  officer  whose  duty  it  is  to  record  births,  marriages,  and 
deaths.  Marriage  laws  sometimes  provide  that  clergymen  shall  register 
their  names  and  sometimes  it  is  necessary  for  them  to  take  out  licenses. 
The  state  sometimes  provides  for  the  licensing  of  undertakers  by  the 
towns  as  in  Rhode  Island.  In  Pennsylvania  a  state  board  for  the 
regulation  of  undertaking  has  been  established.  This  board  consists  of 
five  undertakers  appointed  by  the  governor.  All  persons  engaged  as 
undertakers  may  register  with  the  board  for  a  fee  of  ten  dollars.  In  the 
future  all  persons  desiring  to  become  undertakers  must  be  examined 
particularly  as  to  their  ability  to  care  for  bodies,  dead  of  contagious 
disease,  and  may  be  licensed  for  twenty-five  dollars.  All  licensed 
undertakers  must  register  with  the  local  board  of  health.  "No  person 
can   act  as  undertaker  unless  so  licensed.     There  is  a  similar  law  in 


1  Providence,  Ordinances  (1900),  Chapter  44,  Sec.  8. 


REGIS TJ! A  TION   OF    1 7  T.  1  L    S  T.  I  TJs  Tit  .v  97 

Maine.  Nebraska,  New  York,  South  Dakota,  and  West  Virginia,  and  in 
Iowa,  Masachusetts,  Minnesota,  and  New  Hampshire  the  board  of 
health  is  to  license  undertakers.  Besides  provisions  in  license  laws 
requiring  the  registration  of  physicians,  clergymen,  undertakers,  etc.,  the 
registration  laws  themselves  also  sometimes  contain  this  requirement. 
Many  cities  also  have  local  regulations  requiring  the  registration  of 
persons  concerned  in  the  reporting  of  births,  marriages,  and  deaths.1 
Sextons  are  required  to  be  registered  in  Connecticut,  and  in  Cleveland, 
Memphis.  Minneapolis,   St.   Louis,  and  Syracuse. 

Fees. 

A  very  considerable  proportion  of  the  recorders  of  vital  statistics  are 
paid  for  their  services  by  means  of  fees.  Whether  or  not  this  method 
of  payment  is  desirable  will  not  here  be  discussed.  It  is.  however,  a 
very  common  method  of  paying  town  and  county  clerks.  In  cities  of 
considerable  size  it  is  not  generally  advised,  and  the  recording  and 
similar  officers  of  such  cities  are  frequently  in  receipt  of  salaries.  In 
Massachusetts  and  Michigan  the  law  provides  that  in  cities  of  over 
10,000  inhabitants  a  salary  may  be  granted  instead  of  fees  for  the 
recording  of  vital  statistics.  The  following  are  some  of  the  fees  com- 
monly paid  : 

for  ( 'ollecting  and  Receiving  Records. 

In  Connecticut  and  Massachusetts  fifty  cents  is  paid  for  collecting 
and  recording  data  concerning  each  birth:  as  the  fee  for  recording  in 
these  states  is  twenty  cents,  the  fee  for  collecting  must  be  thirt)  cents. 
In  Maine  and  New  Hampshire  the  fee  for  collecting  is  twenty-five  cents. 
In  Vermont  and  Wisconsin  fifteen  cents  each  is  paid  for  collecting  birth 
and  death  records,  and  in  Rhode  Island  fifteen  cents  for  births,  and  in 
Michigan  ten  cents.  In  Pennsylvania  the  fee  paid  the  assessors  for 
collecting  records  of  births  and  deaths  is  fifteen  cents,  and  in  Kentucky 
it  is  two  cents.  In  Connecticut  ten  cents  is  paid  for  inserting  the  name 
of  the  child  iii  birth  returns  which  are  thus  defective. 

/•'"/■  Reporting  Births,  I>r,iths,  and  Marriages. 

In  Rhode  Island  undertakers  are  paid  five  cents  for  each  certificate 
of  death,  and  in  Wisconsin  physicians  are  paid  twenty-five  cents.  In 
Delaware  five  cents  is  paid  for  each  birth,  marriage,  and  death  reported. 

In    Connecticut,    .Maine.   Massachusetts.    New    York,    Rhode    Island,  and 

Virginia,  twenty-five  cents,   ami   in  Vermont    ten  cents,  for  births.     In 


l  Among     these      Mi;i\       lie      I  nen  I  iellei  I      |{r<  ••  ik  I  V  II,      Buffalo,     <  'le\e|;|lnl.     Dl 

District  of  Columbia,   Erie,   Minneapolis,   Omaha,  the  Pennsylvania   i-ities  r»f  the 
second  class,  Philadelphia,  Rochester,  Wilmington. 


9 8  REG  is  Til.  1  77  0 X  0 F    T  rIT.  i  L   $  7\  1  TIS  Tics. 

New  Hampshire  twenty-five  cents  is  paid  for  returns  of  births,  mar- 
riages, and  deaths.  In  New  York  and  Rhode  Island  twenty-five  cents 
is  paid  for  returns  of  marriages.  In  Connecticut  registrars  receive  five 
cents  for  receiving  and  certifying  returns  of  deaths  and  births;  in  New 
Jersey,  ten  cents,  and  in  Wisconsin,  fifteen  cents. 

For  Recording. 

In  Michigan  twenty-five  cents  is  the  fee  for  receiving,  recording  and 
returning  deaths,  and  the  same  amount  is  paid  in  Minnesota  for  the 
same  service  in  regard  to  births  and  deaths.  In  Connecticut,  Massa- 
chusetts, and  Rhode  Island  twenty  cents  each  is  the  fee  for  receiving, 
recording,  indexing  and  returning  records  of  births,  marriages,  and 
deaths,  except  that  in  Connecticut  for  sending  returns  to  the  state 
registrar  each  month  the  local  registrar  receives  in  addition  two  dollars, 
or  if  over  two  hundred  names,  two  cents  per  name.  In  California, 
Maine,  New  Hampshire,  and  Vermont  the  fee  for  recording,  indexing 
and  returning  is  fifteen  cents.  In  Delaware  and  West  Virginia  it  is 
fifteen  cents.  In  Pennsylvania  the  fee  for  recording  is  five  cents,  and 
in  New  Jersey  cities  three  cents.  In  New  Orleans  fifty  cents  is  charged 
the  family  for  recording  births  and  deaths,  and  one  dollar  for  marriages. 

For  Searching  Records. 

In  most  states  and  cities  the  examination  of  records  is  free  to  the 
public,  but  sometimes  a  fee  is  prescribed  for  a  search  of  the  records  by 
the  officer  in  charge.  In  Pennsylvania  this  is  ten  cents;  in  Delaware, 
fifteen  cents;  in  Brooklyn  it  is  fifty  cents  for  each  year  covered  by  the 
search,  but  in  that  city  no  charge  is  made  for  a  copy  of  record,  but 
twenty-five  cents  is  required  for  certification.1 

For  I  '"j'n  of  Record. 

Generally  the  fee  fixed  for  a  copy  of  record  is  for  a  certified  copy. 
In  New  Jersey  a  copy  of  record  is  ten  cents:  in  Sacramento,  twenty-five 
cents,  in  Delaware,  thirty  cents ;  in  Providence,  forty  cents ;  in  New  York, 
Pennsylvania,  New  (  hleans  (  births  and  deaths),  Wilmington,  fifty  cents  ; 
in  Cleveland,  Cincinnati,  St.  Louis,  and  New  Orleans  (marriages),  one 
dollar:  in  San  Francisco  one  dollar  and  one-half.  In  the  District  of 
Columbia,  Louisville,  and  in  San  Francisco,  for  widows  and  children  of 
soldiers  no  charge  is  made. 

For  Copies  of  Record  Sent  to  Other  Towns. 

Such  copies  must  be  sent  under  the  Massachusetts  law,  and  the 
clerk  receives  therefor  twenty-five  cents  for  each  return. 


1  These  were  the  rules  before  consolidation  with  New  York. 


REGIS  TEA  TION    OF    \  rH\  I  L    8  T  1  Tls  Til  '&  99 

For  Burial  and  Disinterment  Permits. 

Undertakers  are  sometimes  required   to  pay  for  burial   permits.      In 
Connecticut  and  Vermont,  Bradford  and  Reading,  J'a..  and  Pawtucket, 
R.  I.,  the  fee  is  twenty-five  cents.      For  disinterment  permits  the  t 
twenty-five    cents  in   Connecticut,    New   Orleans,  and   Reading;    fifty 

cents  in  Philadelphia,  and  two  dollars  in  California. 

Penalties. 

A  penalty  is  usually  imposed  for  the  violation  of  registration  laws. 
Not  only  are  the  physicians,  midwives,  undertakers,  parents,  clergymen, 
etc.  liable  for  failure  to  send  in  the  required  returns,  but  the  registrar 
is  also  liable  if  he  neglects  his  duties. 

The  penalty  varies  from  a  minimun  of  five  dollars  in  Colorado  and 
Delaware  to  a  maximum  of  one  hundred  dollars  in  Indiana.  Maine, 
Michigan,  and  New  Hampshire. 

Disposal  of  the  Dead. 

Power  to  make  rules  and  regulations  concerning  the  disposal  of  the 
dead  has  been  given  to  towns  and  cities  by  general  statute  in  several 
states  as  in  Massachusetts,  Michigan,  New  Jersey.  New  York.  Penn- 
sylvania, and  by  special  legislation  to  many  cities,  in  the  case  of  Phila- 
delphia as  early  as  22    April,  17i>4. 

Some  of  the  above  states  and  certain  others,  as  ( !olorado  and  Illinois, 
vest  the  control  of  cemeteries  in  the  hands  of  the  local  government, 
authorizing  it  to  forbid  the  further  use  of  cemeteries,  and  to  prescribe 
regulations  for  new  ones.  Cemeteries  are  also  very  often  owned  or 
managed  by  corporations,  church  or  otherwise,  ami  are  therefore  subjeel 
to  their  charters,  which  frequently  prescribe  many  details  of  their  man- 
agement. Many  towns  and  cities  own  cemeteries,  the  ownership  in 
many  cases  dating  from  the  firsl  set t lenient .  Moreover  the  regulation 
of  the  disposal  of  human  remains  is  so  manifestly  a  matter  which  may 
effect  the  public  health,  that  control  of  it  by  the  local  sanitary  author- 
ity is  assumed  in  any  broad  grant  of  powers.  Most  of  the  legislation 
in  regard  to  cemeteries  concerns  the  relations  of  the  corporation  to  the 
lot  or  grave  owners,  the  protection  of  the  grounds,  etc.,  and  does  not 
relate  to  sanitary   matters,  these  being  usually   left   to  the   local    hoard   of 

health.      Isnalh    a    municipal    cemetery   is  managed    b}    a  commit 

hill  sol i let  i nies  it    is  entirely   in  the  hands  of  the  hoard  of  health.       Among 

important    cities   whose    health   department    manages    their   munii 
cemeteries   ma\    be   mentioned    Boston,    Baltimore,    New   Orl<  I 

San  Francisco. 


100  REGISTRATION  OF    VITAL   STATISTICS 

The  danger  of  the  contamination  of  water  supplies  by  cemeteries 
has  been  much  discussed.  The  best  information  seems  to  be  that  the 
danger  is  very  small;  but  the  law  given  below  has  recently  been  passed 
in  Pennsylvania.1 

In  Lowell  it  is  required  that  a  plan  of  drainage  of  cemeteries  shall 
be  filed  with  the  board  of  health. 

As  the  town  and  cities  and  local  health  authorities  have  such  con- 
trol and  power  over  the  disposal  of  the  dead,  most  of  the  regulations 
in  regard  to  these  matters  are  found  among  local  sanitary  enactments, 
rather  than  in  the  state  laws.  Many  regulations  have  to  do  with  the 
care  of  bodies  dead  with  contagious  disease,  but  these  will  be  considered 
in  another  chapter.  Sometimes  very  general  provisions  are  found 
requiring  the  sanitary  disposition  of  bodies.      The  New  York2  rule  is 

"  That  no  person  shall  retain,  expose,  or  allow  to  be  retained  or  exposed,  the  dead 
body  of  any  human  being  to  the  peril  or  prejudice  of  the  life  or  health  of  any 
person.1' 

Carrying  of  Bead  Bodies. 

The  removal  of  a  body  in  any  public  carriage  is  sometimes  forbidden 
as  in  Hartford3  and  Providence. 

Time  of  Burial. 

In  order  to  prevent  concealment  of  crimes  or  contagious  disease,  it 
is  sometimes   forbidden  that  burials  shall    take  place  during  the  night.4 

The  time  during  which  bodies  may  remain  unburied  is  frequently  a 
subject  of  regulation.  In  Florida  and  New  Orleans  this  is  twenty-four 
hours  in  summer  ;  and  in  Florida  forty-eight,  and  in  New  Orleans  thirty- 
six  hours  in  winter.  In  the  city  of  Xew  York  the  limit  is  four  days 
unless  a  permit  stating  the  time  the  body  may  remain  unburied  is 
obtained  from  the   health   department.      In    Minnesota  the    time  is  four 

1  Chapter  151  of  1895: 

tk  Section  1.  Be  it  enacted,  etc.,  That  it  shall  be  unlawful  to  use  for  the  burial 
of  the  dead,  any  land,  the  drainage  from  which  passes  into  any  stream  furnishing 
the  whole  or  any  portion  of  the  water  supply  of  any  city,  except  beyond  the  dis- 
tance of  one  mile  from  such  city  :  Provided  however,  That  the  prohibitions  of  this 
act  shall  not  be  enforceable  against  any  land  now  devoted  to  burial  purposes  in 
which  there  shall  have  heretofore  been  burials  and  sales  of  burial  lots.1'' 

2  City  of  New  York,  Sanitary  Code  (1899),  Sec.  175. 

3  Hartford,  Ordinances,  Chapter  XVIII.  : 

"  Sec.  15.  No  hack  or  public  carriage,  owned  or  kept  for  hire,  shall  be  used  for 
transporting  the  body  of  any  person  who  shall  have  died  of  disease. 

4  Boston,  Ordinances,  Chapter  49: 

11  Sec.  20.  No  person  shall  bury  a  dead  body,  or  cause  one  to  be  buried,  at  any 
other  time  than  between  sunrise  and  sunset,  except  in  accordance  with  a  permit 
from  the  Board  of  Health. " 


REG  is  TRA  TION  0  F    \  rIT.  I  L    S  T.  J  Tls  Tit  .\  mi 

days.  In  Buffalo  the  time  for  which  a  permit  may  be  given  is  six  days, 
and  without  special  permission  a  body  may  remain  unburied  not  over 
three  da}-s.  The  time  in  deaths  from  contagious  dist-as.-  is  often  made 
less  than  this,  frequently  twenty-four  hours.  Besides  regulations  such 
as  the  above,  the  health  officer  sometimes  has  power  to  order  burial.1 

The  two  sections  following  the  one  given  below  provide  for  the 
service  of  the  orders  and  instruct  the  police  to  report  to  the  health 
commissioner  when  bodies  are  kept  too  long-  without  burial,  and  to 
assist  in  enforcing  the  commissioner's  orders  in  regard  to  the  same.  In 
the  City  of  New  York  the  hoard  of  health  may  peremptorily  order  the 
burial  of  bodies  even  in  coroners'  cases.  The  storing  of  dead  bodies 
except  for  ••  freezing  or  embalming"  is  forbidden  in  Memphis. 

Embalming. 

In  order  to  prevent  the  concealment  of  criminal  poisoning  the  fol- 
lowing lias  been  enacted  in  Buffalo:  - 

•  Sec.  71.  STo  person  shall  embalm  any  dead  body  without  a  written  certificate 
from  the  attending  physician  that  there  an-  no  facts  attending  the  illness  and  deatli 
of  the  person  that  would  preclude  such  embalming  from  a  medico-legal  standpoint. 
Provisions  of  tins  ordinance  shall  not  apply  to  cases  of  death  from  injury  or  acci- 
dent. 

■•  Sec.  72.  No  person,  company,  or  corporation  shall  embalm  the  body  of  a 
deceased  person  unless  he  or  it  shall  have  firsl  conformed  to  the  rules  and  regula- 
tions prescribed  by  the  coroner,  and  procured  a  permitfrom  the  health  commis- 
sioner, nor  shall  such  permii  be  granted  until  all  the  rules  and  regulations  of  the 
department  of  health  or  the  commissioner  have  been  complied  with." 

Buriah  only  hi  Cemetery. 

Burial  elsewhere  than  in  a  cemetery  is  forbidden  in  ( Charleston,  ( Cin- 
cinnati,  New   Orleans.  Newport.    Providence,    Heading.   St.  Louis,  and 

other  cities.        Ill    St.    LOUIS  and    Newport    the   health   officer   is  directed   to 

disinter  all  bodies  buried  contrary  to  this  rule. 

1  st.  Louis,  ( Ordinances  I L893),  Chapter  \  I  V. : 

1Sec.  306.  Interment,  when  ordered  to  be  made.  Whenever  the  inter 
men  I  of  the  body  of  any  deceased  person  in  the  limits  of  the  citj  of  St.  Louis  has 
in  the  opinion  of  the  health  commissioner  been  unnecessarily  delayed,  or  where  for 
sanitarj  reasons  the  interment  of  the  bodj  as  aforesaid  should  take  place  forthwith, 
or  where  in  the  opinion  of  the  said  health  commissioner  such  delaj  tnaj  be  injurious 
t..  the  public  health,  or  endanger  the  li\«'>  of  the  citizens  of  this  city,  it  shall  !><•  Ins 

dut\  to  issue  ; rder  directing   that   said    bodj  shall  be  interred  forthwith. 

order  shall  be  directed  to  the  relatives,  friends,  person  or   persons  having  in  • 
the  body  of  Buch  deceased   person.      If  the  relatives,   friends,  person  or  persons, 
a>  aforesaid,  fail  or  refuse  to  obej  said  order,  then  and  in  that   case  the  liealtl 
mission. u-  shall  have  the  power  to  remove  such  body,  and  it   shall  be  his  dutj   to 
cause  the  body  to  !><•  immediately  interred  in  the  public  cemeti 
Buffalo,  Ordinances  (1897),  Chapter  X  \\  . 


102  REGISTRATION  OF    VITAL    STATISTICS. 

Depth  of  Grace. 

This  is  very  commonly  regulated.  It  must  be  three  feet  deep  in 
New  ( h'leans,  five  feet  in  Fitchburg,  six  feet  deep  or  four  below  the 
level  of  the  street  in  the  City  of  New  York,  Buffalo,  and  Memphis  ; 
six  feet  in  Philadelphia,  St.  Louis,  and  Yonkers  ;  and  eight  in  the  built 
up  portion  of  Philadelphia.  The  top  of  the  coffin  must  be  three  feet 
below  the  surface  in  Boston,  Cambridge,  and  Newport  ;  three  and  one- 
half  in  New  Jersey,  if  the  coffin  is  four  feet  long  or  less  ;  four  in  Bridge- 
port and  in  New  Jersey,  if  the  coffin  is  over  four  feet  long ;  and  five  in 
Atlanta.  In  New  Orleans  graves  must  never  be  less  than  two  feet 
apart. 

Only  One  Body  in  a  Grave. 

In  Atlanta,  Buffalo,  and  Charleston  it  is  forbidden  to  place  more 
than  one  body  in  a  grave.  In  Lowell  only  two  bodies  may  be  in  one 
grave,  and  in  other  cities  only  one  body  may  be  placed  in  a  grave  except 
that  a  child  may  be  buried  with  a  parent. 

Grave  to  be  Immediately  Filled. 

According  to  the  New  Jersey  statute,  and  the  rules  of  the  Lowell 
board  of  health,  a  grave  must  be  immediately  filled  when  the  body  is 
placed  in  it. 

Vaults  and   Their  Use. 

Instead  of  burial  in  graves,  deposit  in  a  vault  or  tomb  is  sometimes 
the  method  employed  for  disposing  of  bodies.  This  is  not  considered 
desirable,  and  from  its  expense  and  perhaps  other  reasons,  is  not  very 
common.  Sometimes  the  construction  and  use  of  such  vaults  is  for- 
bidden as  in  Charleston  and  Philadelphia.1 

In  other  cities  permits  are  required  for  the  construction  of  vaults. 
In  Yonkers  a  permit  is  required  for  the  use  of  a  vault.  The  method  of 
construction  of  vaults  is  often  regulated  and  sometimes,  as  in  Buffalo, 
the  plans  must  be  approved. 

Receiving   Va nits. 

Most  cemeteries  have  a  common  receiving  vault  in  which  bodies  may 
temporarily  remain  awaiting  burial  or  transportation.     Often  the  length 


1  Philadelphia,  Rules  of  Board  of  Health  (1895),  Sec.  205e: 

"  The  placing  of  a  dead  body  in  any  unsealed  overground  vault,  catacomb  or 
other  receptacle  above  ground  or  in  underground  vaults,  except  such  as  are  fitted 
with  a  stone  covering  to  be  tightly  cemented  after  each  interment,  is  strictly  pro- 
hibited, unless  the  coffin  or  casket,  containing  the  remains,  shall  be  first  per- 
manently and  hermetically  sealed  in  a  metal  case.  This  rule  does  not  apply  to 
receiving  vaults." 


REGISTRATION  OF    VITAL    STATISTICS.  103 

of  time  a  body  may  remain  in  the  vault  is  limited.  Thus  in  New  Jersey 
a  body  cannot  remain  in  a  vault  over  forty-eight  In  mis  between  tin-  Hist 
of  May  and  the  first  of  November,  unless  the  vault  is  below  ground,  or 
the  body  is  in  an  air  tight  casket.  In  Buffalo1  and  some  other  cities  it 
is  seventy-two  hours  during  the  same  season.  In  Cincinnati2  a  body 
may  remain  in  a  vault  for  live  days.  In  Newport,  R.  I.,3  a  body  may 
remain  in  a  vault  for  ten  days  only,  without  a  permit,  and  must  be  in 
a  strong,  tight  box  ready  for  removal. 

Inspection  ami  Disinfection  of  Vaults. 

In  a  number  of  cities  it  is  prescribed  that  vaults  shall  be  inspected 
and  cleansed  from  time  to  time.  In  Ihiffalo  they  are  to  be  emptied  and 
cleansed  on  the  first  of  May  of  each  year.  The  Newport.  R.  I.,  rule  is 
given  below.4 

Disinterments. 

Permits  are  required  for  the  disinterment  of  bodies  by  the  laws  of 
California,  Connecticut.  Iowa.  Ohio,  Maine.  New  Hampshire  (  for  cities), 
New  Jersey,  and  in  Atlanta.  Augusta.  Boston,  Buffalo,  Cambridge. 
Charleston,  Lowell.  Memphis,  Milwaukee,  Minneapolis,  New  Orleans, 
and  Wilmington.  It  is  sometimes  required,  as  in  Ohio,  that  the  appli- 
cation must  be  made  by  the  next  of  kin  and  must  be  sworn  to.  In 
Wisconsin  the  permit  must  be  approved  by  the  state  board  of  health. 
Forms  for  such  application  and  for  permits  are  shown  in  Appendix  -•">. 

In  San  Francisco"  it  is  required 

"  That  tin-  Inspector  of  Vaults  ami  Disinterments  lie  instructed  to  see  that  disin- 
terments and  removals  of  human  remains  from  the  cemeteries  shall  be  conducted 

so  as  not  to  he  offensive  to  the  senses,  or  injurious  to  public  health." 

»  Buffalo,  Ordinances  tls'.'Ti.  Chapter  25,  Sec.  46. 

Cincinnati,  Manual  of  Health  Department  (1898),  Sec.  100. 
Newport.  Ordinances  (1892),  Chapter 23,  Sec.  12. 

•  \cwport.  Ordinances  (1892-),  Chapter  23,  Sec.  11: 

•■  Every  vault  or  tomb,  buill  wholly  or  partially  above  the  surface  of  the  ground 
ami  used  or  designed  for  t  he  reception  of  dead  ho<]ies  in  anj  cemetery  or  other  place 
in  said  city,  shall  he  examined  ami  shall  he  opened  bj  the  proprietor  thereof,  or  by 
the  person  or  persons  in  charge  thereof ,  for  examination  by  the  mayor  or  the  in- 
spector of  nuisances,  or  any  member  of  the  board  of  health  of  said  city,  or  any 
person  designated  i>>  said  hoard  whenever  and  as  often  as  either  of  the  above  named 
city  officers  or  any  person  designated  by  said  hoard  as  aforesaid,  shall  dea 
requesl  the  same,  and  shall  he  thoroughlj  cleansed  ami  purified  by  such  proprietor, 
f>r  person  or  persons  in  charge  thereof,  under  the  direction  of  said  inspector  of 
nuisances,  or  of  a   person  designated   by  said  hoard  as  aforesaid,  as  often  as  such 

inspector,  or  SUCh  last   named    person  shall    require  the  same  to  he  done,  n 
ing  four  t  hues  in  any  one  \  ear. 

San  Francisco,  Rules  of  the  Board  of  Health,  -:i  Dee.  1884. 


104  REGISTRATION  OF    VITAL    STATISTICS. 

In  Philadelphia  permits  for  removal  from  grave  to  grave  or  cemetery 
to  cemetery  in  the  city  may  be  given  by  the  clerk,  but  all  other  disin- 
terment permits  must  be  given  by  the  board.  In  Pennsylvania  disin- 
terments must  not  take  place  between  sunset  and  sunrise.  In  Phila- 
delphia permits  must  be  used  within  seventy-two  hours  after  they  are 
issued.  In  Ohio  disinterments  cannot  be  made  between  April  1st  and 
October  1st.  The  Wilmington  rules  require  that  a  disinterment  shall 
not  be  made  within  six  months  after  death,  and  in  California  a  body 
cannot  be  disinterred  for  a  year  without  consent  of  the  mayor  and  coun- 
cil. In  ( )hio  the  disinterment  of  contagious  disease  is  forbidden,  and 
in  New  Jersey  it  can  only  be  disinterred  when  in  a  metallic  coffin.  In 
Buffalo  such  a  body  cannot  be  disinterred  for  ten  years  after  burial. 
In  San  Francisco  there  are  two  disinterment  inspectors  who  supervise 
all  disinterments  and  collect  the  fees. 

Cremation  has  received  statutory  recognition  in  several  states,  as 
Connecticut,  Massachusetts,  Minnesota,  and  Pennsylvania.  In  Massa- 
chusetts no  body  shall  be  cremated  within  forty-eight  hours  after  death, 
except  in  cases  of  contagions  disease,  and  not  until  it  has  been  viewed 
by  the  medical  examiner  and  his  certificate  been  given  that  judicial 
inquiry  is  not  necessary.  A  somewhat  similar  law  is  found  in  Con- 
necticut. In  Pennsylvania  where  burial  permits  are  not  required,  it  is 
neccessary  that,  prior  to  cremation,  a  permit  shall  be  obtained  from  the 
health  authorities  of  the  locality  where  the  crematory  is  situated.  In 
St.  Louis1  a  written  application  must  be  made  by  the  friends  of  the 
deceased  and  may  be  refused  by  the  health  commissioner  if  he  is  not 
satisfied  that  it  is  propel'  to  cremate  the  body.  In  Minnesota  a  body 
may  be  cremated  on  request  of  friends.  In  San  Francisco2  it  is  forbid- 
den to  construct  a  crematory  within  three  hundred  feet  of  a  street  or 
park,  and  a  crematory  must  be  operated  so  as  not  to  be  detrimental  to 
public  health  and  decency.  In  ( ionnecticut  plans  of  the  crematory  must 
be  approved  by  the  state  board  of  health.  In  Buffalo3  a  coffin  used  to 
convey  a  body  to  a  crematory  must  not  be  used  again. 

The  use  of  bodies  for  dissection  is  permitted  and  regulated  by  the 
laws  of  several  states. 

The  regulation  found  in  Cincinnati,  which  forbids  the  placing  in  the 
streets  of  ice  which  has  been  used  upon  dead  bodies,  is  in  the  line  of 
decency,  but  it  hardly  seems  that  such  a  regulation  ought  to  be  neces- 
sary. 


1  St.  Louis,  Ordinances  (1892).  Sec.  309. 

-San  Francisco,  Rule  of  Board  of  Health,  March  21,  1894. 

■'■  Buffalo,  Ordinances  (1897),  Chapter  25,  Sec.  53. 


REGISTRATION  OF    VITAL    STATISTICS.  j()5 

STATUTES    CONSULTED    IN    THE    PREPARATION    OF   THIS    ChAPTEK. 

Alabama.     Registration,  Code  (1896),  Sees.  2436-41. 

Marriage,  Code  (1896),  Sees.  2837-51. 
Arizona.     Registration,  Penal  Code  (1887),  Sec.  640. 

Marriage,  Chapter  77  of  1891, 
Arkansas.     Registration,  Statutes  (1894),  Sees.  519-20. 

Marriage,  Statutes  (1894),  Sees.  4906-39. 
California.     Registration,  Political  Code  (1880),  Sees.  3074-84. 

Disinterments.  Act  of  13  March,  1889. 

Marriage,  Civil  Code  (1885),  Sees.  68-79. 
Colorado.     Registration.  Act  of  17  April,  1893,  Sees.  46-50. 

Cemeteries,  Act  of  17  April,  1893,  See.  54. 

Marriage,  Annotated  statutes  (1891),  Sees.  2988-3006. 
Connecticut.     Registration,  General  statutes  (1888),  Sees.  98-116,  2582. 

Registration,  Chapter  155  of  1893. 

Registration,  Fees,  Chapter  166  of  1893. 

Registration.  Completing  Records,  Chapter  195  of  1895. 

Registration,  Fees,  Chapter  1'.'  of  L897. 

Registration,  Completing  Records,  Chapter  121  of  1897. 

Cremation,  Chapter  228  of  1895. 

.Marriage,  General  Statutes  (1888),  Sees.  27*7   89. 

Marriage,  Chapter  6:'.  of  1895. 
Delaware.     Registration,  Revised  Code  (1893),  p.  594.  Chapter  74. 

Marriage,  Revised  Code  (1893),  p.  405,  Chapter 381,  Vol.  in.  Laws  of  Delaware. 
Florida.     Registration,  Chapter  33  of  1899. 

Marriage,  Revised  statutes  (1892),  Sees.  2055  60. 
Georgia.     Marriage.  Code  (1882),  Sees.  1703-10. 
Idaho.     Marriage,  Act  of  14  February,  1899. 
1 1, i, inoi-.     Registration,  Annotated  statutes  (1896),  Chapter  L26a,  Sees.  ;;  9. 

Marriage,  Annotated  Statutes  (1896),  Chapter  89. 
Indiana.     Registration.  Acl  of  28    \|>ril.  L899. 

Marriage.  Statutes  (1897),  Sees.  7642  52. 
low  \.     Registration,  ('ode  (1897),  Sees.  2565  7. 

Marriage,  Code  (1897),  Sees.  :;i  in  52. 
K  \  \  -  \-.     Registral  ion.  <  General  Statutes  (1897),  Chapter  75,  Sec.  9. 

Marriage,  General  Statutes  (1897),  Chapter  123. 
Kenti  cky.     Registration,  Mamies  (1894),  Sees.  2581   90. 

Marriage,  statutes  (1894),  Sees.  2096  --'in;. 
Louisiana.     Registration,  Revised  Code  (1889),  Sees.  338   18. 
i  rat  ion.  Chapter  192  of  1898. 

Marriage.   Revised  Civil  Code  (1889),   Arts.  99    L09. 
M  mm..     Registration,  statutes.  Supple t  (1895),  p.  370,   Intending  Chaptt  i 

Registration,  Chapter  282  of  1897. 

Marriage,  Revised  statutes  (1883),  Chapter 59. 
M  \  i;\  land.     Registration,  Chapter  312  of  1898. 

Anat ical  Material,  Chapter  L66  of  1890. 

Marriage,  Public  General  Laws  (1888  .   Lrt.  62. 
Massachusetts.     R<  gistration,  Public  Statute  Sec.  18. 

Registration,  Chapter  ill  of  1897. 

Burials,  chapter  278  of  1885. 

Burials,  Chapter  i:;7  of  L897. 

i  remation,  chapter  265  of  1885. 
Anatomical  Material,  Chapter  179  ol  1898. 

Marriage.    Public  Statutes  |  L882),  Chapter  I  15. 


106  REGISTRATION  OF    VITAL    STATISTICS. 

Massachusetts,  continued. 

Marriage,  Chapter  300  of  1892. 

Marriage,  Chapter  401  and  409  of  1894. 

Marriage,  Chapter  424  of  1897. 

Marriage.  Chapter  197  and  887  of  1899. 
Michigan.     Registration,  Compiled  Laws  (1897).  Sees.  4014-20. 

Burials,  Compiled  Laws  (1S97),  Sec.  4414. 

Marriage,  Compiled  Laws  (1897),  Sees.  8602-10. 

Marriage,  Chapter  247  of  1899. 
Minnesota.     Registration,  Statutes  (1894).  Sees.  436-441.  107. 

Cremation,  Chapter  132  of  1897. 

Marriage.  Statutes  (1894).  Sees.  4768-84. 
Mississippi.     Registration,  Chapter  15  of  1897. 

Marriage,  Annotated  Code  (1892),  Sees.  2860-65. 
Missouri.     Marriage,  Revised  Statutes  (1899),  Sees.  4315-22. 
Montana.     Registration,  Political  Code  (1895),  Sees.  2870-75. 

Marriage,  Civil  Code  (1895),  Sees.  70-80. 
Nebraska.     Embalmers,  Chapter  52  of  1899. 

Marriage,  Compiled  Statutes  (1899),  Sees.  3642-58. 
Nevada.     Marriage,  General  Statutes  (1885),  Sec.  470. 

Marriage,  Chapter  35  of  1899. 
New  Hampshire.     Registration,  Public  Statutes  (1891),  Chapter  178. 

Registration,  Chapter  53  of  1895. 

Registration.  Chapters  6  and  17  of  1899. 

Embalmers,  Chapter  76  of  IS! if*. 

Marriage,  Public  Statutes  (1891),  Chapter  174. 

Marriage.  Chapter  is  of  1897. 
New  Jersey.     Registration,  General  Statutes  (1895),  p.  2006. 

Burials,  General  Statutes  (1895),  p.  1645,  Sec.  12,  XIV. 

Burials,  General  Statutes  (1895).  p.  76,  Sec.  16. 

Anatomical  Material,  Chapter  395  of  1895. 

Marriage,  General  Statutes  (1895),  p.  2003. 

Marriage,  Chapter  193  of  1897. 

Marriage,  Chapter  119  of  1898. 

Cemeteries,  General  Statutes  (1895),  p.  849. 
New  Mexico.     Marriage,  Compiled  Laws  (1897),  Sees.  1413-30. 

New   Yoke.     Registration,    General    Laws    (1896),    p.    2422.     Public    Health    Law. 
Chapter  25,  Sees,  5,  22,  23. 

Registration,  Chapter  138  of  1897. 

Embalmers,  Chapter  555  of  1S98. 

Marriage,  Genera]   Laws   (1896),    p.   930,   Domestic   Relations   Law,    Chapter  48, 
Art.  II. 

Marriage,  Chapter  272  of  1896. 
North  Carolina.     Registration.  Act  of  1  March,  1893. 

Marriage,  Code  (1883),  Sees.  1809-18. 
North  Dakota.     Registration,  Revised  Code  (1899),  Sec.  274  a-g. 

Marriage,  Revised  Code  (1899).  Sees.  7272-5. 
Ohio.     Registration.  Annotated  Statutes  (1900),  Sees.  6395-9. 

Marriage.  Annotated  statutes  (1900),  Sees.  6884-94. 
Oklahoma.     Marriage.  Chapter  _'•"»  of  1897. 
Oregon.     Marriage.  Annotated  Laws  (1892),  Sees.  2852-8. 
Pennsylvania.     Registration,  Brightly's  Purdon's  Digest  (1894).  pp.  1851-7. 
Registration.  Chapter  156  of  1895. 

Anatomical  Material.  Brightly's  Purdon's  Digest  (1894),  p.  106. 
Cremation,  Brightly's  Purdon's  Digest  (1894),  p.  466. 


R  EG  IS  TIL  i  TION   OF    VITA  L    s  TA  TIS  TI<  >.  107 

Pennsylvania,  continued. 

Cemeteries,  Chapter  151  of  1895. 

Marriage,  Brightly's  Pardon's  Digest  (1894),  p.  1295. 
Rhode  Island.     Registration.  General  Laws  (1896),  Chapter  100. 

Registration,  Chapter  452  of  the  Public  Laws. 

Registration,  Chapter  616  of  the  Public  Laws. 

Marriage,  General  Laws  (1896),  Chapter  191. 

.Marriage.  Chapter  549  of  the  Public  Laws. 
South  Carolina.     Registration.  Act  of  •">  January,  1895. 

Registration,  Revised  statutes  (1893),  Sees.  2157-67. 
South  Dakota.     Embalmers,  Chapter  87  of  1899, 
Tennessee.     Marriage,  Code  (189G),  Sees.  4185-200. 
Texas.     Marriage,  Chapter  170  of  1899. 

Marriage.  Revised  Statutes  (1895),  Sees.  2!i.")4-(iL'. 
I't  ui.     Registration,  Revised  Statutes  (1898  ),  Sees.  1104,  2o:i! •-:!:). 

Registration,  Chapter  45  of  1899. 

Marriage,  Revised  Statutes  (1898),  Sees.  OOl',  2183-97. 
VERMONT.     Registration.  Chapter  59  of  1899. 

Marriage,  Statutes  (1894),  Sees.  2632-4:!. 
Virginia.     Registration,  Act  of  7  March,  1900. 

Marriage,  Code  (1887),  Sees.  2216-22. 
Washington.     Registration,  Code  and  Statutes  (1897),  Sees.  2U7><  69. 

Marriage,  Code  and  Statutes  |  1897),  Sees.  44G7-83. 
West  Virginia.     Registration,  Code  (1899),  Chapter  150,  Sees.  23-29. 

Embalmers,  Chapter  60  of  1899. 

Marriage,  Code  H899).  Chapter  63. 
\\  i-.  onsin.     Registration,  Statutes  (1898),  Sees.  1022-29. 

Registration.  Chapter  250  of  1899. 

Marriage,  Statutes  (1898),  Sees.  2328-39. 

Marriage,  Chapter  301  of  1899. 
Wyoming.     Marriage,  Revised  Statutes  (1899),  Sees.  2955-71. 


CHAPTER   III. 

NUISANCES. 

IT  is  the  popular  idea  that  the  chief  function  of  the  board  of  health  is 
the  abatement  of  nuisances  ;  and  it  must  indeed  be  admitted  that  a 
large  part  of  the  time  and  energy  of  sanitary  officers  is  taken  up  in  the 
performance  of  this  duty.  A  nuisance  has  been  variously  denned  by 
statute  and  by  legal  writers,  but  in  general  it  may  be  said  to  be  any- 
thing which  is  a  violation  of  the  maxim,  "  sic  utere  tu<>  uf  alienum  n<>nx 
laedas."  It  is  the  use  of  one's  own  property  in  such  a  way  as  to 
injure  the  rights  of  another  and  to  inflict  damage. 
The  following  is  a  recent  statutory  definition  :  ] 

"  Whatever  is  dangerous  to  human  life  or  health,  and  whatever  renders  soil,  air, 
water,  or  food  impure  or  unwholesome,  are  declared  to  be  nuisances,  and  every  per- 
son, either  owner,  agent,  or  occupant,  having  aided  in  creating  or  contributing  to 
the  same,  or  who  may  suffer  to  continue  or  retain  any  of  them  shall  be  deemed 
guilty  of  a  misdemeanor." 

Nuisances  therefore  may  be  of  very  many  kinds,  and  it  is  not  with 
all  nuisances  that  boards  of  health  usually  have  to  do.  Nuisances  which 
more  or  less  directly  affect  health,  and  particularly  nuisances  which  con- 
sist of  foul,  offensive  or  otherwise  dangerous  odors  or  gases,  or  which 
are  in  any  way  due  to  decaying  matter,  or  to  impurities  of  any  kind  in 
the  air,  are  the  kind,  the  control  of  which  is  usually  placed  under  Tie 
jurisdiction  of  the  sanitary  authority.  But  long  before  boards  of  health 
were  established  the  control  of  nuisances  was  provided  for.  As  early 
as  1  (>'.>:>  the  colony  of  Massachusetts  Bay  gave  the  selectmen  of  certain 
towns  authority  to  regulate  offensive  trades.  From  that  time  nuisance 
legislation  was  frequently  resorted  to  in  that  and  other  colonies  and  in 
the  states;  and  towns  wrere  during  the  last  century  and  before  there 
was  any  regularly  constituted  sanitary  authority  invested  with  as  broad, 
and  ample  powers  in  regard  to  nuisances  as  they  now  possess.  But 
with  the  development  of  interest  in  sanitary  affairs,  towards  the  middle 
of  the  present  century,  a  more  strict  and  general  application  of  these 
laws  was  felt  to  be  needed.  The  dangers  as  well  as  the  discomforts  of 
filth  were  urged,  doubtless  extravagantly  so,  by  physicians  and  others. 
The  newly  established  boards  of  health  were  therefore  generally  invested 


iUtah,  Chapter  4.')  of  1899,  .Sec.  1. 


NVISAJSTCJES.  109 

with  the  control  of  nuisances  which  before  had  been  exercised  by  the 
selectmen  of  towns  or  the  legislative  department  of  cities.  It  is  the 
general  opinion  that  these  matters  will  he  better  looked  after  by  the 
health  department  than  by  any  other,  and  we  cannot  expect  this  part  of 
the  work  of  the  hoard  of  health  to  become  any  less  in  the  future.  Our 
civilization  ever  demands  greater  cleanliness  and  greater  freedom  from 
nuisances  both  private  and  public;  and  this  is  particularly  true  in 
municipalities,  and  the  necessity  for  greater  care  on  the  part  of  the 
individual  lest  he  permit  or  cause  a  nuisance  increases  with  the  density 
of  the  population.  Hence  the  public  demands  more  than  ever  before 
that  the  municipals/  shall  restrain  such  individual  acts  as  endanger  the 
health  and  comfort  of  those  affected  thereby.  Even  if  it  shall  in  the 
future  l>e  shown  that  tilth  is  not  as  directly  dangerous  to  health  as  it 
has  been  believed  to  be,  there  is  little  probability  that  any  community 
will  cease  to  protect  its  members  from  the  very  great  discomfort  which 
cullies  from  nuisances  due  to  that  cause. 

It  is  not  necessary  then  to  take  up  the  consideration  of  what  a  nuis- 
ance is,  or  discuss  the  flifference  between  a  private  and  public  nuisance 
or  the  redress  which  an  individual  has  either  by  abatement  or  h\  an 
action  for  damages.  Nor  is  it  the  place  to  consider  the  suppression  of 
nuisances  by  injunction.  Our  subject  is  the  statuory  powers  possessed 
by  the  local  health  department  and  the  methods  which  it  roiiininiih 
employs. 

There  are  two  ways  in   which  the  government  commonly  attempts 
to  deal  with  nuisances.     One   is  by   their  abatement,  the   other  is  h\ 
endeavoring  to  prevent  their  creation  by    means  of  appropriate   legisla- 
tive  prohibitions.     The  abatement  of  nuisances  is  rarely  accomplished 
through  the  agency  of   state    sanitan    authority,  but    is    usiialh     left    to 
the    local    government.     I>nt    the   authority    which   the   local   sanitarj 
power  possesses   in    this   held   is  generally  conferred  very  explicitel}   bj 
statute    law.     Usually   these  state   laws  prescribe  quite   minutely   the 
methods  to  he  employed  in  thus  dealing  wit  h  nuisances:    but  sometimes, 
particular^    in    special    charters,  the    power    to    abate    nuisances    is    con- 
ferred   iii    concise    ami    general     terms,  as    it    is    in    Chicago,  Baltimore, 
Omaha,  and    Providence.     Of   the   two   methods   of  dealing  with   nui- 
sances, by  abatement  and  by  prohibition,  the    former  will   be   first   con- 
sidered. 

I.    Abatement  of  Nuisances. 

The  first  general  state  law  that  specifically  provided  for  the  manner 

in  which  the  local  government  should  order  the  abate nt  of  nuisances 

and  secure  compliance  with  its  order  was  that  enacted  in  Massachusetts 
in    17(.»7.     Thai    law   has   remained    practically    unchanged    upon    the 


HO  NUISANCES. 

statute  books  until  the  present  writing,  over  100  years,  and  it  has  served 

for   a   model,  being  copied   almost  verbatim  by  fourteen   other  states.1 

The  following  is  the  law  : 2 

"  The  board  or  the  health  officer  shall  order  the  owner  or  occupant  at  his  own 
expense  to  remove  any  nuisance,  source  of  filth,  or  cause  of  sickness,  found  on  pri- 
vate property,  within  twenty-four  hours,  or  such  other  time  as  it  deems  reasonable, 
after  notice  served  as  provided  in  the  following  section;  and  if  the  owner  or  occu- 
pant neglects  so  to  do,  he  shall  forfeit  a  sum  not  exceeding  twenty  dollars  for  every 
day  during  which  he  knowingly  permits  such  nuisance  or  cause  of  sickness  to  remain 
after  the  time  prescribed  for  the  removal  thereof.'" 

Besides  the  states  above  mentioned,  at  least  fifteen  others  have  made 
provision  by  general  enactments  for  the  abatement  of  nuisances  within 
their  borders,  though  in  Indiana  and  Texas  the  law  only  applies  to 
cities.  Moreover,  Louisiana,  Mississippi,  Nebraska,  Ohio,  and  Ten- 
nessee provide  that  local  governments  within  their  limits  may  make 
ordinances  for  the  "abatement  of  nuisances/'  In  rare  instances  the 
power  to  abate  nuisances  is  granted  in  very  general  terms  as  in  Kansas 
cities,  which  have  power  "  to  prevent  and  remove  nuisances."  Texas 
and  Tennessee  have  similar  laws.  Usually,  "however,  more  explicit 
directions  are  given  as  to  who  shall  exercise  this  authority  and  how  it 
shall  be  done.  All  but  a  few  of  the  more  sparsely  settled  states  have 
felt  the  necessity  of  providing  some  means  for  the  summary  removal  of 
nuisances. 

As  regards  the  larger  cities  it  will  be  found  that  many,  perhaps 
most  of  them,  though  under  special  charters  and  receiving  their  sanitary 
establishment  from  the  charters,  nevertheless  control  nuisances  under 
the  provisions  of  general  statutes.  Yet  among  the  principal  cities  a 
considerable  number  have  been  given  in  their  charters  or  other  special 
acts  authority  to  deal  summarily  with  nuisances.  Among  some  of  these 
cities  may  be  mentioned  Buffalo,  Chicago,  District  of  Columbia.  Minne- 
apolis, New  York,  St.  Louis,  and  San  Francisco. 

As  public  sanitation  in  the  popular  mind  consists  chiefly  in  the  removal 
of  nuisances,  this  work  is  usually  and  naturally  put  upon  the  sanitary 
authority  wherever  that  is  established  ;  but  this  is  not  always  the  case. 
Thus  in  Rhode  Island  it  is  the  town  council  (or  board  of  aldermen 
in  cities)  which  is  to  order  the  abatement  of  nuisances;  and  until 
quite  recently  the  selectmen  in  Vermont  had  similar  duties.  Originally 
this  wast  lie  plan  throughout  New  England,  and  in  Vermont  and  Rhode 
Island,  where  sanitary  organization   has  been  the  slowest  in  developing, 


1  Colorado,  Connecticut,  Iowa,  Kentucky,  Michigan,  Minnesota,  New  Jersey, 
North  Dakota,  Rhode  Island,  South  Carolina,  Wisconsin,  Vermont,  Wyoming,  Wash- 
ington. 

2  Massachusetts  Public  Statutes  (1882),  Chapter  80,  Sec.  21. 


NUISANCES.  HI 

it  has  been  the  longest  retained.  The  trustees  of  Indiana  townships 
have  the  same  power.  By  Chapter  259  of  the  laws  of  Pennsylvania 
for  1895,  it  was  provided  that  the  select  and  common  council  of  any  of 
the  cities  of  the  third  class  may  petition  the  court  of  common  pleas  of 
the  county  which  shall  appoint  a  commission  of  six  to  report  to  the 
court  on  the  fact  of  the  nuisance.  The  parties  maintaining- the  nuisance 
have  thirty  days  in  which  to  appeal,  and  if  not  abated  the  city  may  pro- 
ceed to  abate  at  once. 

The  laws  of  Alabama,  Virginia,  and  West  Virginia  are  much  alike. 
In  Virginia  a  justice  of  the  corporation  may  on  complaint  of  the  health 
officer  abate  a  nuisance,  and  in  Alabama  the  mayor,  intendant  or 
justice  may  do  so.  In  Georgia  nuisances  may  be  abated  by  an  order  of 
"two  or  more  justices  of  the  peace  of  the  county,  founded  upon  the 
opinion  of  twelve  freeholders  who  shall  be  summoned,  sworn  and 
impaneled  for  the  purpose,"  and  in  towns  or  cities  the  mayor,  intend- 
ant or  commissioners  may  order  a  nuisance  abated  with  the  advice  of  the 
aldermen,  wardens,  council  or  commissioners.  In  West  Virginia  either 
a  mayor,  justice,  constable  or  health  officer  may  abate  nuisances.  In 
Washington,  a  justice  when  no  appeal  is  taken,  or  any  higher  court 
after  conviction  tor  maintaining  a  nuisance,  may  issue  a  warrant  to 
abate  the  same.  The  Illinois  and  Tennessee  laws  contain  a  similar  pro- 
vision. In  a  few  states  the  control  of  nuisances  is  still  retained  by  the 
state  authority.  Thus  in  Florida  the  state  health  officer  is  io  abate 
nuisances,  and  in  Mississippi  the  state  department  of  health,  on  com- 
plaint of  a  local  health  officer,  though  municipalities  may  make  rules 
for  the  prevention  and  abatement  of  nuisances.  In  Arkansas  the  gover- 
nor may  abate  a  nuisance  mi  the  advice  of  the  state  board  of  health. 
Certain  state  boards  of  health  also  retain  among  their  other  executive 
powers  control  over  nuisances  under  certain  conditions,  as  when  no  local 
board    has    been  established,  or  when  such  board     fails  Io  act.      See  also 

page  •"». 

In  New  Jersey  and  Delaware  the  state  board  of  health  is  to  act  il 
the  local    board  of    health     fails  to  do  so.  and    in    New     .lersev    also  when 

;i    nuisance   in   one    local    sanitary   district    affects    the   inhabitants   o| 
another. 

It  is  usually  the  board  of  health  that  has  i  he  power  to  order  the 
abatement  of  nuisances  or  the  single  commissioner  who  takes  the  place 
of  the  board  in  maii\    cities:  but  in  some   localities  it  is  nol    necessary 

for  the  board  as  a   whole  to  ael    in   these  cases.      Thus  at    Bridgeport   the 

"board    of  health  or  either   mber  thereof  or  an)    person  under  their 

direction    or    the    direction    of    either    of    them"     ma\     abate    nuisances. 

In    New    Hampshire  each    member  of  the   board   of  health   ma\ 


112  NUISANCES. 

orders.  In  Massachusetts  the  board  of  health  or  health  officer  may 
issue  the  order,  and  in  Rhode  Island  the  health  officer  may  do  so 
"  when  the  council  cannot  be  conveniently  convened."  In  Cleveland  the 
health  officer  issues  the  orders.  In  some  cities  the  sanitary  inspectors 
or  similar  officers  have  delegated  to  them  the  power  to  issue  nuisance 
orders.     This  is  so  in  Atlanta,  Augusta,  and  the   District  of  Columbia. 

When  a  board  of  health  or  its  agents  are  given  authority  over 
nuisances,  it  is  generally  assumed  that  power  to  enter  upon  private 
premises  for  purposes  of  inspection  is  included.  This  may  the  more 
reasonably  be  assumed  when  the  board  as  is  often  the  case  is  directed 
to  "  examine  into  nuisances  "  ;  but  power  to  enter  private  premises  is 
specifically  given  in  many  statutes  relating  to  this  subject.1 

Sometimes,  as  in  Connecticut,  it  is  simply  provided  that  the  "  health 
officer  may  enter  all  places  when  such  board  shall  have  just  cause  to 
suspect  any  such  nuisances  or  causes  of  filth  to  exist."  In  West  Vir- 
ginia such  inspection  may  be  made  "  except  in  the  night  time."  The 
Detroit  law  is  as  follows  : 2 

l'Also  to  enter  upon  or  within  any  place  or  premises,  where  conditions  dan- 
gerous to  the  public  health  are  known  or  believed  to  exist,  and  by  appointed  mem- 
bers or  persons  to  inspect  and  examine  the  same  for  the  protection  of  life  and  health 
and  for  no  other  purposes  ;  and  all  owners,  agents,  and  occupants  shall  permit  and 
facilitate  such  sanitary  examinations,  and  it  shall  be  the  duty  of  said  board  of  health 
to  furnish  such  owners  or  occupants  a  written  statement  of  results  or  conclusions 
of  such  examination" — "  The  members  of  said  board,  the  health  officer,  or  any  of 
the  sanitary  inspectors,  and  such  other  officer  or  person,  as  may  at  any  time  be  by 
said  board  authorized,  7iiay,  without  fee  or  hindrance,  enter,  examine  or  survey  all 
grounds,  erections,  vehicles,  structures,  apartments,  buildings,  and  places  in  said 
city,  including  vessels  of  all  kinds  in  the  water,  and  all  cellars,  sewers,  passages  and 
excavations  of  every  sort,  and  inspect  the  safety  and  sanitary  condition  and  make 
plans,  drawings,  and  descriptions  thereof,  according  to  the  order  and  regulation  of 
said  board.  Said  board  may  make  and  publish  a  report  of  the  sanitary  condition, 
and  the  result  of  the  inspection  of  any  place,  matter  or  thing  in  said  city,  so  inspected, 
or  otherwise  as  aforesaid,  so  far  as,  in  the  opinion  of  said  board,  such  publication 
may  be  useful.11 

A  considerable  number  of  cities  which  have  no  such  specific  statutory 
provision  in  their  charters,  nevertheless  by  virtue  of  their  general 
legislative  powers  in  regard  to  sanitation  have  included  such  pro- 
visions in  their  ordinances  or  the  rules  of  their  health  department.3 

1  Among  such  statutes  are  those  of  Alabama,  Colorado,  Connecticut,  Delaware, 
Iowa,  Maine,  Massachusetts,  Michigan,  Minnesota,  New  Hampshire,  Pennsylvania, 
South  Carolina,  Utah,  Virginia,  West  Virginia,  and  Wisconsin.  Such  power  is 
granted  in  the  special  legislation  of  several  cities,  as  Detroit,  Pennsylvania  cities 
of  the  second  class,  and  the  City  of  New  York. 

-  Michigan,  Chapter  10  of  1895,  Sec.  7. 

3  Among  these  are  Albany,  Atlanta,  Bridgeport,  Charleston,  Chicago.  Cleveland, 
Denver,  Jersey  City,  Memphis,  Mobile,  Newark,  Newport,  New  York,  Omaha, 
Rochester,  St.  Louis,  Utica,  and  Yonkers. 


NUISANCES.  113 

In  many  of  these  ordinances  it  is  also  provided  that  no  one  shall 
obstruct  the  officers  in  their  inspections. 

Occasionally  health  officials  have  been  annoyed  by  unauthorized 
persons  representing  themselves  as  inspectors  and  thus  gaining  access 
to  private  premises  for  various  illegitimate  purposes.  This  is  some- 
times forbidden  by  law  as  by  a  recent  enactment  of  Congress  for  the 
District  of  Columbia.1 

A  number  of  the  state  laws  make  provision  for  the  inspection  of 
private  premises  only  when  in  the  ordinary  course  of  work  such  entry 
is  refused.  Most  of  these  laws  follow  the  Massachusetts  statute  which 
was  first  enacted  in  1816.     It  is  given  below.2 

Most  of  the  modifications  of  this  law  provide  for  the  different 
officials,  who  in  the  various  states  shall  issue  the  warrants  and  make 
the  inspections  :  and  occasionally  the  limitation  as  to  "  reasonable  time  " 
is  made  specific  by  the  words,  "between  sunrise  and  sunset." 

Most  of  the  legislation  concerning  nuisances  provides  specifically 
for  the  issuing  of  orders  to  the  parties  interested  before  the  nuisance  is 
abated.  It  is  claimed  that  this  is  not  necessary,  and  the  Alabama  and 
Virginia  statutes  do  not  seem  to  contemplate  it.  nor  does  the  ordinance 
in  Bridgeport  prescribe  it:  and  in  some  cities  it  is  specified  that  under 
certain  conditions  a  nuisance  may  be  abated  without  the  service  of  any 
order.  It  may  be  done  in  San  Francisco  when  the  nuisance  is  on  the 
property  of  the   city  or  of  a  non-resident:   in  New    Haven  and    Omaha, 


1  •-/>'<  it  enacted  by  the  SenaU  and  linns*  •>/  Representatives  of  tin  United  States 
(if  America  in  Congress  assembled,  That  it  shall  he  unlawful  for  any  person  in  the 
District  of  Columbia  to  falsely  represent  himself  or  herself  as  being  an  inspector  "t 
the  health  department  oi  said  District,  or  an  inspector  of  any  department  of  the 
District  government  ;  ami  any  person  so  offending  shall  he  deemed  guilty  of  a  mis- 
demeanor, and  on  conviction  in  the  police  court  of  said  District  shall  he  punished 
by  a  tine  of  net  less  than  ten  dollars  nor  more  than  fifty  dollars  for  the  first  offense, 
ami  for  cadi  subsequent  offense  by  a  line  of  not  less  than  fifty  dollars  nor  more  than 
one  hundred  dollars,  or  imprisonment  in  the  jail  of  the  District   not  exceeding  six 

months,  or  both,  in  the  discretion  of   the  court. 

"Approved,  March  2,  1897." 

-  Massachusetts.  Public  stat  ut es  1 1882),  Chapter  BO,  Sec.  27: 

"  When  the  board    thinks  it   necessary   for  the  preservation  of   the    lives  or  health 

of  the  inhabitants  to  enter  any  land,  building,  or  premises,  or  \ esse l  within  its  town. 
for  the  purpose  of  examining  into  and  destroying,  removing  or  preventing  a  nuisance, 

source  of  tilth,  or  cause  of  sickness,  and  t  he  board  or  anj   agent  thereof  sent  for  t  hat 

purpose  is  refused  such  entry,  any  member  of  the  board  or  such  agent  mas  make  com 
plaint  under  oath  to  anj  just  ice  of  any  court  of  record  or  to  two  justices  of  the  peace 
of  the  county,  stating  the  facts  of  the  case  so   far  as  he  has  knowledge  tin 
and  said  justice  or  justices  may  t  hereupon  issue  a  warrant,  directed  to  the  sheriff  oi 

any  of   the  deputies,  to  such    agent    of   the    hoard,  or  to  any  constable  of   such  town. 

commanding  him  to  take  sufficient  aid.  ami  at  anj  reasonable  time  repair  to  the 
place  where  such  nuisance,  source  of  filth,  or  cause  of  sickness  complained  of  may 
he,  and  to  destroy,  remove,  or  prevent  t  he  same,  under  the  direction  oi   the  board." 


114  NUISANCES. 

when  the  owner  is  unknown  ;  in  Minneapolis,  when  he  cannot  be  found  ; 

in  Pennsylvania  cities  of  the  second  class  and  in  Milwaukee,  when  the 

owners  of  unoccupied  property  live  out  of  the  city  or  cannot  be  found. 

In  St.  Louis  if  the  owner  cannot  be  found,  and  the  statement  by  the 

officer  on  the  return  is  conclusive  of  this,  the  order  must  be  advertised 

two  days  in  the  newspaper  doing  the  city  printing.     In  Cleveland  the 

health  officer  may  "in  case  of  necessity"  "abate  a  nuisance  without 

notice." 

The  ordinances  of  Denver  provide  :  1 

"  Non-residents  owning  property  on  which  a  nuisance  exists,  and  who  have  been 
notified  thereof  and  given  sufficient  time  to  appear  before  the  health  commissioner 
in  reference  thereto,  and  who  fail  or  refuse  to  appear  or  to  have  the  nuisance  remedied 
as  directed,  shall  be  given  ten  days'  notice  by  publication,  and  upon  continued  refusal 
or  omission  to  comply,  the  premises  may  be  placarded  by  the  health  commissioner 
and  declared  a  nuisance  prejudicial  to  the  public  health  or  unfit  for  human  habita- 
tion." 

Usually  it  is  provided  that  an  order  to  abate  a  nuisance  shall  be 
directed  to  the  owner  or  occupant  of  the  property  on  which  the  nuis- 
ance is  found.  This  was  the  form  of  the  Massachusetts  law,  and  it  has 
been  retained  in  those  states  which  have  copied  Massachusetts,  and  it 
appears  in  the  general  nuisance  laws  of  many  other  states  and  in  most 
city  charters.  Sometimes,  as  in  North  Carolina,  the  occupant  is  put 
first  and  the  owner  is  only  notified  when  the  premises  are  unoccupied. 
In  cities  of  the  second  class  in  Pennsylvania  the  term  tenant  is  used, 
and  in  Hartford  occupant  or  tenant.  Several  laws  specify  still  further 
the  parties  to  be  notified.  In  Delaware  it  is  "  the  person  to  whom  it 
belongs  or  in  whose  possession,  or  on  whose  property  it  is,  or  the  per- 
son causing  the  nuisance."  In  Florida,  "  the  person  committing,  creat- 
ing, maintaining  or  keeping  '*  the  nuisance.  In  Ohio  the  nuisance  may 
be  ordered  abated  by  "  the  owner,  agent,  or  other  person  or  persons 
having  control  of  the  same,  or  being  responsible  for  the  condition."  In 
the  District  of  Columbia  the  order  is  to  the  person  "permitting,  creating, 
or  keeping  the  nuisance  " ;  in  Wilmington,  Del.,  to  "  the  owner,  agent, 
occupant,  or  other  person  causing"  the  same.  The  following  is  the  law 
in  the  City  of  Xew  York:2 

:-  Service  of  any  order  of  said  board  of  health  shall  be  deemed  sufficient  if  made 
upon  a  principal  person  interested  in  or  upon  a  principal  officer  charged  with  duty 
in  respect  of  the  business,  property,  matter,  or  thing,  or  the  nuisance  or  abuse  to 
which  said  order  relates;  or  upon  a  person,  officer  or  department,  or  one  of  the 
department  who  may  be  most  interested  in  or  affected  by  its  execution.  If  said 
order  relate  to  any  building,  or  the  drainage,  sewerage,  cleaning,  purification,  or 
ventilation  thereof,  or  of  any  lot  or  ground  on  or  in  which  such  building  stands, 
used  for,  or  intended  to  be  rented  as,  the  residence  or  lodging  place  of  several  per- 

1  Denver,  Ordinance  44  of  1893,  Sec.  156. 

2  New  York,  Chapter  378  of  1897,  Sec.  1224. 


NUISANCES.  115 

sons,  or  as  a  tenement  bouse  or  lodging  house,  service  of  such  order  on  the  agent  of 
any  person  or  persons  for  the  renting  of  such  building,  lot  or  ground,  or  for  the  col- 
lecting of  the  rent  thereof,  or  of  the  party  thereof  to  which  said  order  may  relate, 
shall  be  of  the  same  effect  and  validity  as  due  service  made  upon  the  principal  of  such 
agents  and  upon  the  owners,  lessees,  tenants,  occupants  of  such  buildings  or  parts 
thereof,  or  of  the  subject  matter  to  which  such  order  relates."' 

In  Minnesota  the  order  may  be  served  on  the  agent.  The  Denver 
ordinances  !  prescribe  that 

"  Whenever  the  owner  or  owners  of  any  property  are  not  present  in  Denver,  or 
when  any  estate  is  held  in  trust  for  minor  heirs,  the  person  receiving  the  rents  of  the 
same  may  be  held  responsible  for  the  execution  of  any  orders  made  by  the  health 
commissioner  for  the  sanitary  improvement  of  the  property.1' 

Usually  no  provision  is  made  for  a  preliminary  hearing,  though  it  is 
sometimes  urged  that  such  should  be  granted.  In  Denver,  however,  ii 
is  required  that  a  hearing  shall  be  given  after  a  two  days'  notice,  and  in 
the  City  of  New  York  and  in  Detroit  a  hearing  must  In-  griven  if 
requested.  In  Ohio  and  Georgia  a  hearing  must  be  held  before  a  nui- 
sance is  abated  by  the  board  of  health.     The  following  is  the  <  >hio  law  :  - 

•l  In  all  cases  where  the  order  of  the  board  of  health  is  neglected  or  disregarded, 
in  whole  or  in  part,  the  board  may  elect  to  cause  the  arrest  and  prosecution  of  the 
person  or  persons  offending  as  hereinafter  provided,  or  may  elect  to  do  and  perform, 
by  its  officers  and  employes,  what  the  off  ending  party  should  have  done.  It  the  latter 
course  is  chosen,  before  the  execution  of  the  order  of  the  board  is  begun,  ii  shall 
cause  a  citation  to  issue,  and  be  served  upon  the  person  or  persons  responsible,  if 
residing  within  the  jurisdiction  of  the  board ;  but  if  not,  shall  cause  it  to  be  mailed 
by  registered  letter  to  such  person,  if  the  address  is  known  or  can  be  found  by 
ordinary  diligence;  and  if  the  address  cannot  be  found  by  ordinary  diligence,  shall 
cause  the  citation  to  be  left  upon  the  premises,  in  charge  of  any  person  residing 
thereon.  The  citation  shall  briefly  recite  the  cause  of  complaint  and  require  the 
owner  or  other  person  or  persons  responsible  to  appear  before  the  board  of  health 
at  a  time  or  place  stated,  or  as  soon  thereafter  as  a  bearing  can  be  had.  and  show 
cause,  it' any.  why  the  board  shall  ool  proceed  and  furnish  the  material  and  labor 
neci  ssary  to,  and  remove  the  cause  of   complaint."" 

Doubtless  il  is  uncommon  for  health  officials  excepl  in  urgenl  cases 
to  proceed  immediately  to  indict  the  penalty  as  soon  as  the  time  speci- 
fied in  the  order  has  elapsed.  When  good  cause  is  shown  further  action 
is  often  delayed  in  the  matter,  al  the  option  of  the  executive  officer. 
Occasional!}  provision  is  made  for  such  an  extension  of  time.  Thus  in 
Hartford,3 

••  It  the  party  served  with  an  order  bj  the  board  "i   health  before  the  execul 

of  the  order  is  commenced,  apply  to  the  board  t<«  have  its  order  or  its  execution 

stayed  or  i lined,  ii   shall  be  the  duty  of  the  board  to  temporarily   suspend  <>r 

modify  if.  and  give  the  party,  as  the  case  may  require,  a  reasonable  and  fair  oppoi 

t  unity  to  he  heard  and  to  present    proofs  and  lads  against   the  execution  of  the  oi-der. 

"i  iii  ta\ or  of  iis  modifical ion." 


1  Denver,  Ordinance  1 1  of  L893,  Sei ,  L38. 

1  Ohio,   Annotated  Statutes  |  L900),   Sec.  2129. 

Hartford,  Ordinance  of  20  January,  !>>•">.  see.  r. 


116  NUISANCES. 

Often  no  directions  are  given  in  regard  to  the  service  of  the  order, 
and  sometimes  the  matter  of  the  service  of  these  and  other  orders  and 
notices  is  covered  by  other  statutes.  Frequently,  however,  provision  is 
made  for  the  service.  The  following  is  the  section  of  the  Massa- 
chusetts statute  relating  to  this  : 1 

"Such  order  shall  he  made  in  writing,  and  served  by  any  person  competent  to 
serve  a  notice  in  a  civil  suit,  personally  on  the  owner,  occupant,  or  his  authorized 
a^ent;  or  a  copy  of  the  order  may  be  left  at  the  last  and  usual  place  of  abode  of  the 
owner,  occupant,  or  agent,  if  he  is  known  and  within  the  state.  But  if  the  premises 
are  unoccupied  and  the  residence  of  the  owner  or  agent  is  unknown  or  without  the 
state,  the  notice  may  be  served  by  posting  the  same  on  the  premises  and  advertising 
in  one  or  more  public  newspapers  in  such  manner  and  for  such  length  of  time  as  the 
board  or  health  officer  may  direct." 

Posting  on  the  premises  without  advertising  is  provided  for  in  the 
New  York  and  New  Jersey  law.  In  Cleveland  when  after  "  due  search, 
neither  owner  or  occupant  can  be  found,  or  are  non-residents,"  the  notice 
may  be  posted  on  the  front  door,  or  wall,  or  fence,  and  an  advertisement 
inserted  for  one  week  in  the  daily  newspapers  of  the  city,  and  the  cost 
of  advertising  can  be  collected  with  the  cost  of  abating  the  nuisance. 
The  fact  that  the  owner  is  often  so  difficult  to  reach,  and  that  in  point 
of  fact  it  is  the  agent  that  is  sometimes  the  one  most  responsible  for  the 
nuisance,  has  led  to  the  service  of  the  notice  upon  him,  he  being  sup- 
posed to  be  in  communication  with  the  owner  and  responsible  to  him. 
This  service  is  permitted  by  the  Massachusetts  and  Rhode  Island  law, 
and  in  the  City  of  New  York.  The  New  Jersey  statute  provides  for  a 
dual  service,  one  notice  upon  the  "  owner  or  owners  "  and  "  a  duplicate 
of  the  notice  so  given  shall  be  left  with  one  or  more  of  the  tenants  or 
occupants."  In  New  Hampshire  the  notice  may  be  left  at  the  abode  of 
the  owner.  In  some  cities,  as  Chicago2  and  Denver,3  the  abatement  of 
a  nuisance  is  facilitated  by  a  requirement  that  the  agent  of  the  property 
shall  disclose  the  name  of  the  owner  when  required  by  the  health  officer 
to  do  so. 

Many  of  the  laws  refer  to  the  time  which  shall  be  given  the  parties 
maintaining  a  nuisance  to  abate  the  same.  In  several  states  the  time 
specified  in  the  statute  to  be  allowed  for  the  abatement  of  the  nuisance 
is  twenty-four  hours.  This  is  the  law  in  Colorado,  Minnesota,  North 
Carolina,  Vermont,  and  Wisconsin.  In  the  District  of  Columbia, 
Florida,  Iowa,  Massachusetts,  and  Rhode  Island  the  time  is  twenty-four 
hours  "or  such  other  reasonable  time"  as  may  be  directed.     In  Con- 


1  Massachusetts,  Public  Statutes  (1882),  Chapter  80,  £ec.  22. 
-Chicago,  Municipal  Code  (1881),  ^'ec.  1S77, 
3  Denver,  Ordinance  44  of  1898,  ^ec.  83. 


NUISAN'CJSS.  117 

necticut  and  Delaware,  and  in  Philadelphia,  the  time  given  shall  be  that 
directed  by  the  health  officer  or  the  board  of  health.  In  Denver  it  is 
such  time  as  may  seem  "  reasonable  to  the  health  officer.'"  In  Provi- 
dence most  of  the  orders  give  seven  days  for  abatement.  In  the  City 
of  New  York  and  Detroit  "  it  is  five  days,  or  less  if  so  stated  in  time  of 
pestilence."  In  Buffalo  the  time  is  five  days,  in  San  Francisco  and 
Jersey  City  three  days,  in  Atlanta  six  hours. 

By  Chapter  143,  Georgia  Laws  of  1895,  it  is  provided  that  in 
comities  in  which  there  is  a  city  of  over  60,000  inhabitants  an  order  to 
bury  offensive  animal  or  vegetable  matter  must  lie  complied  with  in 
three  hours.  In  Wyoming  the  time  given  to  abate  a  nuisance  is  by 
statute  twenty-four  hours,  and  a  continuance  of  neglect  is  considered 
an  additional  offence  for  each  twenty-four  hours  of  continuance. 

In  Boston,  although  permitted  by  statute  to  iix  '-a  reasonable  time.*' 
the  board  of  health  on  account  of  the  difficulty  in  proving  what  is 
reasonable  always  fixes  the  time  in  the  order  as  twenty-four  hours,  for 
the  law  reads  "  twenty-four  hours  or  such  other  time  as  it  deems  rea- 
sonable *'  :  but  alter  the  service  of  the  orders,  what  seems  to  the  board 
as  a  reasonable  time,  is  always  given  before  further  action  is  taken.  It 
is  probable  that  sanitary  authorities  very  rarely  take  advantage  of  the 
short  interval  permitted  by  the  statutes.  As  a  rule  much  more  than 
twenty-four  hours  is  given,  usually  several  days,  and  often  the  time  is 
further  extended  at  the  instance  of  the  parties  to  whom  the  orders  are 
issued.  Undue  haste  in  the  abatement  of  nuisances  is  not  a  character- 
istic of  sanitary  officials.  It  does  not  take  many  days  in  a  health  office 
to  learn  thai  those  injured  by  the  nuisance  I'eel  that  the  proceedings  are 
far  i"i  i  slow. 

After  the  time  specified  in  the  order  lias  elapsed  two  modes  of 
action  are  usually  open  to  the  officials.  A  criminal  action  may  be 
brought  against  the  parties  who  have  failed  to  obey  the  Older  and  the\ 
may  be  lined,  or  the  nuisance  may  be  summarily  abated.  It  is  also 
possible  that  both  of  these  courses  may  be  pursued. 

The  penalty  provided  for  failure  to  comply  with  orders  i>>  abate 
nuisances  of  course  varies  considerably  in  different  states.  Usually  il 
is    a    line,  though    occasionally    imprisonmenl    is    an    alternative.      In 

Detroil   the  person   violating  an  order  of    the   board  of  health  ma\    be  im 

prisoned  not  to  exceed  six  months.  In  Ohio  if  a  person  fails  to  obey 
an  order  he  is  subjeel  to  a  line  of  one  hundred  dollars  or  imprisonment 
for  ninety  days,  bul  shall  not  be  imprisoned  for  the  first  offence.  In 
the  case  of  a   corporation   the  line   maybe  three  hundred  dollars  and 

"any  officer  of  the  corporation  having  authority  in  the  matter  ami  per- 
mitting  the    violation   shall    be  subject    to   a   line  or   imprisonment,  or 


118  NUISANCES. 

both."1  The  procedure  in  such  cases  is  given  below.2  In  Delaware 
delinquents  are  to  be  fined  or  to  be  sent  to  jail  until  the  fine  is  paid. 
The  average  fine  is  perhaps  not  to  exceed  fifty  dollars.  The  smallest 
is  in  North  Carolina  where  the  fine  is  one  dollar  for  each  day  of 
neglect.  In  St.  Louis  it  is  not  to  exceed  five  hundred  dollars,  and 
in  Detroit  not  to  exceed  one  thousand  dollars.  In  several  states  as 
Iowa,  Massachusetts,  North  Carolina  and  Rhode  Island,  the  law  pro- 
vides that  the  fine  may  be  imposed  for  each  day  during  which  neglect 
of  the  order  continues.  As  in  most  cases  the  order  to  abate  a  nuisance 
is  to  be  served  on  the  "  owner  or  occupant,"  so  in  most  cases  it  is  on 
the  owner  or  occupant  that  the  fine  is  to  be  imposed.  When  the  notice 
is  served  on  the  occupant  alone  as  in  North  Carolina,  it  is  the  latter 
that  is  to  suffer  the  penalty.  In  Detroit  it  is  "every  person  who  shall 
wilfully  violate  or  refuse  to  obey  "  the  order ;  and  in  Ohio  the  board  of 
health  may  cause  the  arrest  or  prosecution  of  "  the  person  or  persons 
offending." 

After  the  service  of  an  order  and  the  expiration  of  the  time  specified 
therein  the  board  of  health  or  its  agents  may  abate  the  nuisance.  In 
Ohio  before  the  nuisance  can  be  abated  the  owner  must  be  cited  to 
appear  as  is  shown  by  the  law  quoted  on  page  115.  In  St.  Louis  the 
health  commissioner  is  to  abate  the  nuisance  if  after  the  specified  time 
it  is  not  done,  "  or  if  the  owner  fails  to  show  good  cause  why  he  cannot 
or  ought  not  to  comply." 


1  Ohio,  Annotated  Statutes  (1900),  Sees.  2137-8. 

2  Ohio,  Annotated  Statutes  (1900) : 

"Sec.  2139.  Prosecutions  under  this  chapter  and  the  civil  action  provided  for  in 
the  preceding  section  shall  be  instituted  before  any  justice  of  the  peace  within  the 
county,  or  justice  of  the  peace,  mayor,  or  police  judge  of  the  city  or  village  where 
the  offense  was  committed,  or  the  offending  person  resides.  If  imprisonment  is,  or 
may  be  a  primary  penalty,  the  court  shall,  after  plea  of  not  guilty,  unless  a  trial  by 
jury  is  waived,  issue  a  venire  to  any  constable  of  the  county,  containing  the  names 
of  sixteen  electors  residing  within  the  county,  to  serve  as  jurors  to  try  such  cause. 
Each  party  shall  be  entitled  to  two  peremptory  challenges,  and  challenges  for  cause 
in  all  particulars,  as  in  criminal  cases  in  the  court  of  common  pleas.  If  the  sixteen 
names  be  exhausted  without  obtaining  a  panel  of  twelve,  the  court  may  direct  the 
constable  to  summon  any  of  the  bystanders,  to  fill  the  panel  to  twelve,  or  on 
demand,  shall  issue  other  venires  for  four  electors  at  a  time  until  the  panel  of 
twelve  is  full.  In  prosecutions  under  this  chapter,  no  deposit  for  costs  shall  be  re- 
quired; and  a  judgment  or  verdict  of  guilty  shall  be  immediately  followed  by  sen- 
tence and  execution  thereof,  unless  suspended  pending  the  preparation  and  allow- 
ance of  a  bill  of  exceptions;  and  all  fines  collected  under  this  cbapter  shall  be  paid 
to  the  treasurer  of  the  municipality  or  township  and  credited  to  the  sanitary  fund  of 
the  board  of  health  instituting  the  prosecution.  No  fine  imposed  in  any  prosecu- 
tion under  this  section  shall  be  remitted  by  the  magistrate  before  whom  the  com- 
plaint is  made.1' 


NUISAN'CES.  119 

The  following  is  an  important  section  of  the  New  Jersey  law:1 

"And  be  it  enacted,  That  no  injunction  shall  issue  oiit  of  any  of  the  courts  of  this 
state,  to  stay,  stop  or  enjoin  proceedings,  or  to  prevent  any  Ideal  board  of  health 
from  proceeding  ^vith  the  removal  of  any  alleged  nuisance,  source  of  foulness  or 
cause  of  sickness,  hazardous  to  the  public  health,  until  such  board  has  been  duly 
notified  to  appear  and  be  present  at  the  hearing  of  such  application,  and  has  an 
opportunity  to  be  heard  thereon." 

In  almost  all  eases  the  law  in  regard  to  abating  nuisances  is  permis- 
sive, "the  board  of  health  may  cause  the  nuisance  to  be  abated";  but 
sometimes,  as  in  Connecticut,  Florida,  and  New  Jersey,  and  some  other 
cities,  it  is  mandatory,  the  "board  of  health  shall  cause  the  nuisance  to 
be  abated."  Occasionally  more  specific  directions  are  given  as  to  who 
shall  abate  the  nuisance.  In  Pennsylvania  boroughs  the  order  -shall  lie 
executed  by  the  health  officer,  his  subordinates  and  workmen."  In 
Detroit  it  is  the  board  of  health,  "its  officers  and  employees."  who  may 
lawfully  enter  upon  any  premises  and  suppress  or  remove  the  nuisance. 
In  Bridgeport  "the  board  of  health  or  either  of  the  members  thereof  or 
any  person  under  their  direction  may  at  anytime  abate  or  remove  nui- 
sances." In  Alabama  "the  mayor  or  intendant,  or  a  justice  of  the 
peace  of  the  county  in  which  such  lot,  house  or  vessel  is,  ma\  issue  his 
warrant,  directed  to  the  sheriff,  marshal,  constable,  or  other  lawful 
office]1,  requiring  him  to  enter  such  house,  lot  or  vessel,  and  under  the 
direction  of  such  health  officer,  to  remove  such  infected  person,  or  to 
remove  or  destroy  the  source  of  infection  or  disease."  The  Virginia 
law  is  very  like  that  in  Georgia,  and  it  is  the  sheriff  or  deputy  sheriff  of 
the  county  who  is  to  abate.  In  Buffalo  the  department  of  public  works 
is  to  abate  nuisances. 

Usually  it  is  intended  that  the  costs  of  abating  ;i  nuisance  shall  be 
paid  by  the  owners  of  the  property  on  which  it  is  found:  but  sometimes 
no  such  provision  is  found  in  the  law.  It  is  not  in  Delaware.  In  North 
Carolina  the  health  officer  can  only  abate  a  nuisance  when  the  owner 
pleads  poverty,  as  is  shown  below.2 


1  New  Jersey,  General  Statutes  (1895),  p.  L638,  Sec.  1"». 
North  Carolina,  A.t  of  I  March,  L893,  Sec.  22: 

"Whenever  and  wherever  a  nuisance  upon  premises  shall  exisl  which  in  the 
opinion  of  the  countj  superintendent  <a  health  is  dangerous  to  the  public  health,  it 
shall  be  his  duty  t<>  notify  in  writing  the  parties  occupying  the  premises  (or  the 
owner,  it'  i  he  premises  are  not  occupied)  of  its  existence,  its  character  and  the  means 
i if  abating  it.  I  *  | •< >n  this  notification  i  lie  parties  shall  proceed  t"  abate  the  nuisance, 
inn  failing  to  do  this  shall  be  adjudged  guilty  of  misdemeanor  and  shall  pay  a  fine 

of  'MM'  dollar  a  daj   dating  fr twenty-four  hours  after  the  notification  has  1 a 

served,  the  amounts  so  collected  to  l»e  turned  over  t"  the  county  treasurer:  Pro- 
vided, however,  thai  it'  the  partj  notified  shall  make  oath  or  affirmation  before  a  justice 
bf  the  peace  "i  his  or  her  inability  i"  carrj  "in  the  directions  of  the  superintendent, 


120  NUISANCES. 

In  Florida  and  Detroit  the  cost  of  summarily  abating  a  nuisance  by 
the  sanitary  authority  is  to  be  paid  by  the  "  person  or  persons  commit- 
ting, creating,  keeping  or  maintaining  such  nuisance."  In  Massachu- 
setts and  Iowa  the  owner  or  occupant  must  be  "  actually  notified."  In 
Massachusetts  the  costs  are  to  be  paid  by  the  "  owner  or  occupant  or 
other  person  who  caused  or  permitted  the  same,"  and  a  similar  provi- 
sion is  found  in  other  states.  In  New  Hampshire,  too,  to  the  costs  are 
to  be  added  the  fees  of  the  health  officer.  In  Bridgeport  it  is  from  the 
person  permitting  the  nuisance  that  the  cost  is  to  be  collected ;  in  the 
Pennsylvania  cities  of  the  second  class,  from  the  person  offending ;  in 
Minneapolis  from  those  "  who  created  and  suffered  such  nuisance."  In 
Detroit 1  the  cost  is  a  "  charge  upon  the  occupant  or  upon  any  or  all 
of  the  occupants  "  ;  but  it  is  further  provided 

"  In  case  the  common  council  upon  the  certificate  of  said  board  as  to  the  amount 
of  the  expense  aforesaid  and  the  purposes  for  which  the  same  were  incurred  may 
cause  an  assessment  to  be  levied  upon  said  premises  and  the  owner  or  owners  thereof 
and  the  same  to  be  collected  in  the  same  manner  and  by  the  same  proceedings  as 
special  assessments  are  levied  and  collected  for  the  construction  of  sidewalks  in  said 
city.  In  case  such  expense  is  paid  by  any  occupant  or  lessee  of  such  premises  he 
may  recover  from  any  other  person  having  an  interest  in  such  premises  such  propor- 
tion of  the  said  expense  as  the  court  adjudges  should  justly  and  equitably  be  borne 
by  such  defendant,  and  he  may  deduct  and  retain  from  any  rent  payable  to  such 
defendant  the  amount  so  recoverable  as  an  offset  thereto.'" 

A  somewhat  similar  provision  is  found  in  the  charter  of  New  York,2 
where 

"The  charge  of  abating  a  nuisance  shall  be  against  each  of  the  owners  or 
part  owners  and  each  of  the  lessees  and  occupants  of  the  building,  business,  place, 
property,  matter,  or  thing  to  which  said  order  relates,  and  in  respect  of  which  said 
expenses  were  incurred.'" 

In  Indiana  the  cost  of  abating  the  nuisance  and  ten  per  cent,  additional 
is  to  be  collected.  In  Mobile  if  the  owner  refuses  to  pay  within  three 
days  the  cost  of  abating  the  nuisance  he  is  to  be  fined  fifty  dollars. 

Special  provision  is  made  in  many  statutes  for  the  manner  in  which 
the  cost  of  abating  a  nuisance  is  to  be  collected.  In  Massachusetts 
the  expense  incurred  in  abating  a  nuisance  dangerous  to  the  health  is 
to  be  recovered  from  an  individual  or  a  corporation  by  an  action  of  con- 


it  shall  be  dune  at  the  expense  of  the  town,  city,  or  county  in  which  the  offender 
lives.  In  the  latter  case  the  limit  of  the  expense  chargeable  to  the  city,  town,  or 
county,  shall  not  be  more  than  one  hundred  dollars  in  any  case;  Provided,  further, 
that  nothing  in  this  section  shall  be  construed  to  give  the  superintendent  the  power 
to  destroy  or  injure  property  without  a  due  process  of  law  as  now  exists  for  the 
abatement  of  nuisances." 

i  Michigan,  Chapter  10  of  1895,  Sec.  19. 

2  New  York,  Chapter  378  of  1897,  Sec.  1270. 


mrisANCEs.  121 

tract,  in  Iowa  by  civil  action,  in  Rhode  Island  by  an  action  of  the  case, 

in   many  states  like  debts  or  by  action  of  debt.     In  Albany  the  action 

may  be  brought  "  against  the  owner  or  any  one  or  more  of  the  owners." 

In  Ohio  ]  the  board  of  health  after  abating  a  nuisance  is  to 

"  Certify  the  cost  and  expense  to  the  auditor  of  the  county,  and  if  the  material 
and  labor  are  itemized,  and  the  statement  is  accompanied  by  the  certificate  of  the 
president  of  the  board,  attested  by  the  clerk,  reciting  the  order  of  the  board,  and 
that  the  amount  is  correct,  the  auditor  shall  have  no  discretion,  but  shall  place  the 
sum  against  the  property  upon  which  the  material  and  labor  were  expended,  which 
shall,  from  the  date  of  entry,  be  a  lien  upon  the  property,  and  be  paid  as  other  taxes 
are  paid.'" 

In  St.  bonis  the  president  of  the  board  of  public  improvements  shall 
ascertain  the  cost  like-  street  improvements,  and  special  tax  bills  are 
rendered  against  the  property.  In  Detroit  the  costs  are  collected  like 
sidewalk  assessments.  In  Colorado,  Milwaukee,  and  New  Haven  also 
the  costs  are  to  be  assessed  like  taxes,  but  in  the  two  cities  the  abate- 
ment of  nuisances  must  be  done  with  funds  set  apart  for  the  purpose. 
The  charter  of  the  City  of  Xew  York  provides  in  an  elaborate  and 
explicit  manner  for  the  collection  of  the  costs  of  abating  nuisances.2 
In  Philadelphia,3 

lt  The  expenses  attending  the  removal  of  any  nuisance  shall  be  and  remain  a  lien 
upon  the  premises  from  which  such  nuisance  lias  lien  removed,  and  it  shall  be  the 
duty  of  the  said  board  of  health  to  file  the  claim  therefor  against  the  owner  or 
reputed  owner,  in  the  office  of  the  clerkof  the  district  courl  for  the  city  and  county 
of  Philadelphia,  which  said  court  shall,  in  all  cases,  have  jurisdiction  of  the  same, 
and  the  said  claims  may  be  tiled,  recorded  and  proceeded  on  by  scir<  faciasto  recover 
the  same,  in  like  manner  as  mechanics*  liens  are  recoverable,  upon  the  trial  of  which, 
the  tact  of  t  In-  nuisance  shall  not  be  inquired  into,  and  the  defendant  or  defendants 
shall  only  he  permit  ted  to  give  evidence  of  payment,  or  that  unnecessary  expenses 
wen-  incurred  by  the  hoard  in  the  removal  of  the  nuisance." 

Iii  some  stales,  besides  the  provision  made  tor  the  abatement  of 
nuisances  by  the  board  of  health  or  other  blanches  of  the  local  govern- 
ment, the  statutes  dired  that  the  courts  may  after  conviction  for  the 
maintenance  of  a  nuisance  order  the  nuisance  abated  at  the  cost  of  those 
maintaining  it.  Such  provisions  are  found  in  the  Laws  of  Colorado, 
Illinois,  Iowa,  .Michigan,  Mississippi,  Tennessee,  and  Washington. 

In  Detroit  the  statute  provides  for  the  prevention  of  a  threatened 
nuisance  by  injunction  by  an\  court  of  equity  having  jurisdiction  and 
furthermore  requires  the  law  department  of  the  cit\  to  bring  suit  for 
tins  purpose  when  requested  by  the  board  of  health.4     'This  method  oJ 

1  Ohio,  Annotated  statutes  (1900),  Sec.  2130. 

\c-a  y,,rk.  Chapter  378  of  1897,  Sees.  1275  L281. 

Pennsylvania,    Brightly's    Purdon's  Digesl   (1895),  p.  1488,    \>t   of  7   Lpril,  I 

2. 
1  Michigan,  chapter  10  .a   is'.'-"..  Sec.  29. 


122  NUISANCES. 

asking  for  an  injunction  to  abate  a  nuisance  is  provided  for  in  the  New 
Jersey  statutes,1  and  is  sometimes  adopted  by  local  boards  of  health.2 

In  Mississippi3  the  state  board  of  health  when  informed  by  a  county 
health  officer  may  declare  a  nuisance  anything  calculated  to  cause  or 
aggravate  contagious  or  epidemic  disease.  The  board  shall  notify  the 
district  attorney  who  shall  bring  the  case  before  the  court  and  a  jury 
trial  shall  be  granted  if  asked.  From  the  decision  there  can  be  no 
appeal  and  the  nuisance  shall  be  abated.  As  is  shown  above,  the  statute 
provides  that  in  Philadelphia  the  decision  of  the  board  as  to  a  nuisance 
cannot  be  inquired  into  and  in  Massachusetts  the  adjudication  that  a 
nuisance  exists  is  conclusive  and  no  appeal  lies  therefrom.4 

The  cleansing  of  filthy  premises  is  usually  accomplished  under  gen- 
eral nuisance  laws  by  orders  and  forcible  abatement,  or  it  may  be  secured 
by  enforcing  such  ordinances  or  local  rules  as  prescribe  cleanliness  ;  but 
in  some  states,  as  Delaware,  Maine,  Minnesota,  and  West  Virginia,  there 
are  special  provisions  in  the  statute  designed  to  give  the  health  author- 
ities power  to  cause  private  premises  to  be  promptly  cleaned  if  in  a 
filthy  condition.  The  laws  in  the  first  three  states  above  mentioned  are 
very  similar.  The  Delaware  statute  is  given  below.5  A  similar  pro- 
vision is  found  in  the  law  establishing  a  board  of  health  in  the  City  of 
New  York6  and  Detroit.  Besides  such  special  orders  some  cities  pro- 
vide by  general  rules  for  the  cleansing  of  premises,  as  Fitchburg.7 

1  New  Jersey,  General  Statutes  (1895),  p.  1640,  Sees.  28-30. 

2  New  Jersey,  Report  of  State  Board  of  Health  (1897),  pp.  155  and  257. 

3  Mississippi,  Annotated  Code  (1892),  Sec.  2277. 

4  City  of  Salem  vs.  Eastern  R.  R.  Co.,  98  Mass.,  p.  449. 

5  Delaware  Laws,  Vol.  16,  Chapter  345: 

"  Sec.  8.  The  board  of  health  shall  have  power,  in  case  of  the  prevalence,  or 
of  reasonable  ground  to  apprehend  the  prevalence  of  malignant  disease  within  its 
jurisdiction,  to  direct  especially  the  cleansing  of  houses,  cellars,  yards,  docks,  or 
other  such  places  as  the  board  shall  consider  requisite  or  prudent  for  the  preserva- 
tion of  the  public  health,  or  for  the  mitigation  of  disease,  and  if  such  direction 
shall  not  be  observed  and  fulfilled,  within  the  time  prescribed,  by  the  person  or 
persons  to  whom  the  directions  were  given,  the  said  board  shall  order  an  officer  of 
the  board,  or  some  other  person  or  persons,  to  carry  the  same  into  effect,  and  the 
expenses  thereof  shall  be  paid  by  the  person  or  persons  to  whom  the  direction  was 
given,  unless  the  board  shall  otherwise  order;  and  if  payment  of  the  same  shall  not 
be  made  on  demand,  the  treasurer  of  the  board,  city  council,  or  town  commissioners 
shall  pay  the  same,  and  shall  recover  the  same,  with  interest  and  costs,  from  the 
person  who  ought  to  have  paid  the  same,  as  debts  of  like  amount  are  recoverable.1' 

6  New  York,  Chapter  378  of  1897,  Sec.  1176. 

7  Fitchburg,  Rules  and  Regulations  of  the  Board  of  Health  (1S97): 

"  Rule  2.  All  putrid,  decaying  or  decayed  animal  or  vegetable  matter  shall  be 
removed  from  the  cellars  and  outbuildings  on  or  before  the  first  day  of  June  in  each 
year. 

"Rule  7.  The  owner  or  lessee  of  any  hotel,  lodging  or  tenement  house  within 
the  limits  of  the  city  shall,  when  in  the  opinion  of  the  Board  of  Health  or  its  duly 


NUISAHTCES.  123 

II.     Prohibition  of  Nuisances. 
A.      General  Stuff  Legislation. 

There  has  been  in  the  aggregate  a  great  deal  of  state  legislation  to 
prevent  nuisances.  This  may  be  found  in  laws  of  general  application 
and  to  a  still  greater  extent  in  special  or  charter  legislation.  The  gen- 
eral laws  in  regard  to  nuisances  more  often  deal  with  such  special  sub- 
jects as  the  pollution  of  potable  waters  or  the  regulation  of  offensive 
trades,  and  will  be  considered  in  another  place.  Some  state  laws,  as  those 
of  Colorado,  Georgia,  Utah,  and  Washington,  simply  give  expression  to 
the  principles  of  common  law,  defining  in  general  terms  what  are  to 
be  considered  nuisances  and  prescribing  methods  of  procedure  and  in 
some  cases  imposing  penalties  upon  the  persons  committing  them.  <  M't.n 
other  nuisances  than  those  affecting  health  are  mentioned,  and  most  of 
this  legislation  is  not  such  as  to  he  of  special  interest  to  sanitary  officials. 
Some  statutes  of  general  application  do  specifically  deal  with  nuisances 
which  usually  come  under  the  jurisdiction  of  boards  of  health  and  may 
be  usefully  invoked  by  them  in  their  routine  work. 

Among  states  which  have  legislation  of  this  character  may  be  men- 
tioned: California,1  Connecticut,2  Florida,3  Illinois,4  Indiana."'  Iowa,6 
Kansas,"  Maine,8  Ohio,9  Tennessee,1"  Washington,11  West  Virginia.12 
The  Ohio  law  is  given  in  Appendix  26. 

Penalties  are  attached  for  the  violation  of  the  provisions  of  these 
statutes  and  often  they  are  quite  severe  as  shown  in  the  Ohio  law.  In 
Illinois  the  offender  shall  be  lined  not  exceeding  one  hundred  dollars 
for  the  first  offence  and  for  a  subsequent  offence  a  like  amount,  and 
confined  in  the  county  jail  not  exceeding  three  months.  In  [owa  the 
line  is  not  to  exceed  one  thousand  dollars.      In    Indiana    it    is    from    ten 


authorized  agent  ii  is  deemed  accessary,  whitewash,  paint  or  otherwise  clean  and 
make  wholesome  the  walls  ami  ceilings  of  the  c us  ami  passage-ways  of  the  build- 
ing." 

I  California,  Penal  Code  (1886),  Sec.  370. 

.nnecticut,  Chapter  s.;l  Laws  of  L889. 

Florida,  Art  of  1  June,  1895. 
<  Illinois,  (  riminal  Code  |  L896)    I  lhapter  88,  Se<  ,  '-'--'1. 
»  Indiana,  Statutes  |  1894),  Sec.  2154. 
•■  [owa,  Code  (1897),  Sec.  -".078. 

Kansas.  General  Statutes  (1897),  Sec.  2458. 
-  Maine,  Revised  Statutes  (1883),  Chapter  IT.  Sec.  5-12. 

"  <  >bio,  Annotated  Statutes  1 19 Sec.  6921  ■  I  aeq. 

io  Tennessee,  Code    L896),  Sees.  5689,  57  i''-7. 

II  Washington,  Chapter  14,  Laws  of  1895. 

w  WYst  Virginia,  Code  (1899),  Chapter  L50,  Sec.  ■-'<>. 


124  nuisances. 

dollars  to  five  hundred  dollars.     In   West  Virginia  the  fine  is  from  five 
dollars  to  fifty  dollars. 

In  a  number  of  states  the  court  may  after  conviction  for  violation 
of  the  nuisance  laws  cause  the  immediate  abatement  of  the  nuisance 
through  the  agency  of  a  constable,  sheriff  or  other  officer. 

B.     Special  or  Charter  Legislation  in  regard  to  Nuisances. 

In  some  charters  a  considerable  number  of  provisions  are  found  for 
the  prevention  of  nuisances.  Among  the  cities  that  are  thus  legislated 
for  b}^  statute  may  be  mentioned  the  City  of  New  York,  Pennsylvania 
cities  of  the  second  class  and  Detroit.  In  the  Detroit  law  there  is  a 
provision  requiring  and  regulating  water  closets  in  factories,  work- 
shops, offices,  etc.,  and  requiring  ail  such  to  be  properly  ventilated,  and 
the  same  regulations  apply  to  schoolhouses.  In  Pennsylvania  cities 
of  the  second  class  all  persons  are  forbidden  putting  offensive  matter  in 
the  streets  or  on  lots  or  in  other  places  where  it  may  be  a  nuisance ; 
and  no  person  may  keep  his  "  premises  in  such  a  condition  as  to  be 
offensive  to  the  neighborhood."  This  law  also  regulates  the  slaughter- 
ing of  animals  and  other  offensive  trades,  provides  for  the  construction 
and  sanitary  condition  of  vaults,  drains,  etc.,  and  regulates  the  cleaning 
of  vaults.  Besides,  or  in  place  of  specific  prohibitions,  very  broad  pro- 
hibitions are  sometimes  found,  as  in  the  City  of  New  York,  shown 
below.1 

C.     Local  Legislation  Concerning  Nuisances. 

There  can  be  little  doubt  that  power  to  legislate  concerning  nu - 
sances  is  implied  when  general  power  to  legislate  on  sanitary  affairs  is 
conferred  even  if  nuisances  are  not  specifically  referred  to.     The  success 


1  New  York  Chapter  378,  of  1897,  Sec.   1220: 

"The  word  '  nuisance,'  as  used  in  this  act,  shall  be  held  to  embrace  public  nui- 
sance, as  known  at  common  law,  or  in  equity  jurisprudence;  and  it  is  further  en- 
acted that  whatever  is  dangerous  to  human  life  or  detrimental  to  health;  whatever 
building  or  erection,  or  part  or  cellar  thereof,  is  overcrowded  with  occupants,  or  is 
not  provided  with  adequate  ingress  and  egress  to  and  from  the  same,  or  the  apart- 
ments thereof,  or  is  not  sufficiently  supported,  ventilated,  sewered,  drained,  cleaned, 
or  lighted,  in  reference  to  their  or  its  intended  or  actual  use;  and  whatever  renders 
the  air  or  human  food  or  drink,  unwholesome,  are  also,  severally  in  contemplation 
of  this  act,  nuisances;  and  all  such  nuisances  are  hereby  declared  illegal;  and  each 
and  all  persons  and  corporations  who  created  or  contributed  thereto,  or  who  may 
support,  continue  or  maintain  or  retain  them,  or  any  of  them,  shall  be  jointly  and 
severally  liable  for,  or  toward,  the  expense  of  the  abatement  and  remedying  of  the 
same;  but  as  between  themselves,  any  such  persons  and  corporations  may  enforce 
contribution  or  collect  expenses,  according  to  any  legal  or  equitable  relations  exist- 
ing between  them;  but  nothing  herein  contained  shall  annul  or  defeat  any  common 
law  liability  or  responsibility  in  respect  of  nuisances." 


NUISANCES.  125 

of  New  York  and  Brooklyn  in  enforcing  the  provisions  of  their  sanitary 
codes  attests  this.  Nevertheless  it  has  been  thought  advisable  in  many 
states  to  specifically  confer  such  power  in  regard  to  nuisances.  The 
following  is  the  Massachusetts  law:  l 

■■  The  board  of  health  of  a  town  shall  make  such  regulations  as  it  judges  neces- 
sary for  the  public  health  and  safety,  respecting  nuisances,  sources  of  filth  and  causes 
of  sickness,  within  its  town,  or  on  board  of  vessels  within  the  harbor  of  such  town, 
and  respecting  articles  which  are  capable  of  containing  or  conveying  infection  or 
contagion,  or  of  creating  sickness,  brought  into  or  conveyed  from  its  town,  or  into 
or  from  any  vessel.  Whoever  violates  any  such  regulation  shall  forfeit  a  sum  not 
exceeding  one  hundred  dollars.1' 

This  has  been  closely  followed  in  Colorado,  Iowa,  Michigan,  Ver- 
mont, and  Wisconsin.  The  New  Jersey-  law  gives  the  board  of  health 
power 

"  To  define  and  declare  what  shall  constitute  nuisances  in  lots,  streets,  docks, 
wharves,  vessels,  and  piers,  and  all  public  or  private  places.*1 

This  law  also  gives  power  of  legislation  concerning  a  number  of 
other  matters  which  will  be  duly  considered.  In  Ohio  the  board  of 
health  may  make  regulations  for  "  the  abatement  or  suppression  of 
nuisances."  Illinois  cities  and  villages  may  "  declare  what  shall  be 
nuisances  and  abate  the  same  and  impose  fines."  In  .Mississippi  muni- 
cipal corporations  have  power  "to  make  regulations  to  prevent,  remove 
and  abate  nuisances."  In  Louisiana  local  boards  of  health  may  pass 
ordinances  "for  defining  and  abating  nuisances  dangerous  to  the  public 
health." 

Special  and  charter  provisions  also  often  confer  this  power.  Thus 
in  Baltimore  the  mayor  and  city  council  are  to  pass  an  ordinance  "to 
prevent  and  remove  nuisances."  The  Bridgeport  city  council  has  power 
to  pass  ordinances  "relative  to  all  nuisances.**  The  common  council  of 
Chicago    IS    "to    abate    and    remove    nuisances    and    punish  the    authors 

thereof  by  penalties,  fine  and   imprisonment   and   to  define  and   declare 

what  shall  be  deemed  nuisances."'  The  government  of  Memphis  may 
"define,  prevent  and  remove  nuisances.'*  The  board  of  health  of  San 
Francisco  also  may  "define"  what  shall  be  a  nuisance. 

As  a  rule  the  number  and  complexity  of  these  regulations  increase 
with  the  size  <>f  the  municipality  and  the  densitj  of  the  population. 
I  i.w  n ships  and  villages  need  comparatively  lew  ordinances  of  this  Kind. 
Man\  things  ma\  be  freely  permitted  in  a  sparsely  settled  region  which 
would  be  unendurable  in  a  metropolitan  city.     The  end  constant^  held 

in   view  in  all    these  regulations    is  to  secure    pure  air,  pine  water  and  a 


Massachusetts,  Public  Statutes  (1882),  Chapter 80,  Sec.  Is. 
•  Ww  Jersey,  General  Statutes  (1895),  p.  1680,  Sec.  12,  ll. 


126  isruiSAisrcEs. 

pure  soil  for  all  men ;  by  pure  is  meant  free  from  decaying  organic 
matter  or  its  products ;  free  from  "  filth "  and  all  offensive  odors. 
Therefore  rules  are  made  in  regard  to  the  disposal  of  excreta  and  waste 
material  of  all  kinds.  Cesspools,  privy  vaults,  sewers,  drainage  and 
plumbing  are  to  be  constructed  and  maintained  in  a  proper  manner. 
Offensive  trades  are  to  be  regulated,  stables  kept  clean  and  refuse  of 
all  kinds  removed  without  causing  a  nuisance.  Dwellings  are  to  be 
properly  constructed  and  not  overcrowded,  and  must  be  kept  clean.  A 
consideration  of  these  local  sanitary  regulations  will  be  found  in  the 
succeeding  chapter. 

Administrative  Methods  of  Dealing  with   Nuisances. 

Most  municipalities  of  less  than  20,000  inhabitants  compel  their 
health  officer  or  other  executive  sanitary  official  to  perform  the  duties 
of  inspector  of  nuisances.  Occasionally,  smaller  communities  have  a 
sanitary  inspector,  but  lie  is  more  often  so  only  in  name  :  practically  he 
is  a  general  executive  officer.  In  New  Jersey  every  town  of  2,000 
inhabitants  must  appoint  a  sanitary  inspector,  and  if  he  neglects  his 
duty,  or  if  one  is  not  appointed  by  the  town,  the  state  board  of  health 
may  appoint  one  at  a  salary  of  $50  a  year  to  be  paid  by  the  town.1 
Some  cities,  much  larger  than  20,000,  have  no  inspector,  as  the  City  of 
Pawtucket  with  40,000,  and  Providence  had  no  permanent  special  in- 
spector of  nuisances  until  1883,  at  which  time  the  population  was 
117,000.  Inspectors  of  nuisances  are  sometimes  known  by  this  name, 
but  more  often  as  sanitary  inspectors  and  in  many  places  as  sanitary 
police.  Occasionally  they  are  called  health  inspectors,  as  in  Portland, 
Me.,  and  New  Bedford,  or  sanitary  officers  or  executive  officers,  as  in 
St.  Louis  and  Wilmington,  Del.  In  some  cities,  as  in  Boston,  Cleve- 
land, Jersey  City,  Louisville,  Memphis,  New  York,2  and  Spokane,  some 


*Xew  Jersey,  General  Statutes  (1895),  p.  1636,  Sees.  30-32. 

2 New  York,  Chapter  378  of  1897,  Sec.  1324: 

"The  board  of  health  shall  make  requisition  upon  the  police  board  for  the  detail 
of  at  least  fifty  and  not  more  than  one  hundred  suitable  officers  and  men  of  at  least 
five  years'  service  in  the  police  force,  who  shall  be  selected  for  their  peculiar  fitness, 
for  the  enforcement  of  the  provisions  of  the  sanitary  code  and  the  acts  relating  to 
tenement  and  lodging  houses.  These  officers  and  men  shall  be  detailed  to  such  ser- 
vice by  the  police  board,  and  the  department  of  health  shall  pay  to  the  police  depart- 
ment monthly,  the  amount  of  the  pay  of  the  officers  and  men  so  detailed,  who 
shall  belong  to  the  sanitary  company  of  the  police  and  shall  report  to  the  board  of 
health.  At  least  thirty  of  the  officers  and  men  so  detailed  shall  be  employed  exclu- 
sively in  the  enforcement  of  the  laws  relating  to  tenement  and  lodging  houses.  The 
board  of  health  may  report  back  to  the  police  board  for  punishment,  any  member 
of  said  company  guilty  of  any  breach  of  orders  or  discipline,  or  of  neglecting  his 
duty,  and  thereupon  the  police  board  shall  detail  another  officer  or  man  in  his  place, 


NUISANCES.  127 

or  all  of  the  inspectors  are  regular  members  of  the  police  force  and 
detailed  for  sanitary  work,  and  act  under  the  immediate  direction  of  the 
health  department.  Under  the  old  law  in  the  City  of  New  York  there 
were  detailed  for  this  purpose  in  1896,  one  sergeant,  two  roundsmen,  and 
forty-seven  policemen  (men  of  long  experience  in  the  police  force  of  the 
city).  They  are  known  as  the  sanitary  company  of  police.  In  many 
other  cities,  as  Charleston,  Denver,  Hartford,  Jersey  City,  Mobile, 
Omaha,  Philadelphia,  and  Providence,  the  board  of  health  is  authorized 
to  call  upon  the  police  for  assistance  in  inspection  or  else  such  inspec- 
tions area  prescribed  part  of  the  police  work.  In  Chicago  the  com- 
missioner of  health  is  authorized  to  appoint  five  women  as  sanitary 
police  at  a  salary  of  fifty  dollars  per  month.1 

In  New  York  in  1896,  besides  the  sanitary  police  referred  to  above, 
there  was  the  sanitary  bureau,  proper,  consisting  of  a  superintendent, 
assistant  superintendent,  order  clerk,  complaint  clerk,  four  other  clerks, 
typewriter,  chief  inspector  with  two  clerks  and  thirty-eight  sanitary 
inspectors.  Under  the  charter  of  the  City  of  New  York-  the  board  of 
health  is  to  appoint  fifty  sanitary  inspectors  and  may  appoint  twenty 
more.     Another  provision  of  the  charter  is  thai  ,; 

"  The  board  of  healtb  may,  from  time  to  time,  engage  a  suitable  person  or  tier- 
sons  t<>  render  sanitary  engineering  service  and  in  make  or  supervise  practical  and 
scientific  sanitary  investigations  ami  examinations  in  the  city  requiring  engineering 
skill,  ami  to  prepare  plans  ami  reports  relative  thereto." 

The  other  large  cities  have  an  organization  similar  to  that  of  New 
York,  though  less  elaborate,  and  as  we  p;i>s  to  the  smaller  cities  the 
number  of  employees  becomes  less  until  we  at  last  find  only  the  single 
health  officer.  In  the  smaller  cities,  where  there  are  only  one  or  two 
inspectors,  they  usually  work  under  the  immediate  supervision  of  the 
executive  officer  of  the  department,  and  no  formal  rules  for  their  guid- 
ance aie  necessary;  but  in  some  cities  of  moderate  size  and  in  mosi  of 
the  large  cities  rules  are  provided  lor  the  conduct  of  the  inspectors. 
The  most  elaborate  rules  are  to  be  found  in  Atlanta.  Augusta,  Ch 
ton.  and  Cincinnati.  The  rules  for  the  inspectors  in  Atlanta  are  given 
in  Appendix  27. 

The  hours  of  service  vary  in  different  cities,  being  usually  from 
seven    to   nine   boms  a   day.     Sanitary    police   however,  usually    have 

ami  the  .lis,  ipiine  of  the  said  members  ■■!'  the  sanitary  companj  shall  be  in  the  jurii 
diction  ..t  the  police  department ;  bul  al  any  time  the  board  'if  healtb  max  objeel  to 
the  efficiency  of  any  member  of  said  sanitary  company,  and  thereupon  another  officei 
<>r  man  shall  he  detailed  in  his  place." 
1  Chicago,  Ordinances  (1881),  Sec.  1 L82. 
.-.  York,  i  baptei  -.7-  oi    L807,  Sec.  1 185. 
New  i'ork,  chapter  378  -i    1897,  Se< .  1 186. 


128  NUISANCES. 

longer  hours,  the  same  as  the  rest  of  the  police  force.  In  many  cities, 
perhaps  most,  the  sanitary  inspector,  while  having  working  hours  fixed 
by  rule  are  "  considered  as  always  on  duty."  In  Denver  the  inspection 
hours  are  8  A.  M.  to  4  p.  M.  with  one  hour  at  noon.  In  Augusta,  Ga.,  from 
7  A.  m.  to  6  p.  M.  with  two  hours  at  noon.  In  most  places  a  two  weeks' 
vacation  is  allowed,  but  this  as  well  as  the  hours  of  service  is  usually 
the  same  for  sanitary  inspectors  as  for  other  similar  city  employees.  In 
almost  all  the  large  cities  sanitary  inspectors  are  required  to  engage  in 
no  other  work.  In  small  places  where  there  is  only  one  inspector  or 
where  the  health  official  does  inspector's  work,  all  his  time  is  not  needed 
for  his  official  duties.  Occasionally  in  large  cities,  as  in  Baltimore, 
where  physicians  are  employed  as  inspectors,  they  are  only  expected  to 
give  a  part  of  their  time,  as  much  as  may  be  necessary  to  do  the  work 
laid  out.  Usually  they  do  not  wear  a  uniform  unless  as  sanitary  police 
they  are  detailed  from  the  regular  police  force ;  but  in  some  cities,  as 
Atlanta,  Cambridge,  Milwaukee,  Cincinnati,  Pittsburg,  Columbus,  Ga., 
St.  Paul,  San  Francisco,  and  Reading,  uniforms  are  required.  Generally 
a  badge  is  worn  which  is  exhibited  by  the  inspector  to  show  his  authority 
under  the  law  for  entering  upon  private  property  and  making  his  exa 
minations.  The  table  given  below1  shows  the  number  of  inspectors  and 
their  salaries  in  certain  cities. 

Number  of  Salary 

City.  Population.  Inspectors.  per  annum. 

a    i          x>     i     v    t                              ax  aaa                              9  i  Chief  $b000 

A  sbury  Park,  N.  J 4o,000 2      -,'  ' 

'  As st.  <o0 

Atlanta 89,872 7      (  Chief  1,500 

Augusta,  Ga 39,441 5\4 I  «00 

Baltimore 508,957 64     1,000 

Boston 500,892 16     1,100-1,800 

Brookline 20,000 1 

Buffalo 352,219 42    1,000 

Cambridge 91,886 3V 800-  1,000 

Charleston 55,807 4     600 

Chicago 1,698,575 34     1,000 

Cincinnati 325,902 20*    600 

Cleveland 381,768 20     900 

Columbus,  ( ) 125,560 8     720 

District  of  Columbia 278,718 7      1,200 

Dayton 85,333 2      700 

Denver 133,859 11      900 

Kvansville 59,007 1      936 

TT      ,     ,                                             -«  q-a                            ^  S  Chief    1,800 

Hartford 79,850 2     ' 

<  Asst.        600 


1  Chief  is  allowed  board  of  horse. 
-  Six  in  summer. 

3  Disinfect. 

4  Look  after  communicable  disease. 


NUISANCES. 


L29 


Number  of  Salary 

City.  Population.                    Inspectors.                          per  annum. 

Indianapolis 169,164 r>:.- 

kowell 94,969 4     |8  00-3  50  per  day 

Itfnn 68,513 2      .' l.nnu 

Manchester 56,987 2 

Memphis 102,320 12 

Milwaukee 285,315 13*    j  Chief       900 

'  Assts.       sun 

Minneapolis 202,718 7-    900 

Newark 246,070 15     2  75  per  day 

New    Haven 108. 027 .;>.-  

New  Orleans 287,104 l'.i-    j  Chief    1,800 

I  Assts.      600 
Newton :j:;.;,s7 31,2 750     1,000 

Pittsburg 321,616 17-    j  Chief    1,000 

!  Assts.       900 

Providence 175,597 2     .  (Chief    1,200 

Asst.        600 
Richmond 85,050 4 

Rochester 162,425 5     600 

St.  Paul 163,632 6     700 

Sail   Lake  City 53,531 1  . ..  1,000 

San  Francisco 342,782 5 J  1 .200 

Somerville 61,643 1  1,000 

Syracuse 108,374..  •'-•  j  Chief    1,500 

Ust.        900 
Toledo 131,822 101,2 

I'tica 56,382 3 

Wilmington,  Del 76,508 4'.- 


From  an  inspection  of  the  above  table  it  will  be  seen  that  the  popu- 
lation served  by  an  inspector  varies  verj  much  in  different  cities.  Of 
the  above  cities  ii  is  the  largest  in  Providence  where  there  is  only  one 
inspector  for  a  population  of  87,000.  The  smallest  population  for  a 
single  inspector  is  13,000  in  Toledo.  The  number  of  persons  which 
one  inspector  can  serve  depends  somewhat  upon  the  density  of  the 
population,  though  not  as  much  so  as  one  would  imagine.      While  it  takes 

time  i"  go  from  house  to  house  in  a  thickly  settled  region,  the  nui- 
sances are  usually  more  1111 ions  and  require  more  attention    in  such  a 

section.  Some  cities  require  more  careful  inspection, owing  to  the  char- 
acter of  the  population,  industries,  geographical  position,  or  long  con- 
tinued neglecl  of  sanitary  work.  It  is  also  difficult  to  compare  the 
work  of  inspectors,  because  in  some  cities  they  have  many  more  duties 

than    in   others.      In    soi it i»-s   they   apparently  do  not  do  more  than 

look  after  complaints   that   are  made  by  citizens.      In  others  the}   n 

1  I  nsinfect. 
Look  after  communicable  disease. 
0 


130  NUISANCES. 

a  systematic  inspection  of  premises  outside  of  houses.  In  other  cities, 
as  Boston,  Chicago,  and  New  York,  considerable  time  is  given  to  house 
to  house  inspection,  particularly  in  tenement  house  districts,  all  parts  of 
the  houses  being  examined.  h\  New  York  City  the  sanitary  police,  fifty 
in  number,  are  detailed  exclusively  for  this  work.  Again,  in  some  cities, 
as  Augusta,  Ga.,  Baltimore,  Cincinnati,  Milwaukee,  Minneapolis,  New 
Orleans,  Pittsburg,  San  Francisco,  and  many  others,  the  sanitary 
inspectors  have  duties  in  connection  with  contagious  diseases,  such  as 
placarding  houses  and  disinfecting.  In  San  Francisco  the  plumbing 
inspectors  look  after  all  nuisances  connected  with  plumbing.  In  New- 
port the  sanitary  inspector  attends  to  the  flushing  of  sewers.  In  other 
cities,  as  Charleston,  the  inspectors  have  to  give  much  time  to  enforc- 
ing the  rules  in  regard  to  the  removal  of  garbage.  In  Detroit  two 
inspectors  are  detailed  especially  for  this  work.  In  Cleveland  the  sani- 
tary police  collect  returns  of  marriages  and  births.  An  average  of  all 
the  cities  in  the  table  gives  the  population  for  one  inspector  as  about 
30,000. 

If  there  is  more  than  one  inspector,  the  city  is  divided  into  districts, 
and  each  inspector  is  assigned  to  one  district  and  confines  his  work  to 
it,  and  thus  becomes  familiar  with  it.  In  Denver  this  division  is  a  ward. 
In  Newark  there  is  one  inspector  for  each  district  and  also  one  at  large. 
Usually  inspectors  report  at  the  health  office  daily,  sometimes  twice 
a  day  as  in  Providence.  In  New  York  City  they  report  at  the  depart- 
ment twice  each  week,  different  inspectors  reporting  on  different  days. 
Inspectors  in  Denver  communicate  with  the  office  by  telephone  twice 
daily  besides  reporting  in  person  at  4  p.  m.  daily  to  write  up  their  day's 
work  in  the  record  book  in  the  office.  In  Charleston  the  sanitary 
inspectors  are  required  to  visit  fifty  premises  daily,  and  they  report 
each  day  at  noon,  bringing  a  report  with  fifty  signatures  of  the  occupants 
of  the  premises  they  have  inspected. 

Except  in  systematic  house  to  house  inspection  the  first  step  in 
the  suppression  of  nuisances  is  the  entering  of  a  complaint  —  citizen's 
complaint  as  it  is  called.  Large  numbers  of  such  complaints  are  every- 
where received,  showing  that  the  public  expects,  demands,  and  needs 
protection  from  nuisances.  In  some  cities  anonymous  complaints  receive 
no  attention,  as  Brookline,  Elmira,  and  Syracuse.  In  Albany,  Reading, 
and  Scranton  it  is  forbidden  by  rule  to  look  up  such  complaints,  but  in 
other  places  they  are  noticed.  The  experience  of  the  writer  has  been 
that  anonymous  complaints  are  about  as  likely  to  be  well  founded  as 
are  those  where  the  name  of  the  complainant  is  given.  A  considerable 
number  of  citizens'  complaints  are  based  on  spite,  or  are  due  to  an  unrea- 
sonable  fastidiousness.       The   proportion   of  unfounded   complaints    in 


■        .        NUISANCES.  181 

Providence  is  about  twenty-live  per  cent.  In  Newark  it  is  reported 
to  be  about  the  same.  Citizens'  complaints  are  usually  entered  in  a 
book  by  a  clerk  or  whoever  attends  to  the  office.  In  Buffalo  the  com- 
plaint book  is  classified  bystreets.  In  some  places  blanks  are  furnished 
the  complainant  on  which  the  formal  complaint  can  be  written,  or  it  is 
written  on  such  a  blank  for  him  by  the  clerk.  These  may  be  kept  on 
file  in  the  office  or  they  may  be  given  to  the  inspector  as  his  memo- 
randum. The  form  of  the  complaint  blank  used  in  Buffalo  is  shown  in 
Appendix  28.  Sometimes  the  inspector  in  his  rounds  uses  a  plain 
memorandum  book  for  his  notes  or  lie  may  have  one  with  printed 
blanks.  The  form  used  in  Providence  is  about  3J  b\  .">.>  inches  and 
contains  blanks  for  the  location,  owner's  name  and  address,  description 
of  the  nuisance  and  the  officer's  signature. 

It  is  primarily  the  duty  of  the  inspector  to  report  the  results  of  his 
visit  to  the  central  office,  though  he  is  often  expected  and  required  to 
give  advice  and  directions  in  regard  to  minor  matters  as  occasion  offers 
during  his  rounds.  Sometimes,  as  in  Philadelphia,  he  is  to  issue  and 
serve  a  formal  notice  as  soon  as  a  nuisance  is  discovered.  In  sue! 
he  would  report  the  service  and  the  nuisance  together  at  the  offi< 
the  department.  In  small  places  where  there  is  only  a  health  officer,  or 
one  sanitary  inspector,  such  officer  must  himself  enter  his  reports  in  the 
office,  tile,  record  and  index  them  and  make  out  the  orders,  etc.  ;  but  in 
Larger  cities  the  office  work  of  recording  and  indexing  is  often  done  by 
special  clerk.-.  In  these  cities  the  inspectors  make  a  formal  return  for 
each  nuisance  found,  or  if  it  is  a  citizen's  complaint,  or  the  inspection 
for  contagions  disease,  or  a  house  to  house  inspection,  a  single  slip  is 
often  handed  in  for  each  inspect  ion.  The  inspector's  report  in  Buffalo  is 
exactly  like  the  complaint  form  shown  in  Appendix  28.  In  New  Haven 
the  inspector  carries  with  him  a  book  of  notices  shown  in  Appendix  -W 
and  tills  them  out  as  he  goes  along.  When  he  returns  to  the  office  he 
Copies  them  on  their  stubs  and  then  sends  t  hem  to  t  he  owners  of  1  lie 
properties    inspected.      In    Boston,    Denver,    Indianapolis,    Newark,    St. 

Louis,  and  a  n ber  of  other  cities  a  special  sanitary  inspection  is  made 

in  each  case  of  communicable  disease,  and  often  a  special  blank  form  is 

prepared  for  making  a  return  <•!    the  s e.     Some  "I    these  are  shown 

in  the  Appendices  to  ( lhapter  N. 

Besides  making  reports  of  individual  nuisances,  inspectors  are 
frequently  required  to  send  in  each  day  or  at  other  stated  intervals, 
summaries  ..f  the  work  done  b\  them.  Besides  the  reports  of  the  indi- 
vidual inspectors,  weekly  or  daily  reports  of  chief  inspectors  are 
freipieiiih  filed,  or  summaries  made  of  the  work  of  all  the   inspectors. 

A  weekly  summary  of  the  work  of  the  sanitary  inspector  is  made  b\ 


132  NUISANCES. 

the  chief  inspector  in  the  City  of  New  York,  in  which  the  inspections 
are  tabulated  as  inspections  of  tenement  houses,  lodging  houses,  private 
dwellings,  etc.,  fifteen  items  in  all.  This  report  is  on  a  double  foolscap 
sheet.  For  the  weekly  report  of  the  sanitary  police,  the  chief  inspector 
uses  a  similar  sheet,  only  the  classification  of  their  work  is  much  more 
complete,  as  their  services  are  classified  under  thirty-nine  heads  and  the 
nuisances  acted  on  are  classified  under  seventy  heads. 

House  /"  House  Inspection. 

A  few  cities,  of  which  New  York  and  Boston  are  conspicuous  exam- 
ples, carry  out  a  systematic  inspection  of  the  houses  of  certain  districts. 
Other  cities  in  considerable  number  have  at  times  undertaken  a  general 
and  thorough  dwelling  or  tenement  house  inspection  in  time  of  impend- 
ing pestilence,  or  as  the  part  of  a  spasmodic  effort  to  put  the  city  in 
better  sanitary  condition.  As  long  ago  as  1884  the  Illinois  state  board 
of  health  made  a  strong  effort  to  induce  all  the  municipalities  in  the 
state  to  undertake  such  an  inspection  as  a  part  of  its  proposed  "  sanitary 
survey,"  and  its  efforts  have  met  with  very  general  success.  In  New 
Jersey,  too,  owing  largely  to  the  efforts  of  the  state  board  of  health,  a 
number  of  municipalities  make  such  an  annual  inspection.  In  Minne- 
sota the  law  requires  the  health  officer  to  make  such  an  inspection  in 
May  of  each  year,1  and  in  Florida  the  rules  of  the  state  board  of  health 
require  inspection  in  cities  between  1  May  and  1  November.  Among 
other  cities  which  maintain  such  a  house  to  house  inspection  are  Fitch- 
burg,  Mass.,  Lowell,  and  Philadelphia.  In  Lowell  a  card  index  is 
kept,  which  shows  at  a  glance  the  sanitary  condition  of  the  houses. 
Many  health  officers  in  their  reports  urge  the  desirability  of  such  an 
annual  house  to  house  inspection,  at  least  in  the  tenement  districts,  and 
are  deterred  from  making  it,  simply  from  lack  of  funds.  Money  for 
such  purposes  will  be  granted  freely  in  the  face  of  an  epidemic,  but 
withheld  at  other  times.  In  this  connection  it  may  be  mentioned  that 
the  City  of  Newton,  Mass.,  in  the  summer  of  1895  made  5500  house 
to  house  inspections  at  a  cost  of  $650,  or  less  than  12  cents  per  inspec- 
tion. 

New  York  presents  the  best  example  of  house  to  house  inspection. 
For  many  years  such  an  inspection  has  been  made  twice  each  }^ear  in 
the  tenement  house  districts.  In  1896  the  city  was  divided  into  thirty- 
one  districts,  and  for  the  service  there  were  detailed  from  the  regular 
police  force,  forty-seven  patrolmen,  two  roundsmen,  and  one  sergeant. 
These  sanitary  police  also  have  to  inspect  lodging  houses  and  look  after 
the  abatement  of  nuisances.     The  result  of  the  inspection  in  1896  was 

1  Minnesota,  Statutes  (1894),  Sec.  7048. 


NUISANCES. 


loo 


the  abatement  of  38,858  nuisances ;  the  number  of  houses  inspected 
was  42,909. 

Examples  of  forms  for  house  to  house  inspections  may  be  found  in 
Appendices  30  to  32. 

Nuisances  of  whatever  kind,  when  reported  to  the  health  depart- 
ment, should  be  properly  recorded.  The  usual  way  is  to  keep  such  a 
record  in  a  book.     The  form  used  in  Providence  is  shown  below.1 

This  book  is  indexed  by  owners*  names,  but  it  is  an  excellent  plan 
to  have  a  street  index  as  well.  Another  method  is  to  keep  the  record 
of  nuisances  on  index  cards.  In  Buffalo  the  report  of  the  inspector 
(shown  in  Appendix  28)  is  put  in  an  envelope  7  by  9  inches,  together 
with  any  other  papers  relating  to  the  case  and  endorsed  on  the  corner 
as  shown  below2  and  filed  in  drawers,  being  arranged  by  streets. 

It  is  sometimes  required  that  records  of  nuisances  shall  be  open  to 
the   public. 

Ord< 

After  the  report  of  the  inspector  has  been  filed  in  the  health  ofHce, 
the  nexl  step  is  the  notification  of  the  owner  to  abate  the  nuisance,  ft 
is  only  exceptionally  that  an  order  to  abate  a  nuisance  can  lie  mailed  as 
was  provided  in  the  old  Xew  York  City  law,  and  even  then  if  prosecution 
was  contemplated  a  personal  notice  was  usually  made.  Most  nuisance 
laws  require  that  the  order  shall  he  formally  served  personally,  or  by 
leaving  at  the  usual  place  of  abode.  This  is  always  considerable  trouble 
and  often  a  matter  of  much  difficulty.      Hence  it  is  a  common  practice 

1  Size  of  Pagk  13  x  16  I  nches. 


v, 
Notified 


Dateof        „ 
(' plaint. 

LOCATION. 

OWNER.          oJgSS*,. 

(  ONDITION. 

\i    1  lo\ 
1    \M   \ 

2371 

2378 

Complainl                Street                 Owner 
Ex pires I ospected  i>y 


A.l.lr. 


134 


NJTIS.  J  m  A'.s. 


to  send  by  mail  a  letter  to  the  person  in  charge  of  the  property  calling 
his   attention   to  the  nuisance  and  requesting  its   prompt   removal   and 
perhaps  designating  the  rule,  ordinance  or  statute  under  which  further 
proceedings  may  be  taken.     Often  also  the  inspector  at  the  time  of  his 
visit  may  he  able  to  give  such  verbal  directions  and  advice  to  the  owner, 
agent  or  occupant  as  will  result  in  the   prompt  suppression  of  the  nui- 
sance.    These  informal  notices  are  not  relied  upon  when  the  necessity 
for  prompt  action  is  very  great,  or  in  those  cases  when  it  is  known  that  the 
owners  are  liable  to  be  dilatory,  but  they  can  safely  be  sent  in  a  large 
proportion   of  cases,  and  in   a  majority   of  them  they  receive  prompt 
attention.     If   it  is  intended  that  the  next  procedure  on  the  part  of  the 
board  of  health  shall  be  a  prosecution  for  violation  of  any  specific  legis- 
lation forbidding  the  nuisance  in  question,  no  further  order  is  necessary. 
When  a  person  permits  or  commits  an  act  which  is  definitely  forbidden 
by  statute  or  by  a  rule  of  a  board  of  health  properly  adopted  and  pro- 
mulgated it  is  not  required  that  notice  of  any  kind  shall  be  given  before 
legal  proceedings  are  taken.     If  it  is  done,  it  is  a  gratuitous  proceeding 
on  the  part  of  the  sanitary  authorities,  and  is  done   because  experience 
has  taught  .that  in  a  large  proportion  of  cases  such   an  informal  notice 
is  all  that  is  necessary  to  secure  the  abatement  of  a  nuisance.     Below 
is  a  simple  form  of  blank  which  may  be  used   by  properly  rilling,  to  fit 
nearly  all   cases.1     Most  large  cities,  besides  such  a  general  form,  have 


Ward 
No 

Name 


1  Size  4  x  10  Inches. 

S  \mtaky  Division  —  Health  Department. 


t  Owner. 
'  ( (ccupant 
/  Agent. 


Nuisance 


Ward 

No     St.  Louis  189.. 

,   <  iwner. 
rp0  '  <  tccupant. 

/  Agent. 

You  are  hereby  notified  that  a  nuisance  exists  in 
the  form   of 


Location 


Inspection  made  180 

By 

File  in  sanitary  office. 


at 


which  you  are  requested  to  abate  or  remove  at  once. 
Respectfully, 


Inspected  by 


Max  C.  Stabbxoff, 
Health  Commissioner. 


Sanitary  Officer, 


NTTISANCES.  135 

special  blanks,  which  need  no  filling  out,  for  the  more  common  forms  of 
nuisances  such  as  privy  vaults,  cesspools,  stable  manure,  obstructed 
drains,  leaking  sink  pipes,  hog  pens,  etc.  In  New  York  City  a  blank 
form  of  notice  is  used  and  posters  specifying  the  particular  form  of 
nuisances  referred  to  are  fastened  to  the  order.  In  Denver  a  summary 
of  some  twenty-five  of  the  principal  sections  of  the  sanitary  ordinance 
is  printed  on  the  back  and  the  nuisance  to  be  abated  is  referred  to  by 
the  corresponding  number  on  the  face  of  the  order. 

While  it  is  true  as  was  before  stated  that  a  formal  service  of  a  notice 
is  not  usually  necessary,  preparatory  to  a  criminal  action  for  the  viola- 
tion of  such  ordinances  and  rules  as  forbid  specific  nuisances,  vet  some- 
times such  a  notice  is  required  by  the  ordinance  itself.  The  provision 
given  below  is  from  an  ordinance  adopted  in  St.  Louis,  19  January, 
1897.]      Similar  ordinances  are  found  in  Milwaukee  and  Charleston. 

A-  has  been  shown,  the  general  nuisance  laws  almost  always  require 
that  a  formal  notice  or  order  shall  issue  for  the  abatement  of  the  nui- 
sance. Such  orders  are  usually  issued  by  the  board  of  health  or  health 
commissioner,  and  often  by  the  executive  officer  of  the  board  of  health, 
and  occasionally  by  the  sanitary  inspector  or  by  other  officers  than  sani- 
tary officials.  Among  cities  which  authorize  inspectors  to  issue  orders 
may  be  mentioned  Augusta,  Ga.  Atlanta.  Newport.  R.  [.,  Cambridge  (in 
pertain  cases),  5Toungstown,  <  >..  and  Denver.  It  is  in  some  statutes  pre- 
scribed that  such  notices  shall  be  in  writing  and  they  are  almost  always 
signed  by  the  president  or  secretary,  or  clerk  of  the  hoard  of  health,  or 
by  the  executive  officer.  It  is  of  ten  required  by  law  that  a  record  shall 
be  kept  of  all  such  orders  issued,  and  certainly  this  is  the  usual  custom. 
Commonly  such  a  record  is  kept  in  a  book  provided  for  that  purpose. 
Besides  the  record  hook,  the  original  orders  are  often  kept  mi  tile  in  the 
oft  ice.  copies  being  served  on  the  parties  interested.    In  Providence  \\  here 

the  hoard  of  aldermen  is  the  hoard  of  health,  the  original  orders  are  kept 
on  file  in  the  office  of  the  city  clerk  who  is  clerk  of  the  hoard,  and  they  are 
opied  into  the  records  of  the  meeting.  Besides  this  they  are  noted  in 
the  ••  nuisance  hook"  which  is  kept  in  the  office  of  the  health  depart- 
ment. The  Massachusetts  nuisance  law  is  the  oldest,  and  has  served 
as  the  pattern  for  many  others.  The  orders  issued  under  it  in  Boston 
are  shown  in  Appendix  33.  The  forms  used  in  Ohio  and  Rhode  Island 
are  shown  in  Appendices  ;>'  1  and  35.  The  tonus  in  use  by  most  local 
boards  will   be  found    more  or  less  like  these.      The  phraseology  must, 


1  In  the  trial  of  any  person  charged  with  a  misdemeanor,  as  defined  bj  t  0 1- 
nance.  H  must  be  shown  thai  s:ii<l  party  das  been  notified  by  the  the  health 

department,  or  l>,\  a  notice  served   by  the  city   marshal,  to  remedj    the  matter  com- 
plained of,  ;in«l  thai  he  or  she  had  failed  to  obey  such  notice. 


136  NVI8ANCES. 

of  course,  vary  somewhat  to  correspond  to  the  different  statutes.  The 
original  almost  always  has  a  blank  on  the  reverse  for  the  record  of  service 
by  the  proper  officer,  and  a  duplicate  or  copy,  but  without  the  service 
blanks,  is  left  at  the  usual  place  of  abode,  or  served  as  otherwise  pre- 
scribed. Often  the  statute  or  ordinance  is  printed  on  some  portion  of 
it.  Often  the  copy  is  made  to  present  a  different  appearance  from  the 
original,  being  perhaps  printed  on  different  colored  paper. 

In  Philadelphia  the  nuisances  are  abated  by  the  board  of  health 
under  the  Act  of  29  January,  1818.  First  "  complaints  "  are  made  out 
on  blanks  as  in  man}'  other  cities  and  given  to  the  inspector.  After 
examination  of  the  premises,  the  inspector  returns  the  "complaint" 
with  a  report  of  the  "  nuisance  "  upon  the  back.  An  order  is  then 
made  out  in  the  office  and  a  copy  served  by  an  inspector  in  whose  dis- 
trict the  owner  lives.  A  reprint  of  the  office  copy  is  shown  in  Appen- 
dix 36.  After  the  lapse  of  the  required  time,  the  office  order  is  given  to 
the  inspector  who  reports  on  the  back  whether  it  has  been  complied  with. 
If  it  has  not  been  the  board  of  health  may  provide  for  the  summary 
abatement  of  the  nuisance  and  this  order  also  is  written  on  the  back. 
Besides  reporting  his  own  nuisance  work  each  inspector  in  Philadelphia 
makes  a  weekly  return  of  all  notices  or  bills  served  for  other  inspectors. 

After  service  of  the  notice  to  abate  a  nuisance  and  after  the  lapse  of 
the  time  specified  in  the  notice,  one  or  more  inspections  are  necessary 
to  see  that  the  order  has  been  obeyed.  Theoretically,  the  inspection 
should  be  made  immediately  upon  the  expiration  of  the  time  given,  and  if 
the  order  lias  been  neglected  the  penalty  should  at  once  be  imposed. 
This,  however,  is  probably  rarely  the  practice.  Ample  leeway  is  given 
in  most  rases,  particularly  if  it  is  not  believed  that  the  delay  is  wilful 
and  if  the  ease  is  not  an  especially  pressing  one.  Often  very  much  more 
than  the  specified  time  elapses  before  the  inspection.  Such  a  delay  is 
not  so  common  in  the  larger  cities  as  in  the  smaller  ones.  A  report  and 
record  of  secondary  inspections  must,  of  course,  be  made.  Sometimes  it 
is  endorsed  on  the  back  of  the  "  complaint "  as  in  Philadelphia.  Often 
the  result  of  the  inspection  is  simply  noted  in  the  record  book.  In  New 
York  City  a  separate  column  in  the  book  is  given  to  each  inspection,  the 
name  of  the  inspector  being  indicated.  Often  an  extension  of  time  is 
asked  for,  and  it  is  usually  granted  if  the  request  appears  at  all  reason- 
able. As  a  general  thing  it  may  be  said  that  the  health  officer  and 
others  intrusted  with  this  part  of  sanitary  administration  are  too 
lenient  rather  than  too  severe  in  dealing  with  this  class  of  offenders 
against  decency  and  health.  Often  a  final  formal  warning  notice  is  sent 
before  any  further  steps  are  taken  by  the  authorities. 

If  a  person  who  has  been  asked  to  abate  a  nuisance  fails  to  do  so, 


mri-SANCES.  1^7 

two.  or  in  some  cases,  three  methods  may  be  employed  by  the  authori- 
ties. 

FlRST.  The  guilty  person  maybe  proceeded  against  in  court  and  a 
fine  imposed.  Usually  the  matter  is  for  this  purpose  placed  in  the 
hands  of  the  police  or  law  department  of  the  city,  or  the  attorney  of  the 
health  department  in  the  few  cities  which  have  such  an  officer.  The 
duty  of  the  inspectors  in  the  case  is  chiefly  that  of  furnishing  testimony. 
This  testimony  may  be  from  memory  or  from  inspectors'  note  honks  or 
from  the  hooks  or  papers  on  file  in  the  office.  Sometimes,  agam,  the  law 
department,  when  a  case  is  referred  for  prosecution,  sends  out  a  notice 
that  action  is  about  to  be  taken,  thus  giving  another  short  period  of 
grace. 

The  great  objection  to  procedure  by  prosecution  and  tine  in  nuisance 
cases  is  that  many  times  the  desired  end  is  not  secured  owing  to  the  law's 
delay.  If  an  appeal  is  taken  as  it  is  frequently,  months  or  years  may 
elapse  while  the  case  is  pending,  and  all  this  time  the  nuisance  may  con- 
tinue unabated.  The  right  of  appeal  is  however,  sometimes  denied. 
Thus  in   Mississippi,1 

"The  district  judge  shall  try  ail  cas<  s  declared  a  nuisance  by  the  state  1  >- -aid  of 
health,  and  there  shall  lie  had  a  jury  trial  if  desired  and  there  shall   be    no   appeal.11 

In  Wilmington,  Del.,  the  statute  provides  in  case  of  failure  to  com- 
ply with  an  order  of  the  hoard  id'  health  for  a  line  to  he  recovered  in 
the  municipal  court  of  the  city,  or  in  default  of  the  same  commitment 
to  jail,  and  "from  the  judgment  id'  said  court  in  such  cases  there  shall 
be  no  appeal." 

Second.  As  has  been  shown,  a  nuisance,  after  the  formalities  required 
by  law  have  been  complied  with,  may  he  summarily  abated.  Nearly  all 
the  nuisance  laws  provide  that  the  authority  which  is  empowered  to 
order  nuisances  abated   also  has  power  if  its  orders  arc  not  complied 

with  to  peremptorily  abate  the  nuisance.      This  is  effectual,  and  though 

it  may  subject  the  municipalit)  to  a  suit  for  damages,  it  is  Ear  prefer- 
able to  he  a  defendant   than  a  plaintiff  in  such  a  case,  and  it   is  not  c - 

mon  to  find  the  decision  of  the  board  of  health  as  i"  ;i  nuisance  over- 
ruled by  the  courts  after  its  abatement.  A  practical  objection  to  this 
method  of  dealing1  with  nuisances  is  that  it  entails  a  considerable  ex- 
pense.  This  money,  while  ultimate!)  to  he  returned  to  the  treasury,  is 
a  loss  during  the  time  occupied  b}  the  Legal  proceedings  necessar}  for 
its  recover)  .  Furthermore,  the  cost  of  abating  nuisances,  when  actually 
recovered,  often  goes  into  some  fund  other  than  that  controlled  l»\  the 
health  department,  and   hence  is  a  nel  Loss  to  that  department.     Some- 

1  M  ississippi,  ,\i tated  <  lode  (1892),  Sec.  --'^77. 


138  NUISANCES. 

times,  too,  as  in  New  Haven  and  Philadelphia,  it  is  necessary  to  defray 
the  cost  of  abating  nuisances  out  of  an  appropriation  made  for  that  pur- 
pose, and  such  an  appropriation  is  not  always  forthcoming.  It  follows 
that  this 'summary  method  of  dealing  with  nuisances  is  not  employed 
as  generally  as  might  be  expected.  It  is  common  in  Philadelphia  and 
in  the  municipalities  of  Ohio. 

In  Philadelphia,  after  the  board  of  health  has  determined  on  the 
abatement  of  a  nuisance,  this  fact  with  the  name  of  the  contractor  is 
endorsed  by  the  health  officer  on  the  back  of  the  original  order.  When 
the  work  is  done  the  bill  for  the  same  is  presented  to  the  owner  by  an 
inspector.  If  not  paid,  it  is  referred  to  the  proper  legal  officer  for  col- 
lection. In  Newport,  R.  I.,  the  inspector  of  nuisances  when  an  order 
to  abate  is  not  obeyed,  and  the  cost  of  abatement  will  not  be  more  than 
ten  dollars,  is  authorized  to  at  once  abate  the  same,  the  costs  to  be 
"  sued  for  by  him  in  an  action  of  assumpsit;"'1  but  it  is  unusual  to 
give  inspectors  such  powers.  In  Philadelphia  in  a  suit  to  recover  the 
costs  of  abating  a  nuisance  ••the  tact  of  the  nuisance  shall  not  be 
enquired  into."  2  In  New  Jersey  it  is  provided  that  the  courts  shall  not 
enjoin  a  board  of  health  for  abating  a  nuisance  until  such  board  has 
been  given  a  hearing,  and  also  that  in  ease  no  nuisance  is  shown  to  exist 
the  board  of  health  is  not  liable  unless  it  is  shown  that  it  acted  without 
reasonable  cause. 

THIRD.  Another  and  very  effective,  though  indirect  method  of 
securing  obedience  to  sanitary  orders  is  not  unfrequently  employed  by 
health  authorities.  This  is  the  vacation  of  premises  which  are  deemed 
to  be  in   an  unsanitary  condition.      The  following  is  the  Massachusetts 

law  enacted  in  1850  :  3 

i 

"  The  board,  when  satisfied  upon  due  examination  that  a  cellar,  room,  tenement, 
or  building,  in  its  town,  occupied  as  a  dwelling-place,  has  become,  by  reason  of  the 
number  of  occupants,  want  of  cleanliness,  or  other  cause,  unfit  for  such  purpose, 
and  a  cause  of  nuisance  or  sickness  to  the  occupants  or  the  public,  may  issue  a 
notice  in  writing  to  such  occupants,  or  any  of  them,  requiring  the  premises  to  be 
put  into  a  proper  condition  as  to  cleanliness,  or,  if  they  see  fit,  requiring  the  occu- 
pants to  quit  the  premises  within  such  time  as  the  board  may  deem  reasonable.  If 
the  persons  so  notified,  or  any  of  them,  neglect  or  refuse  to  comply  with  the  terms 
of  the  notice,  the  board  may  cause  the  premises  to  be  properly  cleansed  at  the  ex- 
pense of  the  owners,  or  may  remove  the  occupants  forcibly  and  close  up  the  prem- 
ises, and  the  same  shall  not  again  be  occupied  as  a  dwelling-place  without  the  con: 
sent  in  writing  of  the  board.  If  the  owner  thereafter  occupies  or  knowingly  permits 
the  same  to  be  occupied  without  such  permission  in  writing,  he  shall  forfeit  not  less 
than  ten  nor  more  than  fifty  dollars.'' 


1  Newport  Ordinances,  Chapter  24,  Sec.  4. 

2  Pennsylvania,   Brightly's  Purdon's  Digest  (1895),  p.  1433,  (Act  of  7  April,  1S30. 
Sec.  2.) 

:;  Massachusetts,  Public  Statutes  (1882),  Chapter  80,  Sec.  24. 


NUISANCES.  139 

Similar  laws  are  found  in  Colorado,  Delaware,  Iowa.  Maine,  New 
Hampshire,  Rhode  Island,  and  South  Carolina  :  and  there  are  like-  pro- 
visions in  the  special  sanitary  legislation  of  various  cities,  as  Detroit, 
Memphis,  and  San  Francisco.  The  form  of  order  served  upon  the 
tenants  in  Boston  under  the  Massachusetts  law  is  shown  in  Appendix  37. 

A  curious  case  occurred  in  Boston,  where  the  tenants  in  two  houses 
just  alike  were  ordered  to  remove.  They  obeyed  the  order  I >y  exchang- 
ing tenements  and  thus  frustrated  the  purpose  of  the  board  of  health. 
Finally,  however,  an  order  to  vacate  in  thirty  minutes  was  issued,  and 
this  not  being  obeyed,  the  bouses  were  closed  up. 

As  has  been  shown,  a  number  of  states  provide  by  statute  lor  the 
vacating  of  unsanitary  houses.  Outside  of  these  slates,  a  number  of 
cities  have  considered  it  within  the  sphere  of  their  sanitary  powers, 
though  it  might  not  have  been  expressly  so  stated  in  their  charters  or 
the  general  legislation  establishing  their  sanitary  authority.  Several 
such  cities  have  therefore  in  their  ordinances  or  rules  provided  for  the 
vacation  of  unsanitary  dwellings.  Among  such  cities  may  be  mentioned 
Bridgeport,  Buffalo,  Chicago,  Minneapolis,  Newark,  Paterson,  Rochester, 
and  San  Francisco.  Again,  in  some  cities  in  stales  where  the  vacating 
is  provided  for  by  statute,  local  rides  specify  more  closely  under  what 
conditions  and  in  what  manner  action  shall  be  taken.      In  Fitchburg.1 

••  Whenever,  upon  due  examination,  it  shall  appear  to  the  Board  of  Health  that 
any  tenement  or  building  is  not  furnished  with  vaults  constructed  according  to  the 
provisions  of  these  Regulations,  or  with  sufficient  privies  or  water-*  losets,  or  drains 
under  ground  for  waste  water,  they  will  thereupon  issue  their  notice,  in  writing,  to 
the  occupants,  <>r  any  of  them,  requiring  them  to  remove  and  quit  sucb  tenement  or 
building  within  such  time  as  the  Board  shall  deem  reasonable,  and  the  same  shall 
n«it  be  again  occupied  as  a  dwelling  place  without  the  consent,  in  writing,  of  the 
Hoard.'" 

Iii  Ilolyoke,  Mass..-  houses  will  be  vacated  if  there  is  not  100  cubic 
feel  of  aii'  space  Eor  each  occupant  tor  sleeping  room.  This  vacating  ol 
tenements  is  employed  not  only  when  the  houses  arc  entirely  until  lor 
habitation  and  so  dilapidated  as  lo  be  impossible  of  repair,  bill  it  is  made 
Use  of  in  cases  of  obstructed  and  broken  drains,  and  detective  plumbing 

and  accumulations  of  tilth.  It  is  sometimes  the  quickesl  wa\  to  bring 
landlords  to  terms  and  secure  the  abatement  of  nuisances  which  might 
be  proceeded  against  in  other  ways.  A  landlord  will  often  adopt  every 
Legal  expedient  and  make  use  of  every  delaj  ami  excuse  to  put  oil  abat- 
ing a  nuisance,  when  he  would  attend  to  ii  prompt!}  if  bis  attention 
was  called  to  it  by  loss  of  rent,  because  of  a  vacanl  house. 

i  Fitchburg,  Rules  and  Regulations  of  Board  ••!"  Health  |  L807     p.  10   - 
2  llolvoke.  Rules  and  Regulations  of  Board  of  Health  (1897),  -■ 


140  NUISANCER 

When  a  dwelling  has  been  vacated  the  best  way  to  insure  that  it 
shall  not  again  be  occupied  is  to  tear  it  down.  Moreover,  by  this  pro- 
cedure, whatever  nuisance  exists  will  surely  be  abated.  When  an 
order  to  vacate  premises  is  issued  because  of  some  defect  which  though 
serious  in  itself  may  be  easily  remedied,  it  would  of  course  be  unreason- 
able to  destroy  for  such  a  cause,  what  is  otherwise  valuable  property  ; 
and  indeed  in  such  cases,  whatever  the  defect  may  be,  it  is  usually 
promptly  remedied  by  the  owner;  but  when  the  dwelling  is  so  out  of 
repair  and  filthy  as  not  to  be  worth  the  necessary  improvements  required 
to  make  it  a  habitable  structure,  the  best  course  is  to  demolish  it.  This 
is  not  infrequently  done  under  general  nuisance  laws.  '  Sometimes 
special  provision  is  made  by  statute  for  the  destruction  of  such  unwhole- 
some dwellings.     Thus  in  Memphis1  the  government  of  the  city 

"  Shall  have  power,  and  it  shall  be  their  duty  to  condemn  as  nuisances  all  build- 
ings, cisterns,  wells,  privies,  and  other  erections  in  the  Taxing  District  which,  on 
inspection,  shall  be  found  to  be  unhealthy,  and  to  cause  the  same  to  be  abated, 
unless  the  owners  thereof,  at  their  own  expense,  upon  notice,  shall  reconstruct  the 
same  in  such  manner  as  shall  be  prescribed  by  the  laws  of  the  Taxing  District." 

Under  this  provision  many  buildings  are  condemned  and  destroyed 
each  year.  In  New  York  City  a  few  years  ago  by  a  special  act2  author- 
ity Mas  given  to  condemn  and  destroy  unwholesome  tenement  houses. 
This  law  has  now  been  incorporated  in  the  charter  of  greater  New  York 
as  Sections  1315-16.  It  provides  that  the  board  of  health  may  con- 
demn and  order  the  removal  of  any  building  which  from  age,  defects, 
structure  or  position,  is  a  danger  to  its  inhabitants  or  the  inhabitants 
of  adjacent  buildings  and  the  defects  of  which  cannot  be  remedied  ; 
but  the  owners  may  institute  proceedings  in  the  supreme  court  for  the 
condemnation  of  the  building.  The  court,  if  it  is  proved  that  destruc- 
tion is  necessary,  appoints  a  commission  to  determine  the  damages. 
If  the  building  "is  unfit  and  not  reasonably  capable  of  being  made  fit 
for  human  habitation  "  the  compensation  shall  be  the  value  of  the 
material  in  the  building.  Under  this  law  during  the  year  1896,  eighty- 
four  houses  were  vacated  for  the  purposes  of  condemnation.3  Some  of 
these  cases  were  brought  into  court  and  the  action  of  the  board  of 
health  was  upheld  by  the  lower  courts,  but  the  only  case  which  ever 
went  to  the  appellate  division  was  dismissed  on  technical  grounds.  A 
similar  law  has  been  enacted  for  Boston.4  Under  this  law  any  building 
may  there  be  vacated 

1  Memphis,  Ordinances  (1879).  Sec.  102. 
-New  York,  Act  of  9  May,  1895. 

3  New  York,  Board  of  Health  Report,  1896,  pp.  37-41.  This  report  contains  a 
description  of  some  of  these  premises. 

4  Massachusetts,  Chapter  219  of  1897,  and  222  of  1899. 


NUISANCES.  141 

"  Because  of  age,  infection  with  contagious  disease,  defects  in  drainage,  plumb- 
ing or  ventilation,  or  because  of  the  existence  of  a  nuisance  on  the  premises  which  is 
likely  to  cause  sickness  among  its  occupants,  or  among  the  occupants  of  other  prop- 
erty in  said  city,  or  because  it  makes  other  buildings  in  said  vicinity  unlit  for  human 
habitation  or  dangerous  or  injurious  to  health,  or  because  it  prevents  proper  meas- 
ures from  being  carried  into  effect  for  remedying  any  nuisance  injurious  to  health, 
or  other  sanitary  evils  in  respecl  of  such  other  buildings,  so  unlit  for  human  habita- 
tion that  the  evils  in  or  caused  by  said  building  cannot  he  remedied  by  repairs  or 
in  any  other  way  except  by  the  destruction  of  said  building  or  of  any  portion  of  the 
same.11 

It  may  then  be  destroyed  and  tin-  damages  sustained  by  tin' owner  shall 
In-  paid  by  the  city.  The  damages  arc  to  be  determined  by  agreement 
between  the  owner  and  the  board  of  health,  and  arc  to  lie  assessed  by 
jury,  as  are  highway  damages.  In  Boston  in  1899  ninety-two  buildings 
were  condemned. 

Statutes  Consi  lted  in  the  Pbepabation  of  this  Chapter. 

A  i  \isama.     Code  (1896),  Sees.  L'4ns.  2429. 
Abizona.     Definition,  Penal  (ode  (1887),  Sees.  600-  -V 
A.BK  w-  \-.     Powers  of  Cities.  Statutes  (1894),  Sec.  5131. 
California.     Definition,  Penal  Code  (1886),  Sees.  ::~0-4. 
COLOBADO.     Act  of  IT  April,  189§,  Sees.  6,  ln-14. 
Connecticut.     General  Statutes  (1888),  Sec.  2592. 

Deposit  of  filth,  Chapter  237  of   1889. 
DEiiAWABE.     Revised  (ode  (1893),  p.  298,  (Paws  of  Delaware,  Vol.  16,  Chapter  345, 

Sees.  3-8.) 
Fi.okii.  \.     Revised  Statutes  (1892),  Sec.  77:;. 

An  of   1  June.   1895. 
GrEOBGi  \.     <  !hapter  1  13  of  1895. 

Definition,  Code  (1882),  Sees.  2997,   1094  4100. 
Illinois.     Powers  of  Cities,  Annotated  Statutes  (1896),  Chapter  24,  Sec.  63. 

Definition,  Annotated  statutes  (lX'.Mi).  Chapter  38,  Sec.  369. 
Im.i  \\  \.      Let  oi  28  April,  1899,  S< 

Definition,  Statutes  .  1894),  Sec.  2154. 

Powers  of  cities.  Statutes  1 1894),  Sees.  3541,  3794. 
Idaho.     Definition,  Statutes  (1887),  Sees.  3620  25. 

[OWA.      Annotated  Code  (1897),  Sees.  2568   9. 

Definition,  Annotated  Code  (1897),  Sec.  5078. 

Powers  of  Cities,  Annotated  Code  (1897),  Sees.  696  9,  1032. 
K  \  \s  \s.     Powers  of  Cities,  4  reneral  Statutes  (1897),  Chapter  32,  Sec.  v>.  ,/,,-,    //,. 
Ki ah  i  ky.     Statutes  (1894),  Sees.  2055,  2057  9. 
Lot  isi  \\a.     Chapter  182  oi  L898,  Sec.  7. 
Maine.     Supplement  Laws  (1895),  Chapter  17. 

If  a  by  i  \\t>.     Public  General  Laws  (1888),   Lrt.  13   Sec.  5;  Chapter  622  of  185)0. 
Massachusetts      Public  Statutes  (1882),  Chapb  s.  18  27. 

Michigan.     Compiled  Laws  (1897),  Sees.  1412,  1117  •_':;. 

Powers  of   Municipalities,  Compiled  Laws  (1891  1125. 

Minnesota.     Statutes  (1894),  Sees.  7050  3. 

Powers  -I  I  ities,  Statutes  1 1894),  Sees.  970  6,  1224,  tia  nty-thlnl,  i  ! 
Definition,  statutes  (1894),  Se<  ,  6618  et  seq. 
Mississippi.     Code  1 1892),  Sec.  --"-'77. 
Powers  of  I  ities,  <  ode  |  L892),  Sec.  29 


142  NUISANCES. 

Missouri.     Revised  Statutes  (1899),  Sees.  Cit.">l-74. 

Definitions.  Revised  Statutes  (1899),  Sees.  22:!4-<t. 

Powers  of  Cities.  Revised  Statutes  (1899),  Sees.  5281,  5393,  5455,  5707,  5838,  5842, 
5961,  6010,  6164. 
Montana.     Definition,  Penal  Code  (180")'.  Sec.  672  <t  seq. 
Nebraska.     Definition,  Compiled  Statutes  (1899),  Sec.  6890  et  seq. 

rivers  <>f  Cities.  Compiled  Statutes  (1899),  Sees.  704,  1031.  1032,  1226. 
New  Hampshire.     Public  Statutes  (1891),  Chapters  108-9. 
New  Jersey.     General  Statutes  (1895),  p.  1644,  Sees.  G1-G6. 
New  Mexico.      Powers  of  Cities,  Compiled  Laws  (1897),  See.  2402  (45). 
New  Yokk.     Revised  statutes  (1896),.p.  2418,  Public  Health  Law.  Sees.  25-27. 
North  Carolina.     Act  of  1  March.  1893,  See.  22. 

Definition.  Code  (1883),  Sees.  1297-1324. 
North  Dakota.     Code  (1895),  Sees.  259-60. 
Ohio.     Annotated  Statutes  (1900),  Sees.  2116,  2122,  2128. 

Definitions,  Annotated  Statutes  (1900),  Sees.  6919-27. 

Powers  of  Cities,  Annotated  Statutes  (1900),  Sees.  1692,  1878,  1934. 
Pennsylvania.     Powers  of  Cities.  Brightly's  Purdon's  Digest  (1894),  p.  1432,  Sees. 

123-R54;  p.  1558,  See.  134;  p.  240,  Sees.  88-90. 
Rhode  [sland.  General  Laws  (1896),  Chapter  91. 
South  Carolina.     Revised  statutes  (1893),  See.  962. 

Act  of  •">  January.  1895,  See.  4. 
Tennessee.     Powers  of  Cities,  Code  (1896),  Sees.  1915(2),  1924. 

Definition,  Code  (1896),  Sees.  6750-6. 
Texas.      Powers  of  Cities.  Revised  Statutes  (1895),  Sees.  447.  542. 
UTAH.       Revised  Statutes  (1898),  See.   11117. 

Chapter  45  of  1899. 
Virginia.     Code  (1887),  Sees.  L728. 

A  el  of  7  Ma  re]  i.  1900,  Sec.  •">. 
Vermont,     statutes  (1894),  Sees.  4678-80. 
Washington.     Codes  and  Statutes  (1897),  Sec.  3000. 

Powers  of  Cities.  Codes  ami  Statutes  (1897),  Sees.  739,  855,  942,  1015. 
West  Virginia.     Code  (1899),  Chapter  150,  Sec.  20eI-III;  Chapter  179,  Sees.  10-12. 
Wisconsin,    statutes  (1898),  Sec.  1414. 

Powers  of  Cities,  statutes  (1898),  Sees.  892,  925-52(6),  (36),  (37). 
Wyoming.     Chapter  76  of  1899. 

Atlanta.     Chapter  109  of  1874,  Sees.  «',7-71. 

Boston.     Demolishing  buildings,  Massachusetts,  Chapter  219  of  1897,  and  222  of 

181 )'.  I. 

Buffalo.     Chapter  105  of  1891,  Sec.  237. 

Bridgeport.     Act  of  22  March,  1877,  See.  24. 

Detroit.     Chapter  10  of  1895,  Sees.  17-19. 

Hartford.     <  >rdinance  of  27  June.  1885,  Sees.  5-6,  '•  validated  "  by  Act  of  :',  March, 

1886. 
Memphis.     Chapter  11  of  1879,  Sec.  3. 

Milwaukee.     Chapter  184of  1874,  Sub-Chapter  13,  Sees.  4-5, and  Chapter  36  of  1878. 
Minneapolis.     Chapter  413  of  1889,  Sees.  9-10. 
New  Haven.     Chapter  418  of  1897,  sec.  97. 
New  Yoke  City.     Chapter  378  of  1897,  Sees.  1229,  1287-1294. 

Demolishing  buildings,  Act  of  !•  May.  ISO."). 
Providence.     Rhode  Island,  Chapter  598  of  ism;.  Sec.  9,  clause  1. 
St.  Louis.      Revised  Statutes  (1899),  Sees.  '.»465-6. 
San   Francisco.     Political  Code  (1886),  Sees.  2038,  3028. 
Wilmington.     Delaware  Laws.  Vol.  20,  Chapter  550,  p.  664. 


CHAPTER  IV. 

SPECIFIC  NUISANCES. 

IN  the  first  chapter  it  was  shown  that  most  local  governments  have 
been  given  very  great  legislative  power  in  regard  to  sanitary  affairs. 
Sometimes,  as  in  the  Massachusetts  law  and  those  which  follow  it,  rules 
may  be  made  "respecting  nuisariees"  or  for  the  ••  prevention  of  nui- 
sances." In  other  cases  rules  forbidding  nuisances  may  be  made  by 
virtue  of  the  power  to  legislate  "for  the  promotion  of  health."  Some- 
times it  is  the  board  of  health  or  health  officer  who  has  this  power,  bul 
more  often  it  is  the  proper  legislative  branch  of  the  local  government. 
But,  however  they  may  be  made,  almosl  every  city,  and  innumerable 
towns,  villages,  and  townships  have  their  sanitary  codes,  ordinances, 
regulations,  or  rules.  A  considerable  portion  of  these  regulations  arc 
taken  up  with  the  consideration. of  nuisances.  This  is  particularly  true 
of  the  large  cities  where  the  complexities  of  urban  Life  make  it  much 
more  likely  that  a  man  will  give  offence  to  his  neighbor  than  in  rural 
districts. 

While  very  man}  communities,  particularly  the  smaller  cities  ami 
towns,  abate  nuisances  under  state  laws  enacted  for  that  purpose,  as 
described  in  the  last  chapter,  many  others  proceed  in  a  different  way. 
Instead  of  issuing  an  order  for  removal  and  then  proceeding  to  fine  the 
offender  or  abate  the  nuisance  if  the  order  is  not  obeyed,  it  is  customarj 
when  a  nuisance  is  found  to  prosecute  the  offender  for  the  violation  of 
ft  municipal  ordinance,  though  usually  a  preliminary  notice  is  sent.  In 
one  case  the  offender  is  lined  for  failure  to  obey  a  definite  order,  in  the 
latter  for  disobeying  an  established  ordinance.  Anion g  important  cities 
which  follow  the  latter  method  are  Baltimore,  Chicago,  Denver,  .Min- 
neapolis. Newark.  New   York,  and  St.  Louis. 

In  pursuance  of  the  powers  granted,  verj  man}  boards  of  health 
exercise  their  legislative  functions  in  defining  what  shall  be  considered 
nuisances  and  forbidding  the  same  and  affixing  penalties  for  the  viola- 
tion of  their  rules.  Sometimes  the  rules  thus  adopted  are  ven  general 
in  their  term-  nol  specifying  at  all  in  detail  the  acts  which  are  forbid- 
den, bul  more  Minn  such  general  provisions  are  found  in  the  statute 
shown  on  page  123.  Another  example  of  a  ver}  general  statutor}  pro- 
vision forbidding  nuisances  is  found  in  the  charter  of  the'  n 


144  SPEl  IFK '    XI  rls.  I  m ' ES. 

York  1  and  is  shown  below.  Such  general  prohibitions  are  usually  not 
relied  on,  and  specific  declarations  of  nuisances  and  the  prohibition  of 
particular  acts  are  found  by  most  sanitary  authorities  to  be  useful,  and 
it  is  the  purpose  of  the  following  pages  to  consider  some  of  these. 

Filth. 

As  by  far  the  larger  number  of  nuisances  have  to  deal  with  filth  in 
one  form  or  another,  rules  relative  to  accumulations  of  filth  of  various 
kinds  and  their  removal,  are  found  in  all  local  sanitary  legislation.  The 
following  are  examples  of  some  of  these  rules : 

"  Sec.  2.  .  Any  person  or  owners,  agent,  lessees  or  occupants  of  any  building,  yard 
or  lot  of  ground,  who  shall  allow  to  accumulate  orremain  in  oron  said  building,  yard 
or  lut  of  ground,  any  putrid  and  unsound  meat,  pork,  fish,  bides,  decayed  vegetables 
or  food,  manure,  filthy  asb  heaps,  garbage,  offal,  rubbish,  dirt  or  filth  of  any  kind, 
which,  by  its  decay  or  putrefaction,  could  or  would  become  offensive  to  human 
beings,  or  detrimental  to  health,  or  shall  create  a  nuisance,  shall  be  deemed  guilty 
of  a  misdemeanor,  and  upon  conviction  shall  be  fined  not  less  than  ten  nor  more 
than  one  hundred  dollars,  to  be  recovered  for  the  use  of  the  City  of  St.  Louis,  before 
any  court  having  competent  jurisdiction. 

11  Sec.  6.  The  words  filthy  ash  heaps,  whenever  used  in  this  ordinance,  shall  be 
held  to  include  cinders,  coal  and  everything  that  usually  remains  after  fires  that  has 
been  mixed  with  garbage  or  filth  of  any  kind ;  the  word  rubbish  shall  be  held  to 
include  all  loose  and  decayed  material  and  dirt-like  substances  that  attends  use  or 
decay,  or  which  accumulates  from  building,  storing  or  cleaning;  the  word  garbage 
shall  be  held  to  include  every  accumulation  of  both  animal  and  vegetable  matter, 
liquid  or  otherwise,  that  is  received  from  kitchens,  and  also  all  putrid  and  unsound 
meat,  beef,  pork,  fish,  decayed  or  unsound  vegetables  or  fruits;  the  word  tenement 
house  shall  be  taken  to  mean  and  include  every  house,  building,  or  portion  thereof. 
which  is  rented,  leased  or  hired  out  to  be  occupied  as  the  home  or  residence  of  more 
than  two  families  living  independent  of  one  another. 

"  Sec.  T.  Whenever  any  owner  or  agent  of  any  building  in  the  City  of  St.  Louis 
shall  rent,  lease  or  hire  out  to  be  occupied,  any  building,  or  parts  thereof,  as  a  home 
or  residence  of  more  than  two  families  living  independent  of  one  another  or  a  build- 
ing to  different  persons  for  stores  and  offices  in  said  building,  giving  to  each  family 
or  person  the  common  right  to  halls,  yards,  water  closets  or  privies,  or  some  of  them, 
then  such  owner  or  agent  shall  be  liable  for  the  condition  of  said  halls,  yards,  water 
closets  or  privies,  and  said  owner  or  agent  may  also  be  made  a  defendant  in  a  prose- 
cution for  the  violation  of  the  provisions  of  this  ordinance,  and  be  subject  to  fine, 


1  New  York,  Chapter  378  of  1897,  Sec.  1201: 

"  It  is  hereby  delared  to  be  the  duty  of  every  owner  and  part  owner  and  person 
interested,  and  of  every  lessee,  tenant,  and  occupant  of,  or  in  any  place,  water, 
ground,  room,  stall,  apartment,  building,  erection,  vessel,  vehicles  matter  and  thing 
in  said  city,  and  of  every  person  conducting  or  interested  in  business  therein,  or 
thereat,  and  of  every  person  who  has  undertaken  to  clean  any  place,  ground  or 
street  therein,  and  of  every  person,  public  officer,  and  department  having  charge  of 
any  ground,  place,  building,  or  erection  therein,  to  keep,  place  and  preserve  the 
same  and  every  part,  and  the  sewerage,  drainage  and  ventilation  thereof  in  such  con- 
dition, and  to  conduct  the  same  in  such  manner,  that  it  shall  not  be  a  nuisance,  or 
be  dangerous  or  prejudicial  to  life  or  health." 


s i>e<  jFI(    jsnris.  i m  ws.  14.3 

the  same  as  the  occupant  of  the  premises,  and  any  prosecution  for  violation  of  this 
ordinance  may  be  maintained  against  the  occupants,  owner  and  agent  of  the  premises, 
or  either  or  all  of  said  parties."'  l 

In  other  instances  the  rule  takes  the  form  of  a  direction  to  keep  the 
premises  clean  and  in  order : 

Sec.  508.  >~o  person  shall  suffer  or  permit  any  cellar,  vault,  privy  drain,  pool, 
sink,  privy,  sewer,  or  other  place  upon  any  premises  or  grounds  belonging  to  or 
occupied  by  him  or  them,  to  become  offensive  or  injurious  to  public  health. 

"Sec.  510.     No  owner  or  occupant  or  other  person  having  control  or  charge  of 
any  lot,  tenement,  premises,  building  or  other  place  shall  cause  or  permit  any  nui- 
sance to  be  or  remain  in  or  upon  such  lot,  tenement,  building,  or  other  pla< 
between  the  same  and  the  centre  of  the  street,  lane  or  alley  adjoining."  - 

Filth  in  Streets. 

While  filth  upon  a  private  property  may  be  a  nuisance,  on  a  street 
or  public  place  it  is  certain  to  be  so.  When  a  nuisance  of  this  kind 
exists  on  private  property,  ample  provision  is  made  in  most  states  for 
its  abatement  and  usually  this  can  be  accomplished  before  much  harm 
is  done.  When,  however,  filth  is  thrown  or  left  upon  the  street,  thou- 
sands of  persons  may  be  affected  before  it  can  be  removed  ;  and  as  it  is 
usually  difficult  to  find  the  person  who  deposited  the  tilth  and  compel 
him  to  remove  it, the  cost  of  removal  must  be  borne  by  the  city.  Hence 
in  all  cities  effort  is  made  to  have  clean  streets,  not  only  by  a  systematic 
cleaning  by  the  municipality,  but  also  by  attempting  to  prevent  by 
ordinance  the  deposit  of  dirt  of  any  kind  in  the  street.  Some  of  these 
rules  are  here  given  : 

"Sec.  1381.  That  no  swill,  brine,  urine  of  animals,  or  other  offensive  animal 
Bubstance,  nor  any  stinking,  noxious  liquid  or  other  filthy  matter  of  any  kind,  shall 
by  any  person  be  allowed  to  run  or  fall  from  out  of  any  building,  vehicle  or  erection 
into  or  upon  any  street  or  public  place,  or  be  taken  or  put  therein,  save  as  herein 

elsewhere   provided. 

•■  Si .<  .  1382.  That  no  butcher's  offal  or  garbage,  nor  any  animals  nor  any  putrid 
or  stinking  animal  or  vegetable  matter  shall  be  thrown  by  any  person,  or  allowed  to 

<;o  into  any  street,  place,  sewer  or  receiving  basin,  or  into  any  riser,  canal,  slip  or 
standing  or  running  water,  or  excavation,  or  upon  any  ground  or  premises  in  tin- 
said  city." 

While  in  some  cities,  as  Philadelphia,  Baltimore,  and  others  in  the 
south,  the  gutters  are  used  as  sewers  for  the  conveyance  of  waste  water 
other  than  that  from  water-closets,  this  practice  is  not  generally  con- 
sidered advisable  and  is  being  gradually  discontinued  in  the  cities  men- 
tioned. This  discharge  of  waste  water  into  the  -utters  is  therefore 
generally  forbidden  : 


1  St.  Louis,  ■  Ordinance  of  18  January,  1891   Si  i  i.  2,  6,  and  7. 
•Cleveland,  <  ►rdinances  |  L892),  Chaptei  508  BIO. 

"Chicago,  Ordinances  (1881),  Sees.  1881 

in 


146  SPECIFIC    NUISANCES. 

1  No  person  shall  use  the  streets  or  sidewalks  of  the  city,  nor  the  gutters  between, 
as  a  drainage  to  carry  off  any  water  that  has  been  used,  or  other  fluids,  or  soap-suds 
or  dye-stuffs,  or  liquid  manures,  or  any  other  liquids,  whether  from  privies  or  other- 
wise. Any  person  discharging,  or  allowing  to  be  discharged,  any  such  fluids,  shall, 
on  conviction  of  the  fact,  be  fined  in  a  sum  not  exceeding  twenty-five  dollars  and 
costs,  or  condemned  to  work  in  the  chain-gang  not  to  exceed  thirty  days,  either  or 
both,  in  the  discretion  of  the  court.1' 1 

Other  causes  of  filthy  streets  are  forbidden ;  thus  in  Boston  "  No 

person  shall  wash  or  otherwise  clean  any  animal  or  vehicle,  or  shake  or 

otherwise  clean  a  mat  or  carpet  in  an}"  street,"  2  and  similar  rules  are 

found  in  other  Massachusetts  cities.     The  washing  of  vehicles  is  also 

forbidden   in  other  cities   by  the  regulations  relating  to  'stables.     The 

following  forbids  the  deposit  of  rubbish  in  streets : 

"Sec.  1387.  That  no  lime,  ashes,  coal,  dry  sand,  hair,  feathers  or  other  sub- 
stance that  is  in  a  similar  manner  liable  to  be  blown  by  the  wind,  shall  be  sieved,  or 
agitated  or  exposed;  nor  shall  any  mat,  carpet  or  cloth  be  shaken  or  beaten,  nor  any 
cloth,  yarn,  garment  or  material  or  substance  be  scoured,  cleaned  or  hung,  nor  any 
business  be  conducted  over  or  in  any  street  or  public  place,  or  where  it  or  particles 
therefrom  or  set  in  motion  thereby  will  pass  into  any  such  street  or  public  place,  or 
into  any  occupied  premises;  that  neither  any  usual  nor  any  reasonable  precaution 
shall  be  omitted  by  any  person  to  prevent  fragments  or  other  substances  from  falling 
to  the  peril  of  life,  or  dust  and  light  material  flying  into  any  street,  place  or  build- 
ing, from  any  building  or  erection  while  the  same  is  being  altered,  repaired  or 
demolished  or  otherwise.1'3 

"No  person  shall  carry  or  convey  in  any  vehicle  any  earth,  sand,  gravel,  dirt, 
ashes,  or  any  loose  fluid  or  offensive  articles  or  matter,  or  any  articles  whatsoever, 
so  that  the  same  shall  or  may  be  scattered,  dropped,  let  fall,  blown,  or  spilled  there- 
from, and  all  vehicles  conveying  foul,  dusty  or  offensive  matter  of  any  sort  shall 
have  tight  bodies  and  be  closely  and  securely  covered."  * 

The  cleaning  of  fish  in  the  street  is  commonly  forbidden,  and  also 
the  dropping  of  any  refuse  from  the  wagons  of  venders  of  any  kind  of 
produce  and  meats  : 

"  No  person  shall  clean,  scale,  or  wash  any  fish,  meat,  clothes,  carriage,  buggy, 
or  any  other  thing  tending  to  create  a  nuisance,  on  any  of  the  streets,  lanes,  alleys, 
public  grounds,  or  markets  of  the  city.11  5 

One  prolific  source  of  nuisance  in  streets  is  the  obstruction  of  gut- 
ters by  which  filthy  water  accumulates  after  every  rain,  and  in  warm 
weather  often  becomes  very  offensive.  Hence  special  rules  forbidding- 
such  obstruction  : 

"  That  no  person  shall  deposit  on  any  street,  alley,  private  or  public  place  in  the 
limits  of  the  city,  or  upon  any  paved  street  now  or  hereafter  constructed,  any  dirt, 


1  Atlanta,  Sanitary  Rules  and  Regulations,  Sec.  83. 

2  Boston,  Ordinances  (1890),  Chapter  49,  Sec.  35. 

3  Chicago,  Ordinances  (1881),  Sec.  1387. 

4  District  of  Columbia,  Police  Regulations,  Chapter  8,  Sec.  10 

5  Cleveland,  Ordinances  (1892),  Chapter  30,  Sec.  514. 


SPJEi  IFK  '    XI  Is.  [  \'<  Ks.  y\~ 

brick  or  other  material,  in  such  manner  as  to  obstruct  the  free  water  flow  of  water 
along  any  ditch  or  gutter."  l 

In  case  gutters  should  become  obstructed,  provision  is  made  in  some 
cities,  as  Baltimore.  Camden,  and  Jersey  City,  for  the  abutters  to  keep 
the  gutters  in  front  of  their  estates  free  from  obstructions  : 

••  No  person  shall  throw,  place  or  deposit,  <>r  allow  to  collect  on  or  run  over  any 
sidewalk,  street,  road  or  alley,  any  slops,  dirty  water  or  filth  of  any  kind;  and  every 
person  shall  keep  the  gutter  in  front  of  his  or  her  premises,  occupied  as  store, 
factory,  dwelling  or  other  building,  free  from  filth,  dirt  or  other  obstructions;  and 
every  person  offending  against  the  provisions  of  this  section  shall  forfeit  and  pay  a 
penalty  of  ten  dollars.'"2 

In  other  cities,  as  Baltimore,  Cleveland,  Memphis,  Newark,  Rochester, 

St.  Louis,  and  Wilmington,  Del.,  this  provision  for  cleaning  by  abutters 
extends  to  the  sidewalks  and  sometimes  includes  a  portion  id'  the 
street  : 

li  The  owners  or  agents  or  occupiers  of  tenements  and  vacant  lots  owned  by  them. 
under  their  charge  or  occupied  by  them,  shall  keep  the  sidewalks  and  gutters  in 
front  of  and  adjoining  their  property  clean,  and  also  all  the  private  alleys  in  the  rear 
of  or  adjoining  the  property  owned  by  them  clean  to  the  center  of  such  alley,  and 
after  any  fall  of  snow  to  be  immediately  removed  from  the  sidewalk  fronting  their 

res] tive   lots   into  the  carriage  way  of  the  street.      Any  person  failing   to  comply 

with  the  requirements  of  this  section  shall  be  deemed  guilty  of  a  misdemeanor,  and 
upon    conviction    thereof   shall    be    lined    not    less   than    five    nor    more   than    twenty 

dollars.'1 

In  Memphis  and  the  District  of  Columbia  the  gutters  must  be 
cleaned  daily  between  the  lirst  of  May  and  the  first  of  December.  In 
New  York  the  abutters  are  onlj  required  to  keep  tin-  sidewalks  clean. 
On  the  other  hand  in  Memphis  the  abutter  is  required  to  clean  lour  feel 
into  the  si  reel  in  all  cases. 

The  condition  of  private  alleys  is  in  inan\  if  not  most  cities  a  con- 
stant annoyance  to  the  board  of  health.  .Most  cities  clean  all  their 
public  highways  at  public  expense  either  h\  their  own  employees  or  by 
contract;  but  the  municipality  cannol  thus  directly  cleanse  private 
ways  without  becoming  permanent!}  responsible  for  their  condition. 
Moreover,  the  City  in  many  eases  does  nol  care  to  expend  its  inoiie\  iii 
the  cleaning  up  of  what  is  really  private  property.  The  plat  owners, 
not  the  abutters,  are  the  real  owners,  and  hence  ii  is   clai d    \>\    some 

that    the   eit\     CannOl    compel    the    ;  1 1  » 1 1 1  1 1  *  IS    to   eleall     the     alle\.         But,    S8    IS 

shown    above,   the  ordinances  of    Memphis  and   St.   I is  require  the 

partial  cleansing  of  alleys,  and  in  Boston  ami  Haverhill  (he  cleansing  is 
required  \>\  the  follow  ing  : 

i  Denver.  Ordinance  1 1  of  L893,  Sec.  78. 
I  amden,  Sanitarj  <  ode  I '  21. 

Louis,  Ordinances  (1893),  Chapter  i  I.  Sec.  374. 


148  SPECIFIC    NUISANCES.   ' 

"No  owner  or  occupant  of  land  abutting  on  a  private  passageway  and  having  the 
right  to  use  such  passageway  shall  suffer  any  filth,  or  waste,  or  stagnant  water  to 
remain  on  that  part  of  the  passageway  adjoining  such  land."  1 

In  Baltimore  if  the  abutter  does  not  keep  the  alley  clean  or  if  he 
does  not  clean  it  when  ordered  the  city  cleans  it  and  charges  the  cost  to 
the  estate.  This  is  done  under  the  ordinances  and  has  been  sustained 
by  the  courts.  Private  alleys  are  treated  in  a  similar  way  in  the  Dis- 
trict of  Columbia.  Alleys  can  be  and  are  kept  cleaner  if  they  are  paved 
and  several  cities  provide  for  the  paving  of  private  alleys.  In  Wil- 
mington, Delaware,  it  is  done  under  the  following  ordinance  which  is 
sustained  by  the  courts,  at  least  the  municipal  court : 

"  The  board  of  health  shall  have  power  to  order  the  paving  of  any  alley,  court, 
yard  or  street,  not  owned  by  the  city;  provided,  that  two  members  of  the  board 
shall  declare  such  a  course  necessary  for  the  preservation  of  the  health  of  the 
neighborhood;  and  if  the  order  of  the  said  board  be  not  executed  within  the  re- 
quired time,  said  board  shall  have  authority  to  have  the  paving  done,  and  to  collect 
the  expenses  thereof  pro  rata,  from  the  parties  owning  or  using  such  alley,  court, 
yard  or  street.1'2 

In  Reading  whenever  a  private  alley  is  offensive  and  a  nuisance,  and 

needs  paving,  the  following  order  is  issued  under  the  authority  granted 

by  Chapter  257,  of  1874,  Sec.  49,  which  gives  cities  of  the  third  class 

authority  to  abate  nuisances  : 

"  Resolved,    That  the  ten-feet-wide  alley  running 

and  between 

streets,  is  hereby  declared  a  nuisance, 

and  the  health  commissioner  is  instructed  to  notify  the  owners  of  property  abutting 

thereon,  to  abate  said  nuisance  within days  from  date,  on  failure 

of  which  he  is  instructed  and  hereby  authorized  to  have  the  said  alley  cleaned  and 
paved,  and  to  proceed  to  recover  the  costs  thereof  from  the  owners  of  property 
abutting  thereon.1'' 

This  is  served  on  the  abutters.  If  they  do  not  pave  the  alley  the 
city  does,  and  bills  are  sent  to  the  abutters  for  the  cost.  These  are 
generally  paid,  but  if  not  are  sued  for,  and  the  courts  have  always  sus- 
tained the  position  taken  by  the  city.  A  number  of  alleys  are  treated 
in  this  way  every  year,  the  number  in  1899  being  twelve.  Previous  to 
1898  the  board  of  health  of  Boston  had  authority3  to  order  private 
alleys  paved  and  drained  at  the  expense  of  the  abutters.  But  in  18984 
the  authority  to  lay  out  and  construct  alleys  as  highways  was  conferred 
upon  the  board  of  street  commissioners.  Under  this  law  the  assess- 
ments are  to  be  made  as  for  highways,  but  the  city  is  not  to  be  liable 
for  defects  or  for  cleaning  off  the  snow. 

1  Boston,  Ordinances  (1890),  Chapter  49,  Sec.  25. 
-  Wilmington,  Health  Ordinance,  Sec.  9. 

3  Massachusetts,  Chapter  323  of  1891. 

4  Massachusetts,  Chapter  298  of  1898. 


spE<  IFir    XV is.  \  N(  Es.  n  4  g 

In  some  streets  the  gutters  are  flushed   with  water  to  eleanse  them, 

and  even  the  streets  themselves  are  occasionally  washed,  and   Chicago, 

Xew   York,  Buffalo,  and   Memphis  require  that  the  excess  of  dirt  l>e 

removed  before  the  water  is  applied  : 

'•That  every  person,  when  cleaning  any  street,  shall  clean,  and  every~contractor 
shall  cause  to  he  cleaned,  the  gutters  and  parts  of  the  street  along  which  the  water 
will  run.  before  using  any  water  to  wash  the  same;  and  no  substance  that  could  be 
before  scraped  away  shall  be  washed  or  allowed  to  be  carried  or  be  put  into  the 
sewer,  or  into  any  receptacle  therewith  connected.1 

Drainage. 

Defects  in  plumbing  and  drainage  are  frequently  sources  of  nui- 
sance and  sometimes  also  are  causes  of  disease.  In  order  to  auard 
against  such  mishaps  it  is  first  of  all  desirable  that  all  work  of  this  kind 
should  be  done  in  the  best  possible  way,  and  at  the  present  time  mosl 
cities  and  many  small  towns  require  a  rigid  inspection  of  all  new  work  ; 
but  the  plumbing  rules,  as  they  are  called,  usually  aPply  only  to  work 
constructed  after  the  date  of  enactment.  The  future  is  thus  provided 
for.  but  other  regulations,  usually  less  stringent,  are  often  made  to  pre- 
vent or  remedy  the  grosser  and  more  dangerous  defects  that  may  be 
found  in  old  work. 

The  following  are  some  of  the  requirements  found  in  various  cities  : 

Drains  Required. 

••  Nil  person  shall  disrharge  any  waste  water  or  water  from  a  sink  or  water-closet 
except  through  a  drain  into  a  sewer  or  cesspool,  or  in  accordance  with  a  permit  from 
the  board  of  health.'1 2 

Drain  .Must  be  Adequate. 

"That  it  shall  be  the  duty  of  every  person  using,  making,  ")■  having  any  drain, 
Boil-pipe,  passage  or  connection  between  anj  sewer  (or  with  either  the  North  or 
East  livers)  ami  any  ground,  building,  erection,  or  place  of  business,  and  in  like 
manner  the  duty  of  t  hi'  owner  and  tenant  of  all  grounds,  buildings,  and  erections, 
and  of   the  parties  interested  in  such    place  of  business  or  the   business   thereat,  and 

in  like  manner  the  duty  of  all  boards,  departments,  officers  ami  persons  (to  the 
extent  of  the  rigid  ami  authority  of  each),  to  cause  ami  require  thai  such  drain, 
soil-pipe,  passage,  and  connection,  shall  at  all  times  be  adequate  for  its  purpose,  ami 
shall  convey  ami  allow,  freely  ami  entirely,  to  pass  whatever  enters  or  should  enter 
the  same,  and  no  change  of  the  drainage,  sewerage,  or  the  sewer  connection  of  any 
house  or  premises,  invoh  ing  changes  in  the  drainage,  sewerage,  or  sewer  connection 
of  anj   other  house  or  premises,   unless  aotice  of  ;u    [east   thiri\   days  in  writing 

t  hereof  shall   have  I M 'en   pre\  iouslj    given  to  tins   I  »t  part  men  i  . 

Drain   Musi   QOl    beak. 

■  \o  person  shall  sutler  any  particular  drain  from  any  building  or  land,  of  which 
he  is  the  owner  or  occupant,  to  leak  or  be  out  of  repair;  nor  shall  an)  persons 


1  The  <  its  of  New  York.  Sanitary  Code  (1899),  Sec.  28. 
Boston,  Ordinances  (1890),  Ohaptej  19,  Sec.  26. 
Citj  of  NeU  >,  ,,,k.  Sanitarj  Code  I L899  .  Sec.  80. 


150  SPECIFIC    XUISANCES. 

sewage,  or  waste  or  stagnant  water,  to   remain  in  any  building,  or  upon  any  land 
of  which  he  is  the  owner  or  occupant."  x 

Drains,  Construction  of  Trap,  etc. 

"  Xo  owner,  occupant,  tenant  or  agent  shall  construct  or  cause  to  be  constructed,  or 
maintain  any  drain  or  any  portion  thereof,  to  connect  with  any  main  drain  or  common 
sewer,  except  the  same  first-mentioned  drain  if  passing  under  buildings  to  be  used 
as  habitable  places,  be  made  of  iron  pipe,  and  every  such  drain  shall  be  so  trapped 
and  secured  as  to  prevent  the  escape  therefrom  of  any  offensive  odor  and  poisonous 
matter. 

"All  sewers  or  drains  that  pass  within  fifty  feet  of  any  source  of  water  used  for 
drinking  or  culinary  purposes  shall  be  water-tight."  2 

Drains  not  to  be  Obstructed. 

"Whenever  a  water-closet,  vault,  privy,  cesspool,  or  drain  becomes  offensive  or 
obstructed,  the  same  shall  be  cleansed  and  made  free,  and  the  owner,  agent,  occu- 
pant, or  other  person  having  charge  of  the  premises  on  which  any  water-closet,  vault, 
privy,  or  drain  is  situated,  shall  remove,  cleanse,  alter,  amend,  or  repair  the  same 
within  such  time  after  notice  in  writing  to  that  effect  given  by  the  board  of  health 
as  shall  be  expressed  in  such  notice."  3 

Strainer  Required. 

"  In  all  cases  where  a  drain  shall  be  made  from  any  lot,  house,  or  other  property 
into  a  public  sewer  constructed  by  this  corporation,  there  shall  be  a  good  and  suf- 
ficient copper  or  cast-iron  strainer  inside  of  the  basement  or  cellar  wall  of  the  prop- 
erty so  drained,  to  prevent  any  vegetable  matter  or  filth  in  a  solid  state  from  pass- 
ing into  the  sewer,  and  such  cellar  or  basement  shall  at  all  times  be  subject  to  the 
inspection  of  such  person  as  may  be  authorized  by  the  mayor  or  corporation  to 
examine  the  same;  and  if  at  any  time  the  strainer  shall  be  found  worn  out  or  choked 
with  filth,  or  if  the  drain  itself  shall  be  choked  with  filth,  the  owner  or  occupier  of 
the  premises,  either  or  both  of  them,  shall  be  fined  not  less  than  five  dollars  nor 
more  than  ten  dollars  for  the  first  offense,  and  not  less  than  ten  nor  more  than 
twenty  dollars  for  the  second  or  any  subsequent  offense,  and  five  dollars  for  every 
twenty-four  hours  during  which  the  strainer  or  drain  shall  remain  out  of  repair  or 
be  choked  up,  the  said  fines  to  be  recovered  as  other  fines  of  this  corporation  are 
recovered.*"  A 

Plumbing. 

Defective  Plumbing. 

•■  Xo  foul  or  leaking  waste,  soil,  vent,  or  drain  pipe  shall  be  constructed  or 
allowed  to  remain  in  any  occupied  or  inhabited  building  in  Denver.  To  ascertain 
the  sanitary  condition  of  the  plumbing  and  draining  in  any  building  the  health  com- 
missioner may  at  any  time  cause  such  tests  to  be  applied  to  it  as  are  demanded  by 
ordinance  Xo.  23  of  the  series  of  1892. 

"  Whenever  any  plumbing  fixtures  in  any  building  are  condemned  by  the  plumb- 
ing inspector  of  the  bureau  of  health  on  account  of  their  foul,  unwholesome  or 
imperfect  condition,  they  shall  be  replaced  by  such  apparatus  as  is  demanded  by  the 
said  plumbing  ordinance  No.  23  of  the  series  of  1892. 


1  Boston,  Ordinances  (1890),  Chapter  49,  Sec.  27. 

2  Albany,  Sanitary  Ordinances  (1892),  Sees.  16-17. 

3  Cambridge,  Regulations  of  Board  of  Health  (1894),  Sec.  34. 

4  District  of  Columbia,  Webb's  Digest,  p.  358,  Sec.  5. 


spjyiFic    NUISANCES.  151 

••  When  the  plumbing  in  any  building  is  altered  or  reconstructed  by  order  of  the 
health  commissioner,  the  said  commissioner  is  authorized  bo  modify  the  require- 
ments for  the  construction  of  plumbing  as  provided  in  said  plumbing  ordinance  No. 
23.  series  of  1802;  provided,  however,  that  in  no  case  shall  plumbing  be  permitted 
to  remain  which,  after  thorough  tests  have  been  applied,  may  be  found  to  be  in 
unsanitary  condition."  * 

Traps  Required  for  Fixtures. 

■  All  sinks,  basins  and  stationary  tubs  in  every  hotel,  lodging,  tenement,  board- 
ing-house, or  other  dwelling  in  the  city  of  St.  Louis,  shall  be  provided  with  proper 
stench  traps,  directly  under  each  sink,  basin  or  stationary  tub  so  connected  with 
waste  or  soil  pipe,  and  so  constructed  as  directed  by  the  health  commissioner, 
approved  by  the  board  of  health,  and  with  the  traps  so  adjusted  as  to  prevent  the 
escape  therefrom  of  foul  odors  and  gases.'1  2 

Ventilation  of  Soil  and  Waste  Pipes. 

••  No  person  shall  have  for  use  or  use  any  water-closet,  urinal,  sink,  tub  or  other 
structure  or  appliance  for  receiving,  holding  or  carrying  away  animal  excrement,  or 
refuse  from  domestic  uses,  or  any  pipe  or  pipes  used  in  house  draining;  unless  each 
of  the  same  shall  be  freely  ventilated  by  appliances  sufficient  to  allow  the  escape  of 
all  gases,  and  to  avoid  the  compression  or  tension  of  the  air  confined  in  such  pipes 
or  drains. 

"The  owner  of  every  dwelling  house  in  said  city,  having  a  waste  or  soil  pipe 
placed  therein,  shall  cause  the  same  to  be  ventilated  by  extending  the  same  by 
means  of  a  pipe  of  the  same  size  to  a  height  of  not  less  than  two  feet  above  the 
roof  of  the  building,  or  pursuant  to  the  terms  of  a  permit  in  writing  from  the  board 
of  health."3 

Sewer  Connection  from  Hydrants. 

••All  persons  using  city  water  from  hydrants  located  upon  their  premises,  be, 
ami  they  are  hereby  required  to  connect  drains  front  the  same  with  the  public 
sewers,  where  such  sewers  are  laid  in  the  street  adjoining  their  premises;  and  they 
are  also  forbidden  to  allow  waste  water  to  run  from  their  premises  upon  the  side- 
walks or  street."  ' 

Sufficient  Water  for  Water-closets. 

"Sec.  112.     That  all  water-closets  now,  or  hereafter,  having  sewer  connections, 

shall  also  have  proper  water  connection  with  the  city  water-works,  or  from  private 
wind  in  ills  or  water- works,  where  there  is  an  ample  flow  of  water,  and  all  said  water- 
closets  shall  be  so  flushed  with  water,  of  sufficienl  flow  and  strength,  -as  will  prevent 
the  accumulation  of  offensive  matter,  ami  will  safely  and  promptly  carry  off  the 
same  into  the  sew  ere."  ' 

Obstruction  of  Water-closets,  Vaults,  etc. 

The  deposil  of  improper  substances  in  water-closets  ami  privy  vaults 
is  forbidden  in  many  cities.  The  following  is  the  ordinance  in  Cleve- 
land : 


Denver,  Ordinance  n  of  L898,  Sees.  128,  130,  132. 
Bt  Louis,  i  Ordinances    L893),  Chapter  l  I.  Sec.  106. 

^  onkers,  .sanitary  Code  1 1892),  Sees,  -'a  and   12. 
1  Fall  River.  Regulations  of  Board  of  Health  (1894),  Sec.  21. 
■  Atlanta,  sanitary  Ordinances,  Sec.  N-. 


152  SPECIFIC   NUISANCES. 

"  No  person  shall  throw  into  or  deposit  in  any  water  or  privy  closet,  vault,  sink, 
privy,  or  cesspool,  any  offal,  ashes,  garbage,  swill  or  other  substance,  except  that  of 
which  any  such  place  is  the  appropriate  receptacle,  and  the  owner,  lessee,  agent, 
tenant,  occupant,  or  other  person  having  control  of  any  building  or  premises  to 
to  which  such  water  or  privy  closet,  vault,  sink,  privy  or  cesspool  appertains,  shall 
be  considered  and  held  responsible  for  any  violation  of  this  section."  1 

In  Providence  a  card  giving  notice  of  a  similar  regulation  is  fur- 
nished by  the  health  department  without  charge.  This  card  is  7  by  14 
inches  and  reads  as  follows: 

"NOTICE   TO    TENANTS. 
Any  person  who  places  any  ashes,  sticks,  stones,  rags,  broken  crockery,  or  any- 
thing else  in  this  closet  which  may  cause  it  to  become  obstructed,  is  liable  to  a  fine 
of  $20. 

Per  order  of  the 

Si   I'ERINTENDENT   OF    HEALTH.'1 

Water-closet  Construction. 

"  No  water-closet  shall  be  allowed  to  be  placed  or  maintained  in  any  part  of  a 
building  where  there  cannot  be  a  direct  communication  between  the  room  in  which 
it  is  situated  and  the  outer  air,  and  all  such  water-closets  shall  be  required  to  be 
directly  ventilated  into  the  outer  air.  No  water-closet  shall  be  allowed  to  be  placed 
or  maintained  in  any  situation  where  its  trap  shall  be  at  a  lower  level  than  the  water 
in  the  harbor  at  mean  high  tide."  2 

Urinals. 

"  No  person  shall  mar,  misuse,  defile,  or  deface  a  public  urinal,  nor  attach  thereto 
any  hand-bill,  advertisement,  or  drawing."3 

Cellars. 

Other  matters  than  plumbing  and  drainage  which  may  affect  the 
sanitary  condition  of  dwellings  and  cause  them  to  become  nuisances  or 
unhealthful,  are  often  regulated  by  sanitary  ordinance.  The  construc- 
tion and  use  of  cellars  is  one  of  these  matters.  The  New  York  rule 
•provides 

"  That  no  owner  or  lessee  of  any  building,  or  any  part  thereof,  shall  lease  or  let, 
or  hire  out  the  same  or  any  portion  thereof,  to  be  occupied  by  any  person,  or  allow 
the  same  to  be  occupied,  as  a  place  in  which,  or  for  any  one,  to  dwell  or  lodge, 
except  when  said  buildings  or  such  parts  thereof  are  sufficiently  lighted,  ventilated, 
provided  and  accommodated,  and  are  in  all  respects  in  that  condition  of  cleanliness 
and  wholesomeness,  for  which  this  Code  or  any  law  of  this  State  provides,  or  in 
which  they  or  either  of  them  require  any  such  premises  to  be  kept.  Nor  shall  any 
such  person  rent,  let,  hire  out,  or  allow,  having  power  to  prevent  the  same  to  be 
used  as  or  for  a  place  of  sleeping  or  residence,  any  portion  or  apartment  of  any 
building,  which  apartment  or  portion  has  not  at  least  two  feet  of  its  height  and  space 
above  the  level  of  every  part  of  the  sidewalk  and  curbstone  of  any  adjacent  street, 
nor  of  which  the  floor  is  damp  by  reason  of  water  from  the  ground,  or  which  is 


1  Cleveland,  Ordinances  (1892),  Chapter  30,  Sec.  480. 

2  Bridgeport,  Ordinance  of  21  September,  1892,  Sec.  23. 

3  Boston,  Ordinances  (1890),  Chapter  49,  Sec.  11. 


SPECIFIC   NUISANCES.  L53 

impregnated  or  penetrated  by  any  offensive  gas,  smell,  or  exhalation  prejudicial  to 
health.  But  this  section  shall  not  prevent  the  leasing,  renting,  or  occupancy  of 
cellars  or  rooms  less  elevated  than  aforesaid,  and  as  a  part  of  any  building  rented  or 
let.  when  they  are  not  let  or  intended  to  be  occupied  or  used  by  any  person  as  a 
sleeping  apartment,  or  as  a  principal  or  sole  dwelling  apartment. 

"That  no  person  having  the  right  and  power  to  prevent  the  same,  shall  know- 
ingly cause  or  permit  any  person  to  sleep  or  remain  in  any  cellar,  or  in  any  bath- 
room, or  in  any  room  where  there  is  a  water-closet,  or  in  any  place  dangerous  or 
prejudicial  to  life  or  health,  by  reason  of  a  want  of  ventilation  or  drainage,  or  by 
reason  of  the  presence  of  any  poisonous,  noxious,  or  offensive  substance,  or  other- 
wise." 1 

Another  specific   provision  is  that  cellars  must    be   ventilated    and 

dry  : 

"  All  cellars  must  be  properly  ventilated  to  keep  them  dry  and  healthful;  and  no 
stagnant  water  or  tilth,  of  any  kind,  will  be  allowed  to  remain  on  any  vacant  land, 
or  under  any  building,  thereby  causing  a  nuisance." 

"  Whenever  any  cellar,  basement  or  part  thereof,  or  any  house  or  building  within 
the  limits  of  the  city  of  Omaha,  shall  be  found  to  be  damp  or  moist  by  reason  of 
leaking  or  defective  hydrants-,  water  pipes,  sewer  pipes,  cisterns  or  wells,  gutters, 
drains,  rain  spouts,  or  seepage  from  the  surrounding  earth,  or  from  a  deposit  of  any 
kind  or  nature,  or  from  any  cause  whatever,  shall  become  detrimental  to  health,  the 
same  shall  be  deemed  a  nuisance.'13 

<  )ther  provisions  relating  to  cellars  are  round  in  the  charter  of  the 
City  of  New  York,4  and  also  in  the  ordinances  of  a  number  of  other 
cities,  as  Buffalo,  Paterson,  and  Philadelphia.  In  the  latter  city  cellar 
tenements  lighted  only  by  a  door,  or  collars  without  a  board  floor,  must 
he  vacated  in  five  days. 

-Roofs  Must  be  Tight. 

■■  The  roof  of  every  house  shall  be  kept  in  good  repair  and  so  as  not  to  leak,  and 
all  rain  water  shall  be  so  drained  or  conveyed  therefrom  as  to  prevenl  iis  dripping 
on  the  ground,  or  causing  dampness  in  the  walls,  yard  or  area.'" 

Fresh  Air  Inlets. 

"In  all  dwellings  or  other  buildings  heated  by  furnaces  the  fresh  air  duct  shall 
receive  its  supplj  of  air  from  outside  the  building,  and  entrance  to  such  air  duct 

shall,  when  possible,  be  raised  above  the  surface  of  the  ground  in  such  a  way  as  to 
exclude  t  he  em  ranee  of  tilt  h." 

Q-as  a"/  to  be  <  hit  off. 

'•  From  and  after  the  passage  Of  this  ordinance,  it  shall  in  it  l>e  lawful  for  the  pro 

prietor  or  proprietors  (either  themselves  or  bj   their  employees)  of  anj  hotel  or 


1  City  of  New   York.  Sanitary  Code  (1899),  N.  s.  •_"-'   _':',. 

-  Fall  River,  I:  igulations  of  Hoard  .a'  Health  |  1894  I,  Sec.  •">". 

<  >maha.  Rules  and  Regulations  of  the  Department  of  Health  (1892     Si 
1  n.-w  York,  Chapter  878  of  1897,  Sees.  L809  10. 

■  Chicago,  Ordinances  (1881),  Sec.  1859. 

■  Denver.  Ordinance  1 1  of  L898,  Se< ,  I  18. 


154  SPECIFIC    NUISANCES. 

boarding  house  in  the  city  of  Atlanta,  where  any  kind  of  gas  is  used  in  bed-rooms 
for  lights,  to  cut  the  gas  off  at  any  time  during  the  night,  except  in  cases  where  the 
premises  may  be  on  fire."  l 

Overcrowding. 

Overcrowding  is  one  of  the  chief  causes  of  the  spread  of  communi- 
cable disease  and  the  conditions  which  are  attendant  upon  and  in- 
separably connected  with  the  huddling  together  of  human  beings  are 
conducive  to  many  other  forms  of  disease.  It  is  only  by  the  most 
careful  attention  to  every  sanitaiy  detail  that  persons  can  live  closely 
packed  together  without  suffering  great  physical  deterioration.  And 
the  immoral  effects  of  crowding  are  so  marked  and  the  tendency  in- 
duced so  degrading,  that  any  efficient  control  of  densely  packed  tene- 
ments is  almost  impossible.  Hence  it  is  felt  that  limits  must  be  placed 
upon  the  concentration  of  population  to  which  their  poverty  is  always 
impelling  the  poorer  classes.  One  means  of  checking  overcrowding  is 
by  the  vacation  of  premises  which  are  found  on  this  account  to  be  a 
menace,  not  only  to  the  health  of  the  occupants,  but  to  that  of  the  pub- 
lic as  well.  This  vacation  as  we  have  seen  has  been  provided  for  by 
statute  in  many  states.  These  statutes  are  usually  to  be  enforced  by 
local  boards  of  health.  In  some  cases,  as  in  Holyoke,  Lynn,  and  New- 
ton, the  degree  of  overcrowding  which  will  there  require  the  applica- 
tion of  the  statute  is  fixed  by  a  rule  of  the  local  board   of  health  : 

"  In  considering  the  number  of  occupants,  in  accordance  with  the  foregoing  sec- 
tion, this  board  will  consider  a  sleeping  room  to  be  overcrowded  unless  there  should 
be  at  least  four  hundred  (400)  cubic  feet  of  air  space  for  each  inhabitant  occupying 
the  same."  '-' 

In  Newton,  Mass.,  the  space  required  is  500  cubic  feet. 

As  we  have  seen,  many  cities  in  states  where  there  is  no  statute 
law  to  vacate  houses  nevertheless  incorporate  such  provisions  in  their 
local  rules,  and  sometimes,  as  in  Lynn,  the  degree  of  crowding  permis- 
sible is  specified.     The  following  is  from  Denver  : 

"In  every  lodging  house,  tenement  house,  hotel,  factory,  woi'kshop,  theatre, 
assembly  hall,  office  or  other  building  or  room  where  human  beings  sleep,  dwell, 
congregate  or  labor,  the  lighting,  ventilation  or  breathing  space  shall  be  sufficient 
for  the  preservation  of  health.  To  prevent  overcrowding,  the  occupants  or  visitors 
of  such  premises  shall  be  so  limited  in  number  that  not  less  than  700  cubic  feet  of 
air  space,  with  sufficient  means  for  its  frequent  renewal  shall  be  provided  for  each 
person."  3 

But  in  New  York  the  rules  in  regard  to  tenement  houses  provide  that 
there  shall  be  400  cubic  feet  of  air  space  for  each  adult  and  200  for 
each  child. 


1  Atlanta,  Sanitary  Ordinances,  Sec.  142. 

2  Lynn,  Regulations  of  Board  of  Health   (1894),  Rule  22. 

3  Denver,  Ordinance  44  of  1893,  Sec.  143. 


SPEC  IFK  ■    NUISu  1  m  '/:'>'.  155 

There  are  many  other  ordinances  in  regard  to  the  sanitary  condi- 
tions of  dwellings  and  other  structures,  many  of  them  of  a  very  general 
nature  and  intended  to  cover  any  and  all  dangerous  defects  which  may 
occur,  but  which  cannot  from  their  great  variety  he  all  specifically  pro- 
vided for  by  separate  enactments.  One  of  these  regulations  is  here 
given.     See  also  section  22  of  the  same  code,  shown  on  page  152: 

"  That  no  person  shall  hereafter  erect,  or  cause  to  be  erected,  or  converted  to  a 
new  purpose  by  alteration,  any  building  or  structure,  or  change  the  construction  of 
any  part  of  any  building  by  addition  or  otherwise,  so  that  it,  or  any  part  thereof, 
shall  be  inadequate  or  defective  in  respect  to  strength,  ventilation,  light,  sewerage, 
or  of  any  other  usual,  proper,  or  necessary  provision  or  precaution  for  the  security 
of  life  and  health;  and  no  person  shall  make  or  use  a  smoke  house  or  room  or  appa- 
ratus for  smoking  meat,  in  any  tenement  or  lodging-house,  without  a  permit  in 
writing  from  the  board  of  health,  and  subject  to  the  conditions  thereof;  nor  shall 
the  builder,  lessee,  tenant  or  occupant  of  any  such,  or  of  any  other  building  or 
structure,  cause  or  allow  any  matter  or  thing  to  be  or  to  be  done  in  or  about  any 
such  building  or  structure  dangerous  or  prejudicial  to  life  or  health."1 

The   sanitary  condition  of  schools,  factories  and  tenements  and  the 

laws  regarding  them  will  he  considered  in  another  connection. 

There  are  a  number  of  things  which  may  at  times  bet  nine  nuisances 
or  injurious  to  health,  but  which  are  not  usually  noticed  in  sanitary 
regulations.  In  most  extensive  sets  of  sanitary  rules  some  lew  of  these 
unimportant  or  unusual  matters  are  treated  of.  The  following  are 
examples  of  some  of  them  : 

Upturning  the  Soil. 

In  Augusta,  Ga.,  Charleston,  New  Orleans,  and  Savannah  and  by 
the  rules  of  the  Florida  state  board  of  health,  the  upturning  of  dirl  or 
soil  in  large  quantities  is  prohibited  from  the  first  id'  May  to  the  first  oi 
November  without  the  written  permission  of  the  board  of  health  or 
mayor.      The  following  is  the  ordinance  in  Charleston:2 

"it  shall  not  be  lawful  to  dig  up.  open;  or  disturb  the  surface  of  the  earth. 
within  the  limits  of  the  city,  between  the  first  day  of  June  and  the  tii'st  daj  of  Octo- 
ber, in  any  year,  for  the  purpose  of  paving  the  streets,  of  excavating  for  drains,  of 
laying  down  gas  or  other  pipes,  or  of  carrying  on  any  other  public  improvement; 
Provided  that  any  incorporated  company,  or  their  agent  or  agents,  may  with  the 
consent  of  the  mayor  at  any  time  during  the  year,  Laj  down  service  pipes  in  any 
street,  lane,  or  alley  of  the  city,  in  which  main  pipes  have  been  already  laid:  upon 
the  express  condition  and  proviso,  however,  thai  between  the  first  day  of  June  and 
the  firsi  day  of  October,  in  every  year,  each  piece  of  service  pipe  shall  he  laid,  and 
the  earth  ami  pavemenl  restored,  during  the  day  in  which  the  surface  of  anj 

lane  or  alley  is  opened  for  the  aforesaid  purpose." 

The  hoard  id'  health  in  New  Orleans  after  a  careful  investigation  of 
the  subject  has  decided  that  little,  if  any  harm  is  caused  l>\  Mich  exca- 
vations ami  it  puts  little  restriction  on  them.3 

I  ity  of  Vew  York.  Sanitarj  Code  1 1  -  21. 

-  charh  ston.  Ordinances  (1897),  Sec.  154. 
New  Orleans,  Reporl  of  Board  of  Health  1^'.»  '.<.  p.  18. 


156  SPECIFIC    NUISANCES. 

Weeds. 

Rules  in  regard  to  weeds  are  also  found  in  Columbus,  the  District  of 
Columbia,  Denver,  St.  Louis,  and  Wilmington,  and  in  Iowa  the  code 
provides  that  cities  and  towns  may  destroy  weeds  in  lots.1  The  St. 
Louis  ordinance  assesses  the  cost  on  the  property,  but  owing  to  the 
expense  and  delay  of  procedure  when  nuisances  are  owned  by  non- 
residents, as  about  half  the  vacant  lots  are,  the  health  commissioner 
of  that  city  does  not  attempt  to  enforce  the  ordinance. 

In  Columbus  the  ordinance  is  similar  to  that  of  St.  Louis,  and  in 
1898  $1,700  was  expended  in  clearing  lots  of  weeds.'  A  case  was 
brought  to  test  the  law,  but  has  not  yet  been  decided. 

In  Charleston2  persons  having  charge  of  burial  grounds  shall  cause 
"  rank  and  offensive  weeds  "  to  be  pulled  up  every  fortnight  and  placed 
in  the  street  for  the  scavengers  to  remove  and  "  also  to  cause  the  grass 
which  may  be  growing  on  such  burial  ground  or  church  yard  to  be  re- 
moved or  cut,  and  taken  away  as  often  as  in  the  opinion  of  the  board 
of  health  the  growth  thereof  may  be  so  rank  and  luxurious  as  to  endan- 
ger the  health  of  the  city." 

Cabbage  Plants. 

"  That  no  cabbage  head,  cabbage  stalk  or  other  portion  of  any  cabbage  plant 
shall  be  allowed  to  remain  upon  any  garden,  field  or  open  space  within  the  City  of 
Chicago,  between  the  15th  day  of  October,  in  any  year,  and  the  15th  day  of  April 
next  thereafter  following,  nnless  the  same  shall  be  covered  under  at  least  one  foot 
of  earth. "  3 

Poisonous  Plants. 

The  following  is  from  Providence,  and  occasion  for  its  application 
not  infrequently  arises  : 

"  The  owner  or  accnpant  of  any  land  upon  which  there  is  any  poisonous  ivy  or 
any  Jamestown  or  Jimson  weed,  within  fifty  feet  of  any  highway  or  street,  shall 
cause  such  ivy  or  weed  to  be  removed  within  five  days  after  receiving  notice  so  to  do 
from  the  superintendent  of  health/'4 

Ailantus  Trees. 

These  are  often  a  nuisance  and  have  been  so  declared  in  the  District 
of  Columbia  and  New  Haven  : 

"  That  ailantus  trees,  the  flowers  of  which  produce  offensive  and  noxious  odors, 
in  bloom,  in  the  cities  of  Washington  and  Georgetown,  or  the  more  densely  popu- 


i  Iowa,  Code  (1897),  Sec.  696. 

2  Charleston,  Ordinances  (1897),  Sec.  128. 

3  Chicago,  Manual  of  Health  Department  (1891),  p.  77. 

4  Providence,  Ordinances  (1900),  Chapter  19,  Sec.  12. 


SPECIFIC    XUIs.  j  m  ES.  1 5  7 

lated  suburbs  of  said  cities,  are  bereby  declared  nuisances  injurious  to  health;  and 
any  person  maintaining  such  nuisance,  who  shall  fail,  after  due  notice  from  this 
board,  to  abate  the  same,  shall,  upon  conviction.  Be  fined  not  less  than  five  nor  more 
than  ten  dollars  for  every  such  offense."  T 

Closets  of  Railroad  Coaches. 

Unless  care  is  taken  the  water-closets  of  railroad  coaches  become 
a  nuisance  about  stations  if  the  closets  are  used  while  the  trains  are 
approaching  or  standing  at  the  stations.  This  matter  is  usually  looked 
after  by  the  railroad  officials,  but  at  least  one  city,  Atlanta,  has  a  rule 
in  regard  to  it. 

Street  Cars. 

The  following  rules  have  been  in  force  in  New  York  City  for  a 
number  of  years : 

"  That  no  railroad  car,  or  vehicle  constructed  for  or  engaged  in  the  business  of 
carrying  passengers  on  any  line  of  railroad  in  the  City  of  New  York,  and  which  car 
is  propelled  by  horse-power,  and  not  by  steam-power,  shall  be  used  with  cushions 
on  the  seats  or  on  the  backs  of  the  seats  thereof. 

'•That  each  and  every  car  used  upon  any  railroad  in  the  City  of  New  York  for 
the  carrying  or  transportation  of  passengers,  shall  on  each  and  every  day  on  which 
it  may  be  used  for  the  carrying  or  transportation  of  passengers,  be  carefully  and 
thoroughly  washed  out  and  cleaned,  so  that  all  filth  and  dirt  are  removed  from  t lie 
inside  of  said  car.  And  no  dirt,  sand,  ashes  or  other  similar  substance  shall  be 
deposited  by  any  person  operating  a  railroad  or  stage  line  in  the  City  of  New  York 
upon  the  surface  of  any  paved  street  in  said  city  without  a  permit  from  this  depart- 
ment. 

■  That  no  person  shall  at  any  time  cany  or  convey  in  or  upon  any  passenger  rail- 
road car,  nor  shall  any  conductor  or  person  in  charge  of  any  such  railroad  car  allow 
to  be  carried  or  conveyed  in  or  upon  such  car,  except  on  the  front  platform,  any 
soiled  or  dirty  articles  of  clothing  or  bedding,  in  baskets  or  bundles. 

11  That  every  car  used  for  the  transportation  of  passengers  in  the  City  of  New 
York,  shall  be  so  constructed  as  at  all  times  to  provide  and  secure  g I  ventilation. 

"Every  company,  corporation  or  person  operating  a  line  of  railroad  cars  for  the 
carriage  of  passengers  l'<>r  hire  in  the  City  of  New  York,  shall,  in  connection  with 
the  running  and  operation  of  cars  as  aforesaid,  have  and  provide  closed  cars  to  i>e 

run  on  said  railroad;    and    at  all  times  shall    have,  provide,  and   operate  at    least  one 

closed  car  in  every  four  cars  so  operated  and  run  for  the  carriage  of  passengers  as 
aforesaid.*1  - 

Salt  in  Streets. 

11  No  person  shall  sprinkle,  scatter,  or  put  upon  the  rails,  switches,  or  other 
appliances  of  a  street  railway  in  any  street,  any  salt,  or  mixture  "f  salt,  except  in 
accordance  with  a  permit  from  the  board  of  health."8 


1  District  of  Columbia,  A.ct  ol   L9  November,  1895,  s> 

i  New  York.  Sanitary  Code  (1899),  Sees,  l-i   188. 

•  Boston,  Ordinances  (1890),  Chapter   19,  Sec.  10. 


158  SPEC  IFK '    NT  rISu  J  N( '  E8. 

Noises. 

Disturbing  noises  are  certainly  a  nuisance,  if  not  a  direct  and  appre- 
ciable injury  to  health.  The  activities  of  modern  life  are  constantly 
increasing  the  volume  of  city  noises,  and  some  of  our  leading  medical 
journals  are  urging  the  necessity  of  taking  some  steps  to  lessen  it.  It 
is  claimed  that  the  constant  irritation  of  the  nerves  produces  a  very 
appreciable  effect  in  bringing  on  that  nervous  exhaustion,  which  is  the 
end  of  man}'  a  busy  man's  career.  Attempts  to  control  noises  are  not 
only  seen  in  general  police  regulations,  but  they  are  often  found  among 
sanitary  regulations.  Rules  in  regard  to  noisy  animals  are  referred 
to  on  pages  162  and  170.  In  Boston1  "No  church  bell  shall  be  rung 
to  disturb  any  sick  person  if  forbidden  by  the  board  of  health."  A 
former  Brooklyn2  rule  was  as  follows : 

"That  no  person  owning  or  occupying  any  building  or  premises  shall  use  the 
same,  or  permit  the  use  of  the  same,  or  rent  the  same  to  be  used  for  any  business  or 
employment,  or  for  any  purpose  of  pleasure  or  recreation,  if  such  use  shall,  from 
its  boisterous  nature,  disturb  or  destroy  the  peace  of  the  neighborhood  in  which 
said  building  or  premises  are  situated,  or  be  dangerous  or  detrimental  to  health." 

In  Meadville,  Pa.,  bells  and  whistles  are  stopped  by  the  board  of 
health  on  a  physician's  certificate  that  a  sick  person's  condition  demands  it. 

Roping  off  Street*  in  Sickness. 

By  an  order  of  the  Commissioners  of  the  District  of  Columbia  of 
23  August,  1883,  the  health  department  issues  permits  to  prevent  the 
the  passage  of  vehicles  in  neighborhoods  where  persons  are  so  seriously 
ill  as  to  make  such  a  step  necessary.  In  1899  sixty-one  such  permits 
were  issued,  but  the  health  officer  does  not  think  such  an  ordinance  is 
required  and  urges  its  repeal.3 

Spitting. 

The  first  anti-spitting  law  in  the  United  States  was  adopted  12 
May,  1896,  in  New  York  City,  at  the  suggestion  of  Drs.  Biggs  and 
Prudden.4  It  was  adopted  for  the  purpose  of  diminishing  the  spread 
of  tuberculosis.  It  had  been  shown  that  tubercle  bacilli  are  thrown  off 
in  large  numbers  in  the  sputum  of  many  cases  of  phthisis,  and  that  this 
Sputum  when  it  becomes  dry  on  the  floor  or  sidewalk  would  be  readily 
pulverized  and  carried  about  by  air  currents,  and  might  on  reaching 
the  air  passages  of  those  who  breathed  this  dust-laden  air,  cause  the 
disease  in  them.     This  danger  was  believed  to  be  a  very  real  one,  and 


1  Boston,  Ordinances  (1890),  Chapter  49,  Sec.  12. 
2 Brooklyn,  Sanitary  Code  (1895),  Sec.  179. 

3  District  of  Columbia,  Report  of  Health  Officer  (1897),  p.  20. 

4  New  York  City,  Report  of  Board  of  Health  (1896),  p.  29. 


sl>E<  IFIt  ■    XVI X  J  X'  ES.  1 59 

hence  the  ordinance.  While  the  evidence  in  support  of  the  view  that 
this  danger  is  great  enough  of  itself  to  warrant  such  legislation  is  not 
entirely  satisfactory,  the  legislation  itself  has  met  with  very  general 
approval.  Spitting  on  the  floor  or  sidewalk  is  a  dirty  habit,  creates  a 
nuisance,  and  is  annoying  to  the  majority  of  persons.  It  is  probably 
because  it  prevents  nuisance  rather  than  because  it  prevents  disease  that 
the  law  meets  with  popular  favor.  It  is,  however,  usually  adopted  by 
boards  of  health  under  authority  to  legislate  for  the  prevention  of 
disease. 

At  present  such  regulations  are  found  in  the  cities  named  below.1 
but  have  not  yet  been  incorporated  into  statute  law:  but  in  Indiana 
they  have  been  promulgated  as  rules  of  the  state  board  of  health. 

Some  of  the  regulations,  especially  the  earlier  ones,  forbade  spitting 
in  street  ears  only,  as  in  Baltimore,  Minneapolis,  Lowell,  Lynn,  Boston, 
Cambridge,  and  New  Orleans. 

"Resolved.  That  the  deposit  of  sputum  in  street  cars  is  a  public  nuisance,  source 
of  filth  and  cause  of  sickness,  anil  hereby  orders:  That  spitting  upon  any  floor  of 
any  street  car  be,  and  hereby  is  prohibited."  - 

The  word  spit  has  in  most  of  the  regulations  been  deemed  sufficient 
to  describe  the  act  which  it  is  desired  to  prohibit,  but  it  has  been  fur- 
ther explained  in  some  cities.  It  has  furthermore  been  found  insuffi- 
cient to  forbid  spitting  on  the  floor,  and  it  has  been  said  that  persons 
seeing  the  rule  above  given  exhibited  before  them,  have  deliberately 
spat  upon  some  other  portion  of  the  ear.  The  Minneapolis  rule  takes 
note  of  both  these  points  : 

"  No  person  shall  spit  <>r  expectorate,  or  deposit  or  plate  any  sputum,  .saliva. 
phlegm,  or  mucus  upon  the  floor  or  inside  furnishings  or  equipments  or  in  any  place 
upon  the  outside,  or  upon  any  platform  of  any  street  ear  while  the  same  is  in  use 
upon  any  of  the  streets  or  highways  in  the  City  of  Minneapolis,  or  in  any  manner 
defile  or  pollute  the  floor,  furnishings,  equipments  or  platform  of  any  street  ear 
while  in  use  11 1 K ,n  any  of  the  streets  or  highways  of  saiil  city.'1 

Most  of  the  more  recent  rules  forbid  spitting  in  any  "public  con- 
veyance." Among  the  conveyances  mentioned  are  "street  cars,"  "rail- 
road cars,"  "ferry  boat."  "omnibus,"  "hack,"  ■•  carriage.*'  "vehicle," 
••  steam  ear.*'  and  ••  Bteamboat." 

1  Boston,  Balti re,  Buffalo,  Brookline,  Cambridge,  Colorado  Springs,  Colum- 
bus, Cleveland,  Cincinnati,  Camden,  Denver,  Dayton,  Fitchburg,  Fall  River,  Hart- 
ford, Indianapolis,  Jersej  City,  Kansas  City,  Louisville,  Lowell,  Lynn,  Minneapolis, 

NYu    Fork,   Nevi   Orleans,  Omaha,   P ia,   ill..   Rochester,  Springfield,  O.,  Salem 

Ban  Francisco,  Scranton,  Seattle,  Trenton,   Waltham,    Worcester,  and   Washin 
I).  (  . 

-  Lowell,  Reporl  of  Board  of  Health,  (1898),  p.  86. 
Minneapolis,  Ordinance  of  25  June,  1897,  Sec.  53. 


160  SPECIFIC    NUISANCES. 

A  good  many  of  the  rules  go  further  and  prohibit  spitting  on  the 
floor  of  "  public  buildings,"  as  in  New  York  City.  Among  public 
places  mentioned  are  "  public  halls,"  "  assembly  rooms,"  "  shops," 
"  stores,"  "  halls,"  "  churches,"  "  school  houses,"  "  railroad  stations," 
"public  places."  The  Indiana  rules  forbid  spitting  on  stairways. 
Some  of  the  rules  go  further  still  and  forbid  spitting  upon  the  sidewalk, 
as  in  the  present  rule  in  Boston,  Cambridge,  and  Lynn,  and  in  Cin- 
cinnati, Providence,  Brookline,  Mass.,  Springfield,  Mass.,  Colorado 
Springs,  and  Rochester : 

"Ordered,  That  no  person  shall  spit  npon  the  floor  of  any  public  conveyance, 
shop,  store,  hall,  church,  school  house,  railroad  station,  or  other  public  building  in 
said  town,  or  upon  the  steps  of  any  of  said  conveyances  or  buildings,  or  upon  the 
sidewalk  (spitting  into  the  gutter  or  street  is  not  forbidden)  of  any  public  way  in 
said  town.1 

These  rules  have  very  generally  met  the  approval  of  the  street 
railway  and  other  transportation  companies,  and  they  have  been  very 
ready  to  post  notices  containing  the  rule,  and  to  assist  in  its  enforce- 
ment. Some  of  the  rules  however,  provide  that  the  companies  shall 
do  this  : 

"Spitting  upon  the  floors  of  public  buildings  and  of  railroad  cars  and  of  ferry 
boats  is  hereby  forbidden,  and  officers  in  charge  or  control  of  all  such  buildings, 
cars  and  boats  shall  keep  posted  permanently  in  each  public  building  and  in  each 
railroad  car  and  in  each  ferry  boat  a  sufficient  number  of  notices  forbidding  spitting 
upon  the  floors,  and  janitors  of  buildings,  conductors  of  cars  and  employes  upon 
ferry  boats  shall  call  the  attention  of  all  violators  of  this  ordinance  to  such  notices."2 

In  Providence  the  street  railway  company  not  only  posted  such 
notices  in  its  cars,  but  furnished  its  conductors  with  slips  on  which  was 
printed  the  rule,  and  the  conductors  were  directed  to  hand  one  of  the 
slips  to  every  person  seen  violating  the  rule.  In  Minneapolis  cards 
containing  the  rule  are  printed  and  very  generally  distributed  by  the 
board  of  health.  In  Brookline  where  spitting  on  the  sidewalk  is  for- 
bidden, the  police  carry  copies  of  the  law  to  show  to  offenders. 

In  order  to  render  compliance  witli  this  rule  easier,  it  is  provided  in 
Colorado  Springs  as  follows  : 

"  Every  owner,  agent,  lessee  or  occupant  of  any  public  hall  or  building  shall 
provide  the  same  with  cuspidors  in  sufficient  number  to  accommodate  the  necessi- 
ties thereof.  And  any  such  owner,  agent,  lessee  or  occupant  who  shall  refuse  or 
neglect  to  comply  with  any  order  of  the  health  officer  in  supplying  said  cuspidors, 
shall  be  fined  in  a  sum  not  less  than  one  dollar  nor  more  than  five  dollars  for  each 
offense."  3 


1  Brookline,  Mass.,  Report  of  Board  of  Health  (1808),  p.- 10,  Orders  of  the   Board 
of  Health,  No.  16. 

2  New  York  City,  Sanitary  Code  (1899),  Sec.  194. 

3  Colorado  Springs,  Sanitary  Code  (1897),  Sec.  60. 


SPECIFIC    NUISANCES.  h;i 

In  New  Orleans  the  rule  first  adopted  only  forbade  spitting  tobacco 
on  street  cars,  but  it  has  been  recently  modified  to  forbid  all  spitting-. 

Stables. 

The  keeping  of  horses,  swine,  cattle,  and  other  domestic  animals,  can 
readily  be  done  in  the  country  without  nuisance  or  damage  to  any  one. 
but  as  soon  as  any  locality  becomes  so  well  occupied  that  the  stables, 
sheds,  and  pens  in  which  these  animals  are  kepi  must  of  necessity  be 
near  the  doors  and  windows  of  neighbors,  then  trouble  begins.  In  vil- 
lages, towns,  and  cities  the  keeping  of  horses  and  the  storing  and  dis- 
posal of  stable  manure  is  always  a  problem  winch  health  officers  have 
to  solve.  The  regulation  of  such  matters  well  comes  within  the  limits 
of  the  general  sanitary  [towers  of  local  government,  but  at  least  two 
states  furnish  a  special  statute  on  this  subject.  The  Massachusetts 
act  was  first  passed  in  1891,  but  was  amended  in  1896  t<>  read  as  fol- 
lows :  l 

•■  No  person  shall  hereafter  erect,  occupy,  it  n>e  for  a  stable  any  building  in  am 
city  whose  population  exceeds  5,000,  unless  firsl  licensed  to  do  so  by  the  board  of 
health  of  said  city  and  in  such  case  only  to  the  extent  so  licensed."" 

The  location  (if  stables  is  sometimes  limited  by  statute  or  ordinance. 
Tims  in  Boston  a  statute2  provides  that  no  livery  stable  shall  he  erected 
within  1T<»  feet  of  a  church  without  the  written  consent  of  the  proprie- 
tors and  the  permission  of  the  hoard  of  health.  By  a  more  recent  act3 
this  provision  applies  to  all  cities,  only  the  distance  is  made  J<hi  feet 
;ii id  the  permit  must  be  from  the  religious  society  or  parish.  In  Chicago4 
no  livery  stable  can  he  built  or  kept  on  air)  residential  street  within 
Seventy-five  feet  of  the  street  without  the  written  consent  of  the  owners 
of  600  feet  id'  property  on  each  side  of  the  lot.  In  Cincinnati  and 
Cleveland5  a  written  application  must  he  made  to  the  board  of  health 
for  a  Livery  stable  license  giving  full  particulars,  and  on  residence 
Btreets  License  is  not  to  be  granted  without  written  consent  "I  owners 
of  dwellings   within    300  feet. 

In  most  of  the  Massachusetts  cities  persons  desiring  \<>  erect  a 
stable  have  to  make  a  written  application,  ami  in  [•"itehburg  there  must 
also  be  filed  a  plan  and  description  of  the  stable.  A  printed  notice  is 
then  sent  tn  the  applicant  explaining  the  rules  that  must  be  followed  in 
the  construction  of  the  stable.     The  license  is  not  issued  until  the  satis- 

i  Massachusetts,  <  lhapter  332  of  1896,  also  see  <  lhapter  128  uf  L* 

Massachusetts,  Chapter  124  of  1810. 

Massachusetts,  Chapter  220  of  L891. 

•  liicago,  « Ordinances  <  189]  i.  Sec.  2241. 

'  Ohio,  Annotated  Statutes  (1900),  Sees.   (2072-20),  i   S4),  |    104 
n 


1  ( ;  2  SPEl  IFK     XJ  T&  1  XCEs. 

factory  completion  of  the  building.  In  Newton,  Mass.,  as  soon  as  an 
application  to  erect  a  stable  is  received,  notices  are  mailed  to  owners  of 
adjoining  property,  and  such  notices  are  also  posted  in  the  vicinity. 
Four  days  are  allowed  for  filing  written  objections  with  the  board  of 
health.  If  no  objections  are  filed,  the  clerk  issues  a  provisional  permit. 
In  Providence  stables  are  licensed  by  the  board  of  aldermen.  When  a 
petition  is  received,  it  is  referred  to  the  alderman  of  the  ward  in  which 
the  stable  is  to  be  built,  and  the  board  usually  accepts  his  report  and 
grants  the  license  without  conditions. 

The  majority  of  cities  have  as  their  first  rule  a  requirement  that 
stables  shall  be  kept  clean.  Various  other  matters,  as  construction  of 
stable,  care  and  removal  of  manure,  and  its  disposal,  commonly  receive 
attention.      The  following  are  examples  of  rules  commonly  in  force  : 

Cleanliness  Prescribed. 

"  The  keeper  or  keepers  of  a  livery  or  other  stahle  shall  keep  his  or  their  stables 
and  stable  yard  clean."1 

\<>ise  Must  Not  Disturb  Neighborhood. 

L-  No  person  owning,  occupying,  or  having  charge  of  any  building,  stable,  or 
other  premises,  shall  keep  or  allow  thereon  or  therein  any  animals  or  birds,  which 
shall  by  noise  disturb  the  quiet  or  repose  of  those,  or  anyone,  therein  or  in  the 
vicinity,  to  the  detriment  of  the  life  or  health  of  any  human  being.  Any  violations 
of  the  provisions  of  this  section  shall  be  punishable  by  a  penalty  of  twenty-five 
dollars.'"2 

Floor  to  In-  Impervious. 

"  Every  stable  or  building  which  may  be  hereafter  constructed  or  reconstructed 
in  the  city  of  Asbury  Park,  in  which  any  horse,  mule,  or  cow  is  kept  or  stabled, 
shall  be  so  constructed  and  drained  that  no  liuid  excrement  or  refuse  liquids  shall 
fiow  upon  or  into  the  ground.  All  of  the  surface  of  the  ground  beneath  every  stall 
in  every  such  building,  and  for  a  distance  of  at  least  four  feet  in  the  rear  of  every 
such  stall  shall  be  covered  and  protected  from  pollution,  by  a  water-tight  floor  or 
covering  which  shall  be  constructed  as  follows: 

•  Where  the  said  water-tight  covering  rests  directly  upon  the  ground  surface,  the 
said  covering  shall  consist  of  concrete  made  witli  finely  broken  stone,  one  part;  sharp 
sand,  one  part;  hydraulic  cement,  one  part:  or  coarse  gravel,  two  parts;  hydraulic 
cement,  one  part:  to  be  laid  at  least  three  inches  in  thickness.  Upon  this  concrete 
foundation  a  layer,  at  least  two  inches  in  thickness  of  best  asphalt:  or  a  layer,  at 
least  two  inches  in  thickness  of  coal  tar  concrete:  or  a  layer,  at  least  two  inches  in 
thickness  of  cement  concrete  made  with  sharp  sand,  one  part;  best  Imperial  Portland 
cement,  one  part,  shall  be  laid. 

•  When  the  water-tight  covering  is  not  in  contact  with  the  surface  of  the  ground, 
it  shall  rest  upon  joist  or  floor  beams  three  inches  by  ten  inches,  laid  twelve  inches 
from  centres,  and  it  shall  consist  of  spruce  oryellow  pine  planking,  three  inches  thick 
and  three  inches  wide,  with  beveled  edges,  and  it  shall  be  closely  laid  so  that  the 
joints  shall  be  V  shaped,  and  be  open  at  the  top  one   quarter  of  one   inch.     Said 


1  Scranton,  Pules  of  Hoard  of  Health.  Sec.  9. 

2  Albany.  Ordinances  (1892),  Sec.  18. 


SPEC  IEIt '    XI  'Is .  1  m  ES.  1 1 ; ;  \ 

joints  shall  be  calked  with  oakum  and  be  made  water-tight.  Every  such  water-tight 
Covering  shall  be  laid  upon  a  grade  not  less  than  one-eighth  of  one  inch  to  each  foot, 
and  shall  be  so  drained  that  all  fluids  which  may  fall  upon  it  will  lie  conveyed  to  a 
street  sewer  or  otherwise  disposed  of  subject  to  the  terms  of  a  permit  from  this 
board.  Portable  wooden  racks  shall  be  placed  upon  all  such  asphalt,  coal  tar,  con- 
crete or  cement  concrete  floors  within  said  stall.  Said  wooden  racks  or  floor  cov- 
erings shall  be  constructed  of  spruce  strips,  two  inches  in  thickness,  made  in  two 
sections,  and  they  shall  be  so  placed  that  they  may  be  readily  removed  for 
cleaning."  1 

The  Asbury  Park  rule  has  since  been  declared  void  by  the  supreme 
court  of  New  Jersey.  The  point  made  was  that  it  was  beyond  the  power 
of  the  board  of  health  to  prescribe  in  what  way  the  floor  should  be 
made  tight.  Nevertheless  in  a  majority  of  existing  rules  the  method  is 
thus  prescribed. 

Receptacle  for  Manure. 

In  very  many  cities  a  pit,  bin,  or  cellar  is  required  for  the  manure: 

••  Every  person  owning,  leasing  or  occupying  any  stall,  stable,  shed,  barn  or 
apartment  where  any  horse  or  any  neat  cattle  shall  be  kept,  and  every  owner  of  any 
horse  or  head  of  cattle  shall  maintain  a  covered  bin,  vault  or  cellar  satisfactory  to 
the  Superintendent  of  Health,  in  which  shall  be  placed  all  manure  or  refuse  from 

such  horse  or  cattle."  - 

in  Newark  there  must  be  provided  an  "underground  and  properly 
covered  manure  vault  of  sufficient  capacity  to  care  for  all  manure  that 
may  accumulate  in  such  stable  or  department  ;  said  vaults  shall  not  be 
nearer  than  ten  feet  to  the  line  of  an  adjoining  lot,  street,  alley,  or 
public  place  without  a  permit  from  the  hoard."  It  is  also  often  required 
that  all  manure  shall  be  kept  in  the  bin  or  vault,  or  that  "  it  shall  not 
be  allowed  to  collect  in  such  stable,  shed.  barn,  or  apartment,  or  on  the 
ground  outside  of  said    boxes,  pits,  or  vaults  "  : 

••  The  manure  pit  shall  be  constructed  of  brick  and  stone,  laid  in  cement  and  so 
situated  as  to  allow  the  manure  when  removed  to  be  loaded  inside  the  stable. 

••  When  such  water-tight  pit  or  cellar  is  situated  under  the  building,  it  shall  be 
ventilated  i>y  a  shaft  not  less  than  twelve  inches  square,  carried  two  feel  above  the 
roof  of  t  he  main  building. 

■•  The  drainage  of  everj  stable  shall  be  properly  conducted  to  the  proper  sewer 
whenever  practicable  and  to  the  satisfaction  of  the  board  of  health. 

14 In  every  case  the  ventilation  and  drainage  shall  be  made  satisfactory  to  the 

hoard  of  health.""  ; 

Iii  Lynn  and  <  lambridge  it  is  simpl}  required  thai  no  manure  shall  be 
allowed  to  remain  uncovered  outside  of  a  stable  building.  In  Boston 
the  board  of  health  requires  huge  stables  to  keep  a  wagon  on  the  prem- 
L8<  -  and  to  keep  the  manure  in   that.      In    New    York   ('ii\    the   use  ol 

1  Asbury  Park,  Sanitary  Code  (1897),  Sec.  i>. 

■  Providence,  Rules  of  Board  oi   Udermen  (1! Chapter  I.  Se< .  0. 

:  Fitchbure.  Rules  and  Regulations  of  Board  of  Health.  Sees.  3,  i    I 


164  8PM  t  IF  It '    N I  rIS.  I  m  MS. 

bins  or  vaults  was  formerly  insisted  upon,  but  lately  they  have  been  for- 
bidden under  sidewalks,  and  their  use  outside  of  stables  requires  a  per- 
mit. The  object  of  the  board  in  discouraging  vaults  is  to  encourage  the 
use  of  baling  as  a  means  of  storing  and  removing  manure,  as  is  shown  in 
the  section  of  the  code  here  given  : 

"  That  every  owner,  lessee,  tenant,  and  occupant  of  any  stall,  stable,  or  apart- 
ment in  the  built-up  portions  of  the  City  of  New  York,  in  which  any  horse,  cattle, 
or  other  animal  shall  be  kept,  or  of  any  place  in  which  manure,  stable  refuse,  or  any 
liquid  discharge  of  such  animals  shall  collect  or  accumulate,  shall  cause  such 
manure,  stable  refuse,  or  liquid  to  be  promptly  and  properly  removed  therefrom, 
and  shall  at  all  times  keep  or  cause  to  be  kept  such  stalls,  stables  or  apartments,  and 
the  drains,  yards,  and  appurtenances  thereof,  in  a  clean  and  sanitary  condition,  so 
that  no  offensive  odors  shall  be  allowed  to  escape  therefrom.  It  shall  be  the  duty  of 
every  such  owner,  lessee,  tenant  or  occupant,  to  cause  all  manure  and  stable  refuse 
to  be  removed  daily  from  such  stable  or  stable  premises,  unless  the  same  are  pressed 
in  bales,  barrels  or  boxes,  as  hereinafter  provided.  It  shall  not  be  lawful  to  remove 
manure  and  stable  refuse  in  carts  or  wagons,  or  to  cart  the  same  within  the  city 
limits  without  a  permit  from  the  board  of  health,  and  such  carts  and  wagons  shall 
lie  of  a  construction  approved  by  said  board,  and  every  such  cart  or  wagon  must 
have  a  permit  from  the  board  in  writing,  and  be  used  in  accordance  with  the  terms 
of  such  permit  and  not  otherwise.  Manure  carts  and  wagons  shall  be  loaded  within 
the  stable  premises  and  not  upon  the  street  or  sidewalk,  and  shall  be  removed  from 
such  premises  in  a  manner  not  in  any  way  offensive  or  to  cause  any  nuisance.  All 
manure  and  stable  refuse  when  transported  through  the  streets  must  be  so  covered 
and  secured  that  no  part  of  the  same  will  fall  upon  the  street,  and  so  as  to  prevent 
the  escape  of  offensive  odors,  and  the  same  shall  not  be  unloaded  or  deposited  within 
the  city  limits,  except  upon  the  conditions  of  a  permit  in  writing  from  the  board  of 
health,  and  at  such  docks  and  places  as  shall  be  approved  by  the  board,  and  to  which 
a  permit  in  writing  tor  such  use  shall  have  previously  been  granted  by  said  board. 
No  manure  or  stable  refuse  shall  be  allowed  to  he  thrown  upon  or  fall  and  remain 
upon  any  street  or  sidewalk  or  upon  any  ground  near  any  stable,  and  no  manure  and 
stable  refuse  shall  be  allowed  to  remain  for  more  than  twenty-four  hours  in  any 
place  within  any  stable,  unless  it  is  pressed  in  hales,  barrels  or  boxes.  No  manure 
vault  or  receptacle  shall  be  built  or  used  on  any  premises  within  the  built-up  por- 
tions of  the  city,  nor  in  any  other  part  of  the  city,  except  pursuant  to  the  terms  of  a 
permit  granted  therefor  by  the  board  of  health. 

:L  Every  owner,  lessee,  tenant  or  occupant  of  any  stall,  stable  or  apartment,  in 
the  built-up  portions  of  the  City  of  New  York,  in  which  any  horse,  cattle  or  other 
animals  shall  be  kept,  and  from  which  the  manure  and  stable  refuse  is  not  removed 
daily  as  hereinbefore  provided,  shall  cause  the  same  to  be  pressed  in  bah  s,  barrels 
or  boxes,  at  least  once  in  each  day,  and  so  pressed  as  to  reduce  the  same  to  not  more 
than  one-third  of  the  original  bulk.  Manure  and  stable  refuse  pressed  in  bales,  bar- 
rels or  boxes,  shall  he  removed  to  such  docks  or  places  as  shall  be  approvi  d  by  the 
board  of  health,  and  to  which  a  permit  in  writing  for  such  use  shall  have  previously 
been  granted  by  said  board,  and  such  hales,  barrels  and  boxes  shall  not  be  opened 
until  delivered  at  such  dock  or  places."'  ' 

Amount  of  Manure  Allowed  on  Promises. 

In  Cambridge  not  more  than  two  cords  of  manure  is  allowed  to 
accumulate  or  remain  on  the  premises.      In   Newport   it   is  three   cords 


1  City  of  New  York,  Sanitary  Code  (1899),  Sec.  120. 


SPECIFIC    NUISANCES.  I,;;, 

between  the  first  of  May  and  the  first  of  November.  In  Lynn  owners 
are  not  to  " allow  large  quantities  of  manure  to  accumulate"  between 
the  above  dates.  In  Scranton  not  more  than  five  wagon  loads  shall 
accumulate  between  the  fifteenth  of  May  and  the  first  of  November. 
In  Cleveland  not  more  than  one  two-horse  wagon  load  shall  accumulate 
except  at  a  slaughter-house,  where  it  is  removed  daily. 

The  use  of  manure  as  a  fertilizer  is  sometimes  permitted  l>v  ordi- 
nance : 

"Provided,  that  a  reasonable  amount  of  manure  may  he  allowed  at  the  discretion 
<>f  the  health  commissioner,  to  be  accumulated  on  private  premises,  for  the  purpose 
of  cultivating  the  same;  and  provided  further,  that  whenever,  in  the  opinion  of  the 
health  commissioner,  such  accumulation  is  a  nuisance  or  detrimental  to  health,  it 
may  be  forbidden  and  designated  a  nuisance  under  the  prior  provisions  of  this  ordi- 
nance.1' ' 

A  similar  rule  is  found  in  Omaha  and  St.  Louis. 
Permits  for  Removal. 

As   shown   above,  permits   are   required  for  removal    in  New  York 
City,  and  they  are  also  required  in  a  few  other  places. 
.Manner  of  Removal. 

.Many  cities  require  the  removal  of  stable  manure  in  tight  wagons 
or  covered  wagons  : 

llNo  person  shall  remove  anj  manure,  excepl  in  a  tight  vehicle,  with  a  canvas 
cover  so  secured  to  the  sides  and  ends  of  the  vehicle  as  to  prevent  the  manure  from 
being  dropped  while  being  removed."'  - 

■■  Manure  shall  not  be  loaded  upon  or  across  any  passageway  or  sidewalk,  except 
in  st  a  hies  heretofor  constructed  from  which  it  is  impossible  to  load  it  ot  berwise,  ami 
in  such  cases  the  passageway  or  sidewalk  shall  he  thoroughly  cleaned  and  swept 
immediately  after  such  loading." 

The  New  York  rules  were  given  on  page  L64.  Now  York  was  the 
firsl  city  to  introduce  baling  manure  in  order  t<»  lessen  the  nuisance 
arising  from  its  storage  and  transportation.  Haling  is  encouraged  as 
was  show  ii.  by   requiring  that    manure  shall   be   removed   dail\    unless 

baled.        \'er\    little  mall  lire   is  as  yet    baled.        Ill    1  89l  i   1 1  le    follow  ing  \\  ere 

the  average  daihj   receipts  at    the  docks: 

Manure  loose  in  carts .096  tons. 

"barrels 05     " 

in  hales I 

Time  and  Frequency  of  Removal  : 

As    was   stated   abo\e.  in   New    York   City,  the    removal   ol    stable 

i nre  must   be  dail\    unless  it   is  baled. 

1  Denver.  <  Ordinance  1 1  of  1893,  Sec.  59. 
Boston,  ordinances  (1890),  Chapter  19,  S( 
Cambridge,  Regulations  of  Board  of  Health  (1897),  Sec.  i". 


1  (j  6  SPE(  IF  1 1 '    Xf  rIS.  1  m  'Es. 

'•  Where  one  or  two  horses  are  kept  the  manure  must  be  removed  once  every  week 
in  summer  and  once  every  two  weeks  in  winter;  where  three  or  four  horses  are 
kept,  and  from  livery  stables,  it  must  be  removed  every  day  to  the  city  dump  or 
without  the  city  limits."  1 

.  .  .  "In  all  cases  where  this  board  shall  by  written  notice  so  require  all 
manure  or  excreta  shall  be  removed  from  all  stables  and  premises  where  it  may 
accumulate  as  often  as  once  in  each  week.""  2 

The  hours  for  removal  are  very  often  limited,  as  it  is  considered  that 

in  certain   locations,  or   at  certain   seasons,  less   nuisance  is  created  by 

removal  at  night.     In  Jersey  City  the  hours  prescribed  for  removal  are 

between  6  p.  m.  and  7  A.  M.     In  Camden  the  inspector  may  forbid  its 

removal  between  <:!  a.  m.  and  10  p.  M.     In  Newport  the  hours  during 

which  it  may  be  removed  are  5  p.  M.  to  10  a.  m.  between  the  first  of 

May  and  the  first  of  November.     In  Boston : 

"No  person  shall  remove  manure,  or  cause  or  suffer  the  same  to  be  removed,  be- 
tween the  first  day  of  May  and  the  first  day  of  November,  except  in  the  night-time, 
after  twelve  o'clock,  and  in  accordance  with  a  permit  from  the  board  of  health. "  3 

In  Cincinnati : 

"  Every  person  using  any  stable,  building  or  structure  in  which  any  horse  or  mule 
is  habitually  kept  or  stabled,  is  required  to  remove  the  manure  from  such  premises 
at  least  once  every  day,  except  during  the  months  of  May,  June,  July,  August,  and 
September,  when  such  manure  shall  be  removed  at  least  twice  every  day,  once  before 
the  hour  of  8  A.  m.,  and  once  after  the  hour  of  0  p.  m."  4 

In  Cleveland  stable  manure  is  not  to  remain  on  the  premises  over 
seventy-two  hours  between  May  and  September  inclusive. 

Disposal  of  Manure. 

In  most  sections  of  the  country,  stable  manure  is  so  valuable  to 
market  gardeners  in  the  vicinity  of  cities  and  large  towns,  that  its  ulti- 
mate disposal  is  a  problem  easily  solved.  The  only  question  is  how  to 
get  the  manure  to  the  consumer.  In  most  cities,  probably  all  except 
the  very  largest,  there  appears  to  be  no  serious  objection  to  carrying  it 
into  the  country  in  properly  constructed  and  covered  wagons  :  but  in 
the  largest  cities,  and  notably  in  Xew  York,  much  nuisance  has  in  the 
past  been  caused  by  the  transportation  of  stable  manure  into  the  country. 
The  dumps  at  which  it  was  loaded  on  to  cars  and  boats,  were  loudly 
complained  of.  The  dumps,  have  however,  been  largely  brought  under 
control  by  enforcing  the  provisions  of  the  sanitary  code  as  shown  on 
page  164.  These  rules  require  that  the  manure  shall  be  closely  covered 
when   carried    through    the   streets    and    only   deposited   at   designated 

1  Denver,  Ordinance  44  of  1893,  Sec.  111. 
-  Newark,  Sanitary  Code  (1888),  Sec.  4(3. 

3  Boston,  Ordinances,  Chapter  49,  Sec.  7. 

4  Cincinnati,  Manual  of  Health  Department  (1898),  Sec.  43. 


sp  E  <  ■  TFIt  ■    XI  rISA  m  ■  E'S.  \  ( 5  7 

places.  In  Milwaukee  the  reprehensible  practice  of  burning  stable 
manure  seems  to  have  arisen,  for  the  following  ordinance  was  adopted 
5  March.  1894  :  1 

"The  burning  of  manure  in  furnaces  by  manufacturing  establishments  and  other 
buildings  anywhere  in  the  city  of  Milwaukee  for  the  purpose  of  keeping  up  a  slow 
fire  through  the  night,  or  for  any  other  purpose,  thus  creating  an  unbearable  stench 
throughout  the  eity,  shall  be  deemed  and  hereby  is  declared  a  public  nuisance." 

Bedding. 

■•Nor  shall  any  straw,  hay,  or  other  substance,  which  has  been  used  as  bedding 

for  animals,  be  placed  or  dried  upon  any  street  or  sidewalk,  or  root'  of  any  building; 
nor  shall  any  such  straw,  hay,  or  substance  be  deposited,  nor  shall  accumulation 
thereof  be  made,  within  two  hundred  feet  of  any  street,  without  a  permit  from  this 
department.'"  - 

Similar  rules  are  found  in  Minneapolis  and  Jersey  City.  In  Fitch 
burg,  "bedding  shall  not  remain  outside  the  stable." 

Washing  Wagons,  etc. 

"Owners  and  occupants  of  livery  and  other  stables  within  the  city,  shall  not 
wash  or  clean  their  carriages  or  horses,  or  cause  them  to  he  washed  or  cleaned  in 
the  streets  or  public  ways.  They  shall  keep  their  stables  and  yards  clean,  and  uot 
allow  large  quantities  of  manure  to  accumulate  in  or  near  the  same  at  any  one  time 
between  the  first  day  of  May  and  the  firs!  day  of  November,  and  no  manure  shall  be 
allowed  to  accumulate  or  remain  uncovered  outside  of  ;i  stable  building.11 

Swine. 

There  is  probably  no  more  offensive  nuisance  than  a  filthy  hogpen. 
The  keeping  of  hogs  is  a  part  of  the  business  of  the  fanner  and  is 
necessary  in  the  country,  but  in  rural  regions  it  is  comparatively  easy 
to  keep  swine  so  that  they  will  not  l»e  a  nuisance  to  anyone.  Not  so  in 
villages  and  cities  where  the  compactness  of  population  is  almost  cer- 
tain to  make  every  hogpen  a  nuisance  to  some  one.  The  intrinsic  dl\ 
offensive  character  of  the  hogpen  is  recognized  in  a  number  of  cities 
which  forbid  absolutely  the  keeping  of  swine  within  their  borders. 
Among  the  cities  may  be  mentioned  Augusta,  Boston,  Cleveland,  Dis- 
trict of  Columbia,  Philadelphia,  Raritan,  Reading,  and  Syracuse.  In 
the  Philadelphia  regulations  "the  keeping  of  hogs  in  the  city  and 
county  of  Philadelphia  is  absolutely  prohibited."  Besides  the  penalty 
imposed  for  violation  of  this,  the  statute  of  5  April,  1849,  provides  as 

follows  : 

•  Whenever  au>  nuisance  shall  be  found  anywhere  within  the  jurisdiction  of  the 
board  of  health,  by  reason  of  the  keeping  of  hogs  or  other  animals,  the  board  of 
health,  in  addition  to  their  power  of  destroying  the  pens  or  other  enclosures  con- 
taining such  animals,  or  of  otherwise  abating  and  removing  such  nuisances,  be  and 

1  .Milwaukee.  Report  of  Board  of  Health,  1894. 
1  City  of  New  York.  Sanitarj  <  ode  (1899),  Sec.  180. 
Lynn,  Board  of  Health  Rule  31. 


1CS  SPECIFIC    NUISANCES. 

they  are  hereby  empowered  to  seize  such  animals  and  deliver  them  over  as  forfeited 
to  the  guardians  for  the  relief  and  employment  of  the  poor  of  the  city  of  Phila- 
delphia, for  the  use  of  said  poor,  and  it  shall  be  the  duty  of  said  guardians  of  the 
poor,  on  notice  of  the  board  of  health,  to  receive  the  said  animals,  and  pay  the 
expense  of  their  removal." 

In  Delaware  local  boards  of  health  are  authorized  by  statute  to 
destroy  offensive  hogpens.1  A  more  moderate  procedure  than  the  pre- 
ceding is  to  forbid  the  keeping  of  hogs  in  certain  sections,  usually  the 
compact  or  built  up  portions  of  the  city.  This  is  the  regulation  in  Fitch- 
burg,  Lowell,  Manchester,  N.  H.,  Memphis,  Newport,  R.  I.,  and  Rochester. 
In  Bangor,  Me.,  they  are  not  to  be  kept  in  the  compact  part  of  the  city 
from  May  to  October  inclusive.  In  Atlanta  hogpens  are  declared  a  nui- 
sance within  one  hundred  yards  of  a  private  residence  or  on  the  water- 
shed of  the  water  works.  In  Cincinnati  hogs  are  not  to  be  kept  "so 
as  to  annoy  or  offend  any  neighbor  or  other  person  whatsoever."  In 
Haverhill  "  no  swine  shall  lie  kept  within  three  rods  of  any  dwelling, 
and  the  pens  must  be  kept  free  from  standing  water  or  filth.  In  Mel- 
rose, Mass.,  "no  swine  are  to  be  kept  within  fifty  feet  of  a  street  or 
within  one  hundred  feet  of  any  dwelling  other  than  that  of  the  owner, 
or  within  twenty-five  feet  of  the  owner's  dwelling.''  In  Hartford  hog- 
pens are  forbidden  if  a  nuisance,  and  in  Wilmington,  Del.,  if  filthy, 
they  are  to  be  removed  as  are  other  nuisances.  In  Fitchburg  hogs  are 
not  to  be  kept  in  or  about  a  stable.  In  Cincinnati  they  are  not  to  be 
about  a  slaughter  house.  In  Bridgeport  they  are  not  to  be  kept  within 
one  hundred  feet  of  a  dwelling,  street,  park,  court,  church  or  school, 
and  in  Scranton,  not  within  one  hundred  feet  of  a  street,  house,  spring, 
or  well  used  for  drinking.  In  Florence,  S.  C,  no  hogs  are  to  lie  kept 
in  a  lot  less  than  two  acres  in  size.  \\\  Connellsville,  Pa.,  swine  cannot 
be  kept  within  one  hundred  feet  of  a  well,  or  thirty  feet  from  a  house 
or  street  unless  the  pen  is  two  feet  from  the  ground  and  cleaned  weekly. 

The  number  of  swine  to  be  kept  is  sometimes  limited.  Thus  in 
Florence  the  limit  is  ten,  in  Chicago  it  is  three. 

The  construction  of  hogpens  is  rarely  regulated,  but  in  Scranton 
the  rules  of  the  board  of  health  require  that  they  shall  be  so  con- 
structed that 

11  The  tloor  or  floors  of  the  same  shall  he  not  less  than  two  feet  from  the  ground 
in  order  that  the  filth  accumulating  under  the  same  may  be  easily  removed;  and 
such  filth  accumulating  in,  about  and  under  the  same  shall  be  removed  at  least  once 
a  week  and  oftener  if  so  ordered,  and  on  the  failure  of  any  owner  or  occupier  of  such 
premises  so  to  do,  then  the  same  shall  be  done  by  the  hoard  of  health  at  the  expense 
of  the  owner."  - 


1  Delaware  Laws,  Vol.  10,  Chap.  345,  Sec.  3. 

-  Scranton,  Rules  and  Regulations  of  Board  of  Health,  Sec  10. 


SPEC  IFK '    XCls.  J  m  ■  ES.  169 

Most  communities  rely,  not  so  much  on  rules  and  regulations,  for 
the  prevention  of  nuisance  from  the  keeping  of  hogs,  as  they  do  upon 
licenses.  The  surest  way  is  to  forbid  the  keeping  of  hogs  without  a 
license,  and  then  withhold  or  revoke  the  license  if  the  hogs  are,  or  are 
likely  to  become  a  nuisance.  Nearly  every  city  which  takes  cognizance 
of  the  matter  at  all  attempts  to  control  the  nuisance  in  this  way. 
Licenses  are  usually  issued  for  a  year  and  are  revocable.  A  fee  is  often 
charged,  varying  from  ten  cents  for  each  hog  in  Newark,  to  one  dollar 
in  Fitch  burg  and  New  Bedford. 

The  yarding  of  hogs  for  sale  or  preparatory  to  slaughter  is  recog- 
nized as  a  different  matter  from  the  "keeping  '"  of  hogs,  but  requires  a 
permit  in  Chicago,  St.  Louis,  Rochester,  and  elsewhere.  The  unload- 
ing of  hogs  and  driving  them  through  the  streets  requires  a  permit  in 
New  York  City  and  the  manner  of  driving  them  also  is  regulated  as 
is  referred  to  in  connection  with  Slaughter  Houses. 

Other  Animals. 

Permits  are  sometimes  required  for  the  keeping  of  other  animals 
than  swine,  horses,  and  cattle.  Fowls  are  frequently  the  cause  of  con- 
siderable nuisance,  and  every  health  officer  in  a  city  of  any  considerable 
size  must  have  a  good  many  complaints  in  regard  to  them.  Geese  and 
ducks  ar<-  even'worse  nuisances  than  fowls,  hut  they  arc  not  so  com- 
monly kept.  Goats  also  may  become  a  nuisance.  Dogs  are  a  common 
cause  of  nuisances  from  the  filth  they  produce,  the  noise  due  to  the 
barking,  and  their  lutes  and  their  destruction  of  property.  The  regula- 
tions concerning  the  keeping  of  cows  will  he  considered  in  connection 
with  the  milk  supply.  The  control  of  dogs  is  usually  attempted  by 
means  of  general  police  regulations  —  provisions  being  made  for  their 
license  and  for  the  payment  of  damages  done  by  the  licensed  A<>^. 
This  will  not  be  considered  in  this  hook  but  the  measures  taken  to  pre- 
\eiit  the  spread  of  hydrophobia  will  he  considered  in  connection  with 
diseases  of  animals. 

There  are  certain  regulations  in  regard  to  animals  which  do  not 
property  he  long  among  sanitary  rules  but  yet  are  sometimes  found  there. 
Among  such  are  regulations  for  the  driving  of  dangerous  animals 
through  the  streets  and  for  the  prevention  of  the  straying  of  animals 
on  the  highways,1  and  the  prevention  of  cruelty  to  animals  such  as 
tying  calves  by  their  legs  and  necks  while  the}  are  being  transported, 
and  i he  overdriving,  heating  or  starving  of  animals.2 

'  n\  .a  \.-w  STork,  Sanitary  Code  (1899)  10. 

-  Cincinnati,  Manna!  of  Health  Department  1 1- 


170  SPECIFIC    NUISANCES. 

The  yarding  of  animals,  whether  they  be  cattle,  swine,  geese,  goats 
or  horses  is  forbidden  in  many  cities,  as  Chicago,  Memphis,  New  York, 
and  Rochester,  unless  a  permit  is  obtained  from  the  board  of  health  : 

L'  That  no  cattle,  swine,  pigs  or  sheep,  geese,  goats  or  horses,  shall  be  yarded 
within  the  city  of  Chicago,  without  the  permit  of  said  commissioner,  or  otherwise 
than  according  to  the  regulations  of  the  department  of  health.111 

Cleanliness  of  the  apartments  in  which  animals  are  kept  is  often 
compulsory,  as  in  Cambridge  : 

"All  henneries,  dog  kennels,  and  pens  for  any  animals  shall  be  kept  clean  and 
free  from  decaying  food,  and  from  filth  of  any  kind.  The  buildings  and  pens  shall 
be  white-washed  or  disinfected  and  put  in  such  condition  as  may  be  "ordered  by  the 
board  of  health.11  - 

In  Bridgeport3  the  board  of  health  may  order  the  removal  of  any 
offensive  sty,  stable  or  hennery,  and  if  the  order  is  not  obeyed,  the 
board  of  health  may  remove  it  at  the  cost  of  the  city. 

Animals  in    Dwellings. 

The  keeping  of  certain  animals  in  dwelling  houses  is  often  forbid- 
den. Among  the  animals  coming  under  this  prohibition  are  cattle, 
horses,  swine,  goats,  geese,  and  fowls.  In  Fall  River  fowls  are  not  to 
be  kept  in  a  store.4 

The  following  rule  is  from  Lynn: 

u  No  person  shall  keep  any  fowl  or  animal  in  any  part  of  a  dwelling  house,  or  in 
any  place  in  the  city. where  the  board  of  health  may  deem  such  keeping  detrimental 
to  the  health  or  comfort  of  the  residents  of  the  neighborhood,  or  to  those  who  may 
pass  thereby;  and  said  board  shall  have  the  power  to  remove  or  cause  to  be  removed 
therefrom,  any  such  fowl  or  animal  so  kept.115 

Noisy  A  n't  m<th. 

These  are  the  subject  of  regulation  in  several  cities.  The  follow- 
ing rule  from  Camden,  X.  J.,  being  the  form  generally  used: 

"  JSY>  person  owning,  occupying  or  having  in  charge  any  stable,  house  or  other 
premises  shall  keep,  or  have  or  allow  thereon,  any  dog,  calf,  bird  or  other  animal 
which  shall  by  noise  disturb  the  quiet  or  repose  of  those,  or  anyone  therein,  or  in 
the  vicinity,  nor  shall  the  unnecessary  blowing  of  steam  whistles  or  the  unnecessary 
ringing  of  bells  be  permitted  in  the  city,  and  any  person  offending  against  any  of 
the  provisions  of  this  section  shall  forfeit  and  pay  a  penalty  of  ten  dollars.118 


1  Chicago,  .Municipal  Code  (1881),  Sec.  1461. 

2  Cambridge,  Regulations  of  Board  of  Health  (1897),  Sec.  22. 
■'  Bridgeport,  Ordinances  of  1802,  No.  14,  Sec.  4. 

4  Fall  River,  Regulations  Board  of  Health  (1894),  Sec.  50. 

5  Lynn,  Rules  of  Board  of  Health  (1896),  Sec.  29. 
8  Camden,  Sanitary  Code  (1894),  Sec.  26. 


SP  K<  IFK  '    NT  USA  m  1ES.  171 

Breeding  of  Animals. 

This  is  forbidden  in  Buffalo  : 

"No  person  shall  maintain  any  establishment  within  the  city  limits  for  the 
breeding  of  animals  which  may  in  any  manner  be  detrimental  to  health."'  ' 

Among  the  animals  which  are  sometimes  licensed  or  concerning 
which  special  regulations  are  adopted  are  the  following: 

Cattle. 

Most  regulations  in  regard  to  cattle  are  designed  to  secure  the  wel- 
fare of  the  animals  themselves,  but  the  following  from  Cleveland  has 
regard  to  their  human  neighbors  : 

"No  person  shall  keep,  stable,  or  corral  any  cow,  calf  or  other  bovine  animal 
within  the  city,  other  than  in  licensed  stock  and  slaughter  yards,  nearer  than 
twenty-live  feet  to  any  house,  building,  or  place  in  use  as  a  place  of  human  habita- 
tion, and  in  the  keeping  such  animals  the  distances  they  shall  be  kept  from  human 
dwelling  places  are  prescribed  to  be  and  shall  not  be  less  than  as  follows,  to  wit: 

For  nne  animal,  as  above  specified,  twenty-rive  feet. 

For  two  animals,  as  above  specified,  fifty  feet. 

Fur  three  animals,  as  above  specified,  seventy-five  feet. 

For  four  animals,  as  above  specified,  one  hundred  feet. 

And  for  each  additional  animal,  as  above  specified,  more  than  four,  there  must 
be  at  least  twenty-live  additional  feet  distance  observed."  '-' 

Fowls. 

Permits  are  required  in  Boston,  Haverhill,  Jersey  City,  Newton, 
New  York,  Rochester,3  and  other  cities.  In  the  latter  city  the  permit 
[uired  only  in  the  built  up  portion  of  the  city,  and  the  application 
for  a  permit  must  be  in  writing-.  In  Newton,  .Mass..1  "No  Live  fowl 
shall  be  permitted  to  run  at  large  outside  the  premises  of  its  owner  or 
keeper."  In  Bradford,  Penn.,  no  fowl  can  be  kept  within  twenty-five 
feei  of  a  dwelling.  See  also  the  rule  from  Lynn  on  the  preceding 
page. 

The  following  rule  is  found  in  Erie,  Pemi. : 

"All  coops  or  other  enclosures  for  the  keeping  of  geese,  ducks,  chickens  and 
other  poultry  shall  be  not  less  than  ten  feet  square  and  five  feel  high,  shall  be  al 
le;isi  twenty  feel  from  any  dwelling,  and  shall  be  cleaned  al  least  once  a  week  "i 
oftener  if  ae<  essary.11 6 

In   Jerse}  City,  Rochester,  and  Elmira,  ducks  and   geese,  as  distinct 

from  fowls,  are  specified  as  requiring  permits. 

1  Buffalo,  ( >rdinani  es    1892),  <  lhapter  25,  Sec.  B. 

-  Cleveland,  Ordinances  (1892),  Chapb  528. 

Rochester,  Ordinances  ol  Board  "i  Health  (1895),  No.  17,  Sec.  •''. 
'  Newton,  Report  ol  Board  of  Health  |  1896),  \>.  29. 
■  Erie,  Rules  of  Board  of  Health  1 1898),  p.  22. 


172  SPECIFIC    WZTISAJSTCES. 

Groats. 

Permits  are  required  for  goats  in  Boston,  Camden,  Fall  River,  Haver- 
hill, Jersey  City,  and  Newark.  In  Lowell  goats  are  not  allowed  in  the 
"close  districts,"  in  which  the  keeping  of  swine  is  forbidden,  and  else- 
where a  permit  is  required.      Paterson  has  the  following: 

"  When  a  permit  to  keep  goats  may  be  granted  it  shall  be  understood  that  such 
goats  shall  be  either  kept  within  the  premises  described  in  the  application  or 
tethered  on  pasture,  and  such  proviso  shall  be  stated  on  the  permit.1 

Pigeons. 

' '  Be >  it  ordained  by  the  council  of  the  City  of  Neto  Orleans,  That  it  shall  be  un- 
lawful for  any  person  or  persons  owning  or  harboring  pigeons  to-  allow  them  to  go 
at  large  within  the  city  limits."2 

Vaults  and  *  'esspools. 

There  is  probably  no  form  of  nuisance  which  in  the  aggregate  causes 
so  lnuc!)  annoyance  as  privy  vaults.  A  single  one  of  these  contrivances 
may  render  life  in  a  whole  neighborhood  almost  unendurable  in  the 
summer  time  :  and  when  it  is  remembered  that  until  within  a  very  few 
years  there  was  scarcely  to  be  found  a  city  in  which  large  numbers  of 
vaults  did  not  exist,  it  is  not  to  be  wondered  at  that  the  department  of 
health  has  waged  an  unceasing  warfare  against  them.  It  is  safe  to  say 
that  before  vaults  were  largely  done  away  with  in  the  city  of  the  writer, 
over  three-quarters  of  all  the  complaints  made  to  him  were  in  regard  to 
them.  Privy  vaults  are  not  only  nuisances,  they  are  probably  also  real 
sources  of  danger  to  health.  The  excrements  in  cholera  and  typhoid 
and  perhaps  in  other  diseases  contain  large  numbers  of  pathogenic 
germs,  and  in  fact  it  is  only  through  the  excretions  that  cholera  and 
typhoid  are  spread.  It  is  certainly  much  safer  to  get  rid  of  all  excre- 
ment promptly  by  turning  it  into  the  sewer  than  it  is  to  store  it  up, 
with  all  its  possible  seeds  of  disease,  near  our  dwelling  places.  There 
is  every  reason  to  believe  that  disease  germs  are  harmless  after  they 
reach  a  sewer  (unless  perchance  the  latter  empties  into  a  public  water 
supply),  but  there  is  certainly  a  possibility  they  may  be  spread  from  a 
vault.  The  fact  that  many  cities  which  have  few  privy  vaults  ( and 
which  have  a  good  water  supply),  are  particularly  free  from  typhoid, 
would  lend  color  to  this  belief.  For  these  reasons,  boards  of  health  have 
long  considered  privy  vaults  things  to  be  rid  of,  or  in  failure  of  this  to 
be  rigid!)  controlled.  Such  nuisances  as  these  so  manifestly  come 
under  the  general  authority  granted  to  local  health  boards,  that  it  is 
rare  that    special    authority  in  regard  to  them  is  conferred   by  statute. 


1  Paterson.  Sanitary  Code  (1887),  p.  -JG,  Sec.  9. 

-  New  Orleans,  Ordinance  N"o.  1390,  Council  Series  of  T  September,  1886. 


sp];<  IFl  l  ■    XI  T.v.  1  m  'B&  173 

This  is,  however,  sometimes  done.  Thus  in  Rhode  Island1  the  town 
councils  may  make  rules  and  regulations  in  regard  to  privy  vaults  and 
cesspools,  and  may  regulate  and  control  the  construction  of  the  same 
In  New  Jersey2  hoards  of  health  are  to  regulate  the  construction,  loca- 
tion, and  manner  of  emptying  cesspools  and  privies.  In  Michigan3  and 
Colorado4  hoards  of  health  may  regulate  the  care  of  vaults  and  may 
abolish  them. 

Students  of  social  science  tell  us  that  many  of  the  institutions  and 
customs  which  are  at  the  present  time  unfavorable  to  the  welfare  and 
progress  of  society,  were  at  a  former  period  of  civilization  steps  in  pro- 
gress. It  is  much  the  same  with  the  privy  vault.  While  in  a  modern 
city,  adequately  sewered,  privy  vaults  are  nuisances  to  he  abolished  as 
speedily  as  possihle.  it  is  otherwise  in  new  communities  unprovided  with 
underground  drains.  Here  the  privy  vault  marks  a  forward  step.  It 
is  far  better  than  the  indiscriminate  disposal  of  excreta  on  the  ground. 
So  we  find  that  while  in  the  modern  city  the  privy  vanlt  is  forbidden, 
it  is  required  in  all  unsewered  districts,  whether  of  city  or  country. 
Rules  were  formerly  found  which  required  the  construction  of  a  privy 
vanlt  ami  cesspool  for  every  house,  hut  with  the  introduction  of  the 
water  close!  this  was  allowed  as  an  alternative,  and  with  the  const  ruc- 
tion of  sewers  the  water  closet  was  alone  permitted.  In  a  few  cities 
the  old  rule  requiring  a  privy  vault  for  every  house  still  remains,  hut  is 
usually  modified  h\  a  later  rule  requiring  water  closets  and  sewer  con- 
nections where  there  is  a  sewer.  Sometimes,  as  in  Cleveland,  a  privy 
vault  or  water  closet  is  required  "for  every  building  and  all  premises." 
In  St.  Louis  they  are  to  he  provided  for  ever}  dwelling,  store,  livery 
-Stable,  tenement  house,  warehouse,  factory,  mill,  or  foundry.  In  Cleve- 
land they  must  be  "  of  sufficient  size  and  number  to  accommodate  all  per- 
sons who  work  in  or  inhabit  "  the  premises.  In  Providence  one  vaull  or 
w  ater-dosei  is  required  for  ever)  dwelling  house.  In  Boston  t  he  statute 
requires  not  less  than  one  to  twenty  persons."  In  Chicago  "  ever} 
owner,  lessee,  keeper,  or  manager  shall  provide  or  cause  to  he  provided, 
adequate  privy  vaults  or  water  closets."  In  Denver  the  health  commis- 
sioner may  order  the  owner,  lessee,  agent,  or  occupanl  to  provide  a  privy 
vault,  but  a  hearing  must  be  given  if  desired.  In  the  District  oi 
Columbia,  where  persons  are  employed  for  trade  or  business,  separate 
accommodations  must  be  provided  for  both  sexes.*3      The  rules  in  regard 

1  Rhode  Island,  General  Statutes  1 1890),  Chapter  92,  S  c.  20. 

New  Jersey,  General  Statutes  (1895),  p.  10.30,  Sec.  12. 

Michigan,  Compiled  Daws  (1897),  Sees.  WOO  7. 
'  Colorado,  A.  t  of  IT  April.  1893,  Sec.  7. 

Massachusetts,  <  lhapter  382  ol    1885    Se<  ,  I. 

\ci  of  Congress  of  25  January,  1898. 


174  SPEC  IFK '    JSTVIjS.  1  NOES. 

to  privy  vaults  and  cesspools  are  often  made  to  apply  only  to  those 
constructed  after  the  passage  of  the  act.  The  act  of  Congress  referred 
to  above,  prescribing  the  construction  of  vaults,  was  not  to  affect  old 
vaults  until  one  year  after  its  passage.  Old,  defective  vaults  may  be 
removed  under  general  nuisance  laws,  and  then  the  new  vault,  which  is 
required,  must  be  built  in  accordance  with  the  regulations.  In  Albany 
the  building  or  "  maintenance  "  of  vaults  is  forbidden  without  a  permit, 
and  in  Denver  the  rules  apply  to  vaults  used  or  maintained  as  well  as 
those  to  be  constructed. 

Permits. 

In  very  man}'  cities  a  permit  is  required  from  the  health  department 

before  a  privy  vault  or  cesspool  can  be  constructed.     This  must  be  a 

written  or  printed  permit  : 

"Any  person  intending  to  construct  a  privy  vault  or  cesspool,  shall  first  obtain  a 
written  permit  so  to  do  from  the  health  officer,  which  permit  shall  designate  the 
location  on  lot,  distance  from  any  house,  well,  or  spring,  the  kind  of  vault  and  cess- 
pool, whether  to  be  made  water-tight  or  otherwise,  and  depth  thereof,  and  shall 
state  that  ventilation  is  required.  In  case  any  less  depth  than  ten  feet  is  required  in 
the  construction  of  any  privy  vault,  such  permit  shall  state  that  the  owner,  agent, 
occupant,  or  person  in  charge  of  the  same,  shall  submit  to  all  requirements  there- 
after made  by  the  health  officer  or  the  director  of  police,  intended  to  keep  said  vault 
clean  and  in  good  condition.  Any  person  violating  such  permit,  or  constructing 
any  such  vault  or  cesspool,  without  obtaining  the  same,  or  disregarding  the  rules, 
orders  or  regulations  of  the  director  of  police,  shall  be  punished  as  prescribed  in 
this  subdivision."'  1 

In  ( 'ambridge 

"Every  application  for  such  permit  must  be  in  writing,  accompanied  by  a  plan 
of  the  premises  showing  the  nearest  adjacent  houses,  and  all  public  or  private  ways 
or  places  on  which  the  premises  abut,  and  a  statement  of  the  number  of  persons  for 
whose  use  the  vault  is  intended.""  - 

In  some  places  a  fee  is  charged  for  the  permit,  as  twenty-live  cents 
in  Camden.  In  several  cities  a  permit  is  only  required  if  the  vault  or 
cesspool  is  to  be  on  the  line  of  a  sewered  street.  Often,  as  we  shall  see, 
vaults  and  cesspools  are  forbidden  wherever  there  are  sewers,  and  hence 
in  Cincinnati  an  application  for  a  permit  must  be  accompanied  with  a 
certificate  from  the  proper  department  that  there  is  no  sewer  on  the 
street. 

Inspection. 

Most  rules  which  require  a  permit  also  require  an  inspection  to  see 
if  the  terms  of  the  permit  or  the  rules  of  the  department  have  been  com- 
plied with.      Thus  in  Wilmington  : 

1  Cleveland,  Ordinances  (1892),  Chapter  30,  Sec.  478. 

-  Cambridge,  Regulations  of  Board  of  Health  of  1897,  Sec.  33. 


SPECIFIC    NUISANCES.  \ 


i  •) 


"The  building  inspector,  who,  being  satisfied  by   personal  inspection,  or  by  a 

deputy,  that  this  ordinance  has  been  complied  with,  shall  give  a  certificate  to  that 
effect,  for  which  certificate  the  person  so  applying  shall  pay  to  the  building  inspector 
a  fee  of  fifty  cents,  and  the  building  inspector  shall  make  and  preserve  a  record  of 
all  such  certificates  issued  by  him,  and  shall  deliver,  at  the  end  of  every  three 
months,  a  list  of  the  same  to  the  secretary  of  the  board  of  health,  who  shall  tran- 
scribe the  same  in  a  book  provided  for  the  purpose."  ' 

Not  only  is  the  usual  penalty  in  the  shape  of  a  line  imposed  in  cave 
vaults  are  constructed  or  maintained  contrary  to  the  regulations  pro- 
vided, but  the  vaults  may  be  summarily  destroyed. 

••  And  in  case  the  condition  or  construction  of  any  vault  or  privy  shall  be  different 
from  the  requirements  of  this  section,  the  board  of  health  may  cause  t lie  same  to  be 
cleansed,  repaired,  amended,  altered  or  removed,  at  the  expense  of  the  owner  or 
party  occupying  the  estate  in  which  such  privy  or  vault  may  be;  provided,  they  shall 
lirst  give  such  owner  or  party  occupying  a  legal  notice,  and  allow  the  space  of  at 
least  forty-eight  hours  f< >r  such  owner  or  occupant  to  comply  with  such  notice."  -' 

Location. 

The  distance  of  vaults  from  the  street  line,  lei  line,  buildings,  wells, 
etc.,  is  often  prescribed.  The  distance  which  a  privy  vaull  must  be  set 
from  the  line  of  the  lot  varies  much  in  different  cities.  Two  feel 
perhaps,  is  the  most  common  limit.  Usually  the  limit  for  the  distance 
from  the  lot  line  and  the  street  line  is  the  same,  but  sometimes  it  is  not. 
Thus  in  Buffalo,  a  vault  may  he  within  ten  feet  of  the  street  (or  nearer 
if  an  alley),  or  five  feel  from  the  lot  line;  in  Paterson,  ten  feetfromthe 
street  and  four  feet  from  the  lot  line:  in  Jersey  City,  ten  feel  from  the 
Mivci  and  three  feel  from  the  lot  line,  and  in  Newark,  ten  feel  from  the 
street  and  two  feet  from  the  lot  line,  in  Lowell  the  vault  must  "he  at 
least  two  feet  from  the  line  of  every  adjoining  lot  unless  the  owner  of 
such  lot  shall  consent  and  agree  otherwise."  Vaults  must  he  a  certain 
distance  from  buildings  upon  the  same  or  other  lots.  Thus  in  Bridge- 
port no  privy  vault  must  he  "nearer  than  twent}  feel  of  the  doors  or 
windows  of  any  dwelling  house,  school  or  building."  In  Rochester  it 
must  he  -at  least  fifteen  feet  distant  in  cither  direct  ion  from  any  adjoin- 
ing building  used  for  human   habitation   or   tor  the  storage  oi    human 

food.**     In  Denver  the  distance  is  ten  feet.     In  Patersoi privy  vault 

shall  he  within  fifteen  feet  of  the  foundations  of  a  dwelling  house.  In 
A  iigusta,  ( >;\.,  t  he  rule  is  thai 

"No  surface  privy  Bhall  exist  within  thirtj  feel  of  any  dwelling  house  in  this 
city,  if  i  lie  yard  iu  which  it  is  located  be  of  such  length  and  width  as  i<>  permit  such 
1 . i  i \  >  to  be  of  like  distance  from  the  dwellings  surrounding  it.  In  such  yards  as  ii 
shall  be  impossible  to  obtain  thirty  feel  from  contiguous  dwellings,  then  such  privj 
shall  be  placed  equidistant  from  all  nearest  dwellings  as  far  as  practicable." 


;  Wilmington,  Health  Ordinance,  Sec,  7. 
'  Lowell,  Rules  of  Board  of  Health  (1894),  p.  30    * 
Lugusta,  Sanitary  Ordinances  (188       §<       L0. 


176  specific    NUISANCES. 

In  Utica  a  vault  must  not  be  near  enough  to  a  house  "to  be  detri- 
mental." It  is  still  more  important  that  vaults  and  cesspools  should  be 
far  enough  removed  from  sources  of  drinking  water  to  prevent  pollu- 
tion. In  Denver  no  privy  vaults  shall  be  built  within  ten  feet  of  a 
well,  and  in  Cincinnati  it  must  not  be  within  eight  feet  of  a  cistern.  In 
Utah  and  Utica  a  vault  must  be  fifty  feet  from  a  well;  in  Camden, 
sixty  feet:  in  Westbrook,  Me.,  one  hundred  feet,  and  Spokane,  two 
hundred  feet  : 

•■N"  privy-vault,  cesspool,  or  reservoir,  into  which  a  privy,  water  closet,  cess- 
pool, stable,  or  sink,  is  drained,  unless  it  is  water  tight  shall  be  constructed,  dug  or 
permitted  to  remain  within  one  hundred  and  fifty  feet  of  any  well,  spring,  or  other 
source  of  water,  used  for  drinking  or  culinary  purposes,  unless  the  surface  of  such 
vault,  cesspool  orreservoir  is  at  a  lower  level  than  the  bottom  of  such  well."  ' 

In  .Jersey  City  vaults  are  not  to  be  "within  a  distance  to  be  deter- 
mined by  the  board  of  health  of  any  well  or  cistern,"  and  the  distance 
fixed  is  ten  feet  in  clay  soil  and  twenty  feet  in  sandy  soil. 

It  would   hardly  seem   necessary   to  forbid  the  location  of  vaults  in 

cellars  of  dwellings,  but  such  a  rule  may  be  found  in  Buffalo  and  other 

cities,  and  sad  to  say,  experience  has  proved  it  necessary.      In  Fall  River 

no  privy  shall  open  directly  from  any  living  or  food  storage  room.      In 

Portland,  Ore.,  cesspools   and   privy    vaults   may   not   be    built   in    the 

street.      Sometimes  specific  provision   is  made  for  changing  the  location 

of  vaults  already  built  which  have  become  offensive  : 

L'  Whenever  any  privy  vault  or  cesspool  is  situated  upon  a  lot  on  a  street  in  which 
there  is  no  public  sewer,  if  the  said  privy  vault  or  cesspool  from  any  cause  becomes, 
in  the  judgment  of  the  board  of  health,  offensive  or  dangerous  to  the  health  of  the 
public,  then  the  board  of  health  may  order  a  change  of  location  of  such  privy  vault 
or  cesspool  to  some  other  place  on  the  same  premises.  In  case  the  owner  or  owners 
01  the  premises  upon  which  such  nuisance  exists  shall  neglect  or  refuse  to  obey  such 
order,  within  seven  days  after  the  same  has  been  issued,  then  the  board  of  health 
may  cause  the  same  to  be  done  at  the  expense  of  the  city."  1 

Size. 

In  Rochester  all  privy  vaults  must  be  of  such  dimensions  as  to  con- 
tain at  least  fifty  cubic  feet  for  every  family  or  group  of  live  persons 
using  the  same.  On  the  other  hand  a  maximum  is  prescribed  in  Cam- 
bridge; "the  cubic  contents  of  any  one  vault  shall  not  exceed  eighty 
cubic  feet  unless  otherwise  stated  in  the  permit."  In  the  District  of 
Columbia3  the  maximum  is  eight  cubic  feet,  or  if  a  movable  receptacle 
is  used  two  cubic  feet.  In  Fall  River  it  shall  not  be  less  than  seventy- 
two  cubic  feet.  In  Elmira  it  must  he  between  fifty  and  two  hundred 
and  sixtv  cubic  feet. 


1  Seranton,  Itules  and  Regulations  of  Board  of  Health  (1887),  Sec.  11. 
J  Bridgeport,  Ordinances  (1892),  p.  180,  Sec.  2. 
;  Ad  of  Congress,  25  January,  1898.     Sec.  4. 


SPECIFIC    NUISANCES.  \~- 

Depth. 

All  sorts  of  regulations  are  in  force  concerning  the  depth  required 
for  privy  vaults.  Shallow  vaults  are  sometimes  prescribed  in  order  that 
they  may  hold  less  and  the  contents  consequently  he  removed  oftener. 
In  other  eases  boards  of  health  imagine  that  it  is  desirable  to  have  them 
deep  in  order  to  keep  the  contents  as  far  out  of  the  way  as  possible, 
and  also  in  order  that  if  it  is  a  leaching  vault  the  liquid  may  leach  away 
better.  Again  if  leaching  vaults  are  allowed,  and  wells  are  also  in  use 
to  furnish  drinking  water  the  shallower  the  vault  the  less  the  danger  of 
contamination.  In  Xew  Orleans  privy  vaults  constructed  after  the  pas- 
sage of  the  ordinance  are  not  to  extend  over  two  feet  below  the  surface  of 
the  ground.  In  Paterson  they  must  not  he  more  than  four  feet  deep. 
Most  cities,  however,  require  deep  vaults.  In  Jersey  City  vaults  must 
net  he  less  than  eight  feet  deep.  In  the  Pennsylvania  cities  of  the  second 
class  vaults  must  he  at  least  six  feet  deep,  and  in  Chicago  they  must  he 
six  feet  dee})  if  within  forty  feet  of  a  street,  dwelling  house  or  well, 
hut  in  such  cases  they  must  he  water  tight.  In  Cincinnati  and  St. 
Louis  they    must    he  ten  feet  deep. 

In  Reading,  Pa.,  and  Wilmington.  Del.,  vaults  must  he  twenty  feet 
deep  except  as  otherwise  provided  : 

"  The.  vaults  of  every  privy  which  may  be  constructed  within  the  city  limits,  shall 
be  digged  to  the  depth  of  twenty  feet,  or  shall  be  at  least  six  feet  deep,  al  the  option 
of  the  owner  or  proprietor,  provided,  however,  that  in  case  of  a  well  six  feet  dee].,  it 
shall  be  luiilt  and  floored  with  sound  ami  well  hiirnt  h  ticks,  laid  on  edge  at  t  he  bottom 
and  in  cement  impervious  to  water,  and  the  wall  shall  he  puddled  with  .lay.  one 
tout  thick,  except  when  the  same  is  digged  in  solid  clay  ground,  and  also  provided, 
that  when  rocks,  or  water  permanently  springing  or  flowing  into  the  well  from 
beneath  the  surface  of  the  ground,  or  other  natural  obstacle,  render  it  expedient,  in 
the  judgment  of  the  Building  Inspector,  t  hat  such  well  should  he  made  of  the  depth 

of  twenty  feet,  such  well  may  lie  sunk  to  any  depth  less  than  twenty  feet  and  not 
less  than  si  \  feci .  as  upon  application  to  him  may  he  allowed  by  the  Building  Inspec- 
tor, who  shall  consider  the  circumstances  of  the  particular  case  and  direct  such 
depth  as    lie  deems  eX  pedient.*'  ' 

Materials. 

Unless  it  is  forbidden  l>\  law  the  privy  will  frequently  he  sel  over  a 
simple  hole  in  the  ground2  and  even  if  a  vault  is  provided  it  will,  unless 
otherwise  ordered,  be  walled  in  and  prevented  from  caving  h\  what- 
ever is  cheapest  and  most  convenient.  Usually  this  is  lumber,  or 
perhaps  rough  stones,  and  then  come  well  laid  stone  walls,  and  finally 
brick  or  stone  laid  in  cement.     Rough  wooden  walls  of  board  or  plank. 

or  perhaps  a   hand  arc  the  kinds  id'  \ault    u>nall\    found   beneath  privies 

Wilmington,  Del..  Health  ordinance  (1802),  Sec.  7. 

'The  Report  of   the  Health  Commissioner  of  St.  I s  foi  1893  94,  p 

thai  there  were  Large  numb<  i    -i  such  privies  in  the  city. 

12 


178  SPEC  IFK '    NUISA 1STCES. 

in  the  country  or  small  villages,  and  are  not  unknown  in  cities  of  large 
size.  Thus  in  San  Antonio,  a  rapidly  growing  city,  the  report  of  the 
board  of  health1  states  that  in  1892  there  were  in  the  city  3,000  lumber 
vaults,  1,000  barrel  vaults,  and  1,300  earth  vaults,  by  which  latter  it  is 
to  be  supposed  is  meant  the  primitive  form  of  vault. 

Most  cities  require  that  privy  vaults  shall  be  water-tight,  and  for  this 
purpose  specify  that  they  shall  be  constructed  of  brick  or  stone  laid  in 
cement.  In  Cincinnati  "  in  exceptional  cases  and  by  special  permission 
will  oak  plank  be  allowed  as  a  substitute. "  In  Bradford,  Pa.,  vaults 
may  be  of  two-inch  plank.  Sometimes,  as  in  Newton,  the  walls  are 
simply  to  be  strong  enough  to  keep  from  caving.  In  mo'st  cities  the 
walls  are  to  be  eight  inches  thick.  In  New  Orleans  the  vault  "  shall  if 
built  adjacent  to  any  wall  whether  party  or  otherwise  be  separated  there- 
from by  solid  masonry  of  not  less  than  two  feet  thickness  laid  in  cement 
and  thoroughly  waterproof." 

Special  attention  is  also  given  to  the  bottom  of  the  vault,  In  some 
cities  the  bottom  may  be  of  twelve  inches  of  concrete  or  of  a  single 
piece  of  flag.  While  efforts  are  generally  directed  to  obtaining  a  water- 
tight bottom,  the  opposite  condition  is  occasionally  sought,  as  in  a  cer- 
tain Ohio  town  where  vaults  must  be  tiled  to  carry  off  the  water.  In 
New  <  )rleans  the  walls  of  vaults  must  be  carried  one  foot  above  the 
surface  of  the  ground.  In  Cleveland  all  vaults  must  be  constructed 
in  accordance  with  plans  furnished  by  the  health  officer.  The  plans 
are  shown  in  Fig.  1. 

In  Cleveland  "  '  sewer  vaults '  may  be  connected  with  the  waste 
water  pipes  from  kitchen  sinks  and  with  the  rain  water  spouts  from 
the  roofs  of  dwellings  or  other  buildings  with  sufficient  water  supply 
therefrom  to  keep  the  same  properly  flushed." 2  Vaults  or  closets 
flushed  with  waste  water  from  the  house  have  been  used  to  a  limited 
extent  in  Providence  and  Haverhill,  but  they  were  not  satisfactory. 
They  have  also  been  used  in  Newark  and  Paterson,  but  are  now  for- 
bidden in  Newark.  These  vaults  receive  all  the  drainage  from  the  house, 
and  the  outlet  leading  to  the  sewer  is  closed  by  a  valve  which  can  be 
raised  daily  or  oftener  to  flush  the  vault.  The  valve  and  method  of 
flushing  may  be  used  in  vaults  which  are  flushed  with  city  water.  A 
valve  of  this  type,  shown  in  Fig.  2,  is  made  b}r  John  Royle  &  Sons,  of 
Paterson,  N.  J. 

The  commissioner  of  health  in  St.  Louis  recommends  that  privy 
vaults  be  constructed  of  large  vitrified  pipes.3 


1  San  Antonio,  Report  of  Health  Department  for  1892,  p.  31. 

2  Cleveland,  Ordinances  (1892),  Chapter  30,  Sec.  447. 

3  St.  Louis,  Report  of  Health  Commissioner,  1893,  p.  56. 


si3 /■:<  TFU     XVISAX<  fES. 


179 


<    8"X 


5:0 


8"  > 


Cross-Sect/on  A-B 

Fig.  1. 
Access  ;iinl  Ventilation. 

It  is  often  specified  thai  vaults  shall  Ik-  easj  of  access  in  inspectors 
and  shall  he  provided  with  suitable  openings  for  cleaning,  ami  thai  such 
openings  shall  !>»■  properly  covered.  In  some  cities  vaults  must  be 
ventilated.  In  New  <  Orleans  they  '-shall  have  a  tine  or  ventilator  suffi- 
cienl  lor  ventilation,  extending  above  the  sunt  mm  I'm-  windows  or  com- 
munical  ing  with  a  chimney  . 

Old  Wells  Nol  to  !»«■  Used  as  Vaults. 

Abandoned  wells  arc  willingly  used  b)  landlords  a-  pri\\  vaults,  for 
their  Leaching  capacit}  is  great,  as  the}  extend   down   into  the  current 


180 


SPE<  IFIC    Xfls. I  X(  A.s. 


IZahi^dz/t 


Fie.  2. 


of  ground  water,  and  they  will  therefore  last  a  long  time  without   being 

cleaned.      Their  capacity  for  mischief  is  correspondingly  great,  for  they 

pollute  a  large  area  of  soil  at  a  depth  which   prevents  rapid   oxidation, 

and  they  arc  certain  to  pollute  neighboring  wells.      Hence  this   use  of 

wells  has  been  in  many  cities  forbidden.     Thus  in  Youngstown,  <).: 

"  No  abandoned  well,  coal  bank,  or  coal  sbaft.  whether  in  operation  or  otherwise, 
shall  be  used  as  a  sink,  cesspool,  or  privy  vault." 

An  inquiry  of  the  state  board  of  health  in  1896  showed  that  such  a 
use  of  old  wells  was  generally  forbidden  in  the  state  of  Ohio. 
Sewer  Connection  for  Vaults. 

The  question  of  connecting  privy  vaults  with  sewers  has  been  treated 
differently  in  different  cities.  Sometimes  it  is  considered  advisable  to 
connect  the  vaults  with  the  sewer  in  order,  it  is  presumed,  that  as  much 
offensive  material  as  possible  may  be  daily  removed  from  the  premises. 
Thus  in  Chicago,  when  on  lots  adjacent  to  sewers,  vaults  must  be  con- 
nected therewith.  The  following  regulation  was  adopted  at  Asbury 
Park  : 

"  Every  privy  vault,  cesspool  or  catch  basin  which  now  is,  or  which  hereafter 
may  be  connected  with  a  street  sewer,  sball  be  provided  with  a  wrought-iron  grat- 


s  p  E(  IFIt '    NVI8. 1  m  'ES.  1  s  1 

inc.  the  openings  of  which  shall  not  exceed  one  inch  in  width.  The  bars  of  such 
grating  shall  be  one-half  inch  in  diameter  and  every  grating  shall  be  of  such  size  as 
maybe  in  each  case  in  writing  directed  by  this  board;  no  such  grating  shall  be  of 
less  size  than  fourteen  inches  square.  Said  grating  shall  be  placed  over  the  outlet 
from  said  vault:  the  said  outlet  to  be  placed  in  the  side  of  the  vault,  and  the  bottom 
of  the  outlet  to  be  not  more  than  one  inch  from  the  bottom  of  the  vault.  A  trap 
shall  be  placed  on  the  drain  from  every  privy  vault  or  catch  basin  as  near  as  possible 
to  said  vault  or  catch  basin.'"  1 

( )ii  the  other  hand  connection  with  a  sewer  is  in  some  cities  expressly 
forbidden,  except  by  permission.  The  practice  of  connecting  vaults 
with  sewers  was  formerly  recommended  in  Providence,  but  it  was 
found  very  unsatisfactory.  To  prevent  solids  from  obstructing  the 
drains,  the  vault  had  to  he  practically  a  catch  basin  and  therefore 
rein, lined  partly  full  all  the  time.  It  was  often  neglected  more  than 
before  the  connection  was  made,  the  owner  arguing  that  the  vault  would 
now  lake  rare  of  itself,  and  needed  no  cleaning.  Moreover,  the  drain 
sooner  or  latter  was  sure  to  become  stopped  and  then  the  condition  was 
the  same  as  if  no  connection  had  been  made.  Such  connections  are  not 
now  allowed,  and  they  are  forbidden  in  many  other  cities. 

The  use  of  "school  sinks"  has  heen  advocated  in  certain  cities  and 
under  certain  conditions  as  offering  a  satisfactory  substitute  for  vaults 
where  water  closets  could  not  well  be  put  in.  A  school  sink  is  rssm- 
tially  a  long  narrow  trough  Idled  with  water  and  used  as  a  vault,  and 
flushed  by  hand  at  stated  intervals,  usually  once  or  twice  daily.  A 
brick  and  cement  vault  may  he  constructed,  which  will  answer  the  pur- 
pose, hut  it  is  not  so  si th  or  durable  as  iron  and  is  more  likely  to  gel 

out  of  order.  These  contrivences  are  most  often  used  for  schoolhouses, 
workshops,  and  tenements  which  have  a  competenl  janitor  in  charge. 
They  are  forbidden  in  some  cities  as  being  less  desirable  than  water- 
closets  : 

••  \'o  sluice  vault  so  called,  or  any  form  of  so  called  water-closets,  ha\  ing  ao  flush 
of  water  applied  at  the  time  of  using,  shall  be  constructed  on  any  premises  in  this 
City.11 

In  Providence  they  are  only  allowed  in  factories,  shops,  and  schools. 
and  experience  has  shown  that  in  other  situations  the\  arc  quite  sure 
to  be  neglected.  When  permitted,  their  construction  and  use  is  regu- 
lated. Thus  in  r.uffalo  the\  are  not  to  be  maintained  in  an \  cellar. 
The  following  is  the  Cincinnati  rule: 

"Basin  water-closets  oi  approved  design  maj  be  connected  with  the  sewers. 
Thej  must  be  bo  constructed  as  to  have  a  proper  supplj  of  water,  ami  allow  tin 

be  flushed  oul   clean  to  the  bott ,  and  they  must   so  be  flushed  oul  al    least  once 

everj  day,  and  any  neglect  or  failur< his  point  will   render  the  offender  liable  to 


1  Asbury  Park,  Sanitary  Code  (1897),  Sec.  12. 

■  Cambridge,  Regulations  oi  Board  of  Health  1 1807),  Sec.  82. 


182  SPECIFIC    NUISANCES. 

be  prosecuted  for  causing  a  nuisance.  They  must  also  be  so  constructed  that  the 
contents  can  not  pass  into  the  sewer  without  a  sufficient  quantity  of  water  passing 
into  the  sewer  at  the  same  time."  a 

Overflow. 

Vaults  must  not  be  provided  with  an  overflow  : 

"No  person  shall  construct  any  drain  for  the  purpose  of  conveying  the  waste  water 
or  overflow  from  any  vault  or  cesspool  upon  his  premises,  to  the  sidewalk,  gut- 
ter or  street  surface,  and  all  persons  who  now  have  such  drains  are  required  to 
remove  the  same,  and  no  person  shall  hereafter  allow  any  waste  water  or  overflow 
from  any  drain,  vault  or  cesspool  to  flow  from  his  premises  on  to  the  street  or  side- 
walk." 2 

Boxes  and  Earth  Closets. 

Tubs,  or  boxes,  or  earth  closets   are  sometimes  substituted  for  the 

regulation  privy  vault.     Boxes  set  above  ground  instead  of  an  excavated 

vault  are   in  use   in  several  cities,   among  which   may   be   mentioned 

Atlanta,   District  of  Columbia,  Macon,  Memphis,   Richmond,    Warren, 

and  other  Ohio  cities.     In  Atlanta  excavated  vaults  are  forbidden  and 

boxes  are  required.     There  were  in  1898,  10,797  of  these  in  use.     In 

Memphis  also,  privy  vaults  are  forbidden,  and  it  is  required  that  there 

shall  be 

"  In  their  stead  a  receptacle  for  fecal  matter,  which  may  consist  of  a  water-tight 
box,  with  handles,  holding  from  three  pecks  to  a  bushel,  let  in  under  the  privy  seat, 
or  a  bucket  or  tub  of  such  size  and  construction  as  the  Board  of  Health  may  pre- 
scribe; or  a  cement  platform,  raised  at  the  edges  six  inches  above  the  earth  and 
sloping  toward  the  centre,  may  be  used,  subject  to  the  approval  of  the  Board  of 
Health;  and  at  least  once  a  day  the  excrement  in  the  receptacle  shall  be  covered 
with  dry  earth  or  dry  ashes."  3 

It  will  be  seen  from  the  last  clause  that  the  privy  receptacles  in  that 
city  are  intended  to  be  earth  closets.  The  same  is  true  in  Atlanta 
Avhere  "  the  contents  of  such  receptacles  are  to  be  deodorized  or  mixed 
with  fine  earth  or  coal  ashes  daily.*'  The  material  is  then  removed  by 
the  city  once  or  twice  a  week.  These  privy  boxes  are  considered  by 
the  health  department  to  be  far  superior  to  the  old-fashioned  vaults. 
The  regulations  in  Warren,  O.,  are  still  more  rigid  : 

"In  every  privy  not  having  sewer  connection  or  vault,  there  shall  be  placed 
a  keg,  box,  or  other  receptacle  containing  dry  earth,  ashes,  or  lime,  or  a  mixture 
thereof,  and  a  cup  or  small  shovel  with  which  to  apply  the  same.  Such  privy 
drawer  or  other  receptacle  in  lieu  thereof,  shall  be  thoroughly  sprinkled  at  least  once 
each  day,  with  such  earth,  ashes,  lime,  or  mixture;  shall  never  be  allowed  to  become 
entirely  full;  and  shall  be  completely  emptied  and  disinfected  as  often  as  once  in 
every  six  months."  4 


1  Cincinnati,  Manual  of  Health  Department  (1S08),  Sec.  o7e. 

2  Fall  River,  Regulations  of  Board  of  Health  (1894),  Sec.  22. 

3  Memphis,  Ordinances  (1879),  Sec.  258d. 

4  Warren,  Sanitary  Code  (1897),  Sec.  24. 


&P E(  IFK  '    XL  XV.  I  X(  ■  A'.s. 


183 


A  printed  notice  to  this  effect  is  posted  in  each  privy.  These 
privies  it  will  be  seen,  approach  in  construction  and  use,  the  true  earth 
closets,  and  it  is  such  privies  that  are  permitted  by  the  rules  of 
Newton  and  Fitcliburg,  and  Westbrook,  Me.  This  form  of  privy  has, 
however,  not  been  much  used  in  New  England  cities.  In  the  District  of 
Columbia  the  construction  of  privies  and  their  receptacles  lias  been 
regulated  by  a  recent  Act  of  Congress.1  The  provisions  of  this  act 
are  set  forth  in  the  following  circular  issued  by  the  health  officer  of  the 
District  : 

"  The  following  memoranda,  based  upon  an  Act  to  regulate,  in  the  Districl  of 
Columbia,  the  disposal  of  certain  refuse,  and  for  other  purposes,  approved  January 
2."..  1898,  liave  been  prepared  for  the  guidance  of  persons  contemplating  the  erection 
of  privies: 

"(1)  No  privy  can  be  maintained  lawfully  without  a  permit  from  the  Health  Officer. 
(2)  No  privy  can  be  maintained  lawfully  on  any  lot  for  the  accommodation  of  which 
a  public  sewer  and  a  public  water  main  are  available.  (3)  No  privy  can  lie  con- 
structed or  maintained  lawfully  unless  every  part  of  it  is  at  leas!  live  feet  from  the 
line  of  any  adjoining  lot,  two  feel  from  any  street  or  public  or  private  passageway, 
t.  ,  .el  from  any  building  used  or  intended  to  he  used  as  a  dwelling  or  place  of  busi- 
ness, and  fifty  feet  from  any  well  or  spring  likely  to  be  used  as  a  source  of  water  for 
drinking  or  domestic  purposes.  (4)  Every  privy  must  be  constructed  and  main- 
tained in  such  manner  and  position  as  to  afford  ready  means  of  access  thereto  for 
the  purpose  of  cleaning  it,  and  so  as  to  permit  the  removal  of  the  contents  from  the 
privy  to  the  public  street  without  carrying  them  through  any  dwelling-house  or 
place  of  business.  (5)  Every  privy  must  be  constructed  so  as  to  prevent  undue 
exposure  of  the  occupants. 

11  The  following  figures  represent  vertical  sections  of  privies,  and  show  such 
details  as  are  required  by  law: 


A       l. 


A- 


C- 


l-'io.  3. 
I'm y  u  nil  ;i  movable  receptacle. 


Fio.   i. 
Privj  «uii  ■  ptacli 


\<-i  oJ  <  kmgress,  25  January,  1 398. 


184  SPECIFIC    NUISANCES. 

i. 

lt  The  following  details  apply  to  all  privies  (See  Figures  3  and  4) : 

"(A)  A  sufficient  opening  for  ventilation,  as  near  the  top  as  practicable,  com- 
municating directly  with  the  external   air. 

"  (B)  A  floor  paved  with  some  non-absorbent  material,  and  constructed  so  that 
its  upper  surface  shall  not  be  in  any  place  less  than  four  inches  above  the  level  of 
the  surface  of  the  surrounding  ground  and  have  an  incline  toward  the  door  of  the 
privy  of  half  an  inch  to  the  foot. 

"  (C)  A  receptacle  for  filth,  provided  with  a  suitable  cover  (c)." 

II. 

"If  such  privies  are  to  be  provided  with  a  movable  receptacle,  the  following 
additional  details  are  necessary  (See  Figure  3) : 

"  (D)  A  floor  over  the  whole  area  of  the  space  immediately  beneath  the  seat, 
the  surface  of  which  floor  shall  not  be  in  any  place  less  than  four  inches  above  the 
level  of  the  surface  of  the  surrounding  ground;  such  floor,  and  the  whole  extent  of 
each  side  of  the.  space  between  the  floor  and  the  top  of  the  seat,  to  be  constructed 
of  some  non-absorbent  material. 

L1  (E)  The  seat,  the  aperture  therein,  and  the  space  beneath,  must  be  of  sucb 
dimensions  as  to  permit  the  movable  receptacle  for  filth  (F)  to  be  fitted  beneath  the 
seat  in  such  manner  and  position  as  to  prevent  the  deposit  of  filth  elsewhere  than  in 
the  receptacle.  The  seat  shall  be  so  constructed  that  the  whole,  or  a  sufficient  part 
of  it,  may  be  readily  removed  or  adjusted  so  as  to  afford  adequate  access  to  the 
space  beneath  for  the  purpose  of  cleaning  the  same  and  removing  the  receptacle 
therefrom  or  fitting  it  therein. 

"  (F)  A  receptacle  for  filth,  not  exceeding  in  capacity  two  cubic  feet,  made  of 
metal,  water-tight,  provided  with  handles,  and  so  constructed  that  it  may  be  closed 
with  a  cover  and  made  air-tight  at  the  time  of  its  removal.11 

III. 

"  The  following  details  apply  to  privies  where  the  receptacle  for  fecal  matter  is 
fixed  (See  Figure  4) : 

"  (G)  The  bottom  of  the  receptacle  must  be  in  every  partat  least  four  inches  above 
the  level  of  the  surface  of  the  adjoining  ground,  and  adequate  means  of  access  for 
cleaning  the  receptacle  and  removing  the  filth  therefrom  must  be  provided.  Such 
receptacle  must  not  exceed  in  capacity  eight  cubic  feet,  and  must  be  constructed  of 
such  material  or  materials,  and  in  such  manner,  as  to  prevent  absorption  by  any  part 
of  it  of  any  tilth  deposited  therein,  or  any  escape  of  its  contents  by  leakage  or  other- 
wise, except  in  process  of  cleaning. 

Cesspools. 

These  contrivances  do  not  receive  the  attention  given  to  privy 
vaults,  for  they  are  usually  covered  and  so  not  offensive,  unless  their 
contents  overflow,  though  it  is  true  that  they  contaminate  the  soil  over 
a  larger  area  than  do  vaults,  and  because  of  the  volume  of  liquid  the 
contents  are  more  likely  to  leach  into  wells.  It  is  a  common  provision, 
however,  to  require  cesspools  to  receive  all  the  house  drainage  of  those 
premises  which  are  not  situated  on  the  line  of  sewered  streets.  Thus 
in  Camden  : 

lt  That  no  person  shall  draw  off,  empty,  pump,  or  allow  to  run  into  any  ground, 
gutter,  water-course,  alley,  or  street  the  contents  of  any  sink,  cesspool,  or  privy- 
vault,  or  any  kitchen,  laundry,  or  other  waste  water,  or  any  water  or  liquor  dele- 
terious to   health,  used  by  any  manufacturer  or  other  person  in  any   trade   or  other- 


SPEC  IFK     XUISAX<  ES.  1 8  5 

wise,  from  any  house,  premises,  place  of  business,  manufactory,  hotel,  restaurant 
or  other  place  or  building  in  this  city;  such  drainage,  when  not  connected  -with  a 
sewer,  must  be  collected  into  water-tight  cesspools  or  reservoirs,  provided  with  the 
proper  traps  and  properly  covered,  and  the  contents  of  said  cesspools  cleaned  and 
removed  as  prescribed  in  section  8,  under  a  penalty  of  ten  dollars."  1 

Sometimes,  as  in  Denver,  it  is  required  that  cesspools  be  ventilated. 
It  is  seen  from  the  above  that  the  pipe  leading  to  a  cesspool  from  the 
house  must  be  trapped,  and  this  requirement  is  found  in  other  cities. 
In  several  Massachusetts  cities  a  minimum  capacity  of  eighty  cubic 
feet  is  provided  for;  in  Lynn  this  is  to  be  measured  two  feet  below  the 
ground.  In  Minneapolis  the  cesspool  "is  to  be  of  such  dimensions  as 
the  inspector  of  buildings  may  direct."  In  Augusta,  Ga.,  cesspools  are 
forbidden  and  must  be  discontinued  and  filled  up  within  such  time  as 
Hi-   president  of  the  board  of  health  may  direct. 

Permits  for  cesspools  are  also  sometimes  required,  for  their  construc- 
tion may  be  supervised  by  the  board  of  health.  The  location  of  cess- 
pools is  usually  the  same  as  that  prescribed  tor  vaults;  bin  in  Omaha 
instead  of  being  required  to  be  a  certain  distance  from  the  lot  line,  they 
are  required  to  lie  as  far  towards  the  rear  line  of  the  lot  on  the  alley  as 
possible.  This  is  doubtless  because  a  covered  cesspool  can  be  no 
offense  to  owners  id'  the  alley,  and  the  farther  it  is  from  the  house  the 
Less  danger  there  is  of  its  leaching  into  the  cellar.  It  is  in  a  few  cities 
as  Cambridge,  Camden,  Omaha,  Paterson,  and  Asbury  Park,  required 
that  cesspools  are  to  be  water  tight,  but  it  can  baldly  be  possible  that 
this  ruli'  is  enforced.  In  other  cities  a  more  reasonable  requirement  is 
that  cesspools  shall  be  tight  in  certain  locations.  Thus  in  Fall  River, 
Haverhill,  and  Lawrence,  if  within  twenty  feet  of  the  lot  line  or  the 
foundation  of  a  dwelling,  or  within  fifty  feet  of  ;i  well,  a  cesspool  must 
be  '-absolutely  waier  tight."  The  following  rules  have  been  recently 
recommended  by  the  state  board  of  health  of  Michigan  for  the  location 
of  vaults  and  cesspools : 

'■ill  Forbid  tin-  construction  or  reconstruction  of  anj  cesspool,  within  one 
hundred  feel  of  any  well  the  water  from  which  is  used  for  drinking  or  culinary  pur- 
poses, however  such  cesspool  is  constructed,  which  is  to  receive  the  contents  <•!'  ;i 
water  closet;  (2)  forbid  the  construction  or  reconstruction  of  anj  privj  vault  within 
one  hundred  feel  of  any  such  well;  (8)  require,  or  al  leasl  recommend,  the  use  of  the 

<lr\  earth  closet  and  frequent  re val  of  its  contents  wherever  there  is  ma  a  public 

waul-  supply  ami  complete  water  carriage  disposal  of  excreta  through  sewers; 
(4)  recommend  and  so  far  as  possible  secure  the  extension  of  the  water  supply  and 
public  sewers,  wherever  this  extension  is  practicable,  to  all  residences  or  buildings 

where  otherwise  there  are  wells  endangered  bj  privies  or  cessj Is;  and  (6)  forbid 

the  use  of  cesspools  and  privj  vaults  wherever  it   is  pracl  icable  to  obtain  sew  it  con- 
■  II.*'- 

1  Camden,  Sanitarj  Code  (1888),  Sec.  '••. 

-  Michigan,  Board  of  Health.  Abstract  of  Proceedings,  i">  January,  1808,  p.  7. 


186  SPECIFIC    NUISANCES. 

Cesspools  like  vaults  must  have  proper  approaches  for  cleaning  and 
they  must  usually  be  covered  over. 

Care  of  Vaults. 

Rules  for  the  maintenance  of  privy  vaults  are  as  necessary  as  for 
their  construction.  Naturally  such  regulations  are  found  almost  exclu- 
sively in  local  ordinances  or  rules  of  boards  of  health,  but  occasionally 
they  are  found  in  statutes.  Thus  in  the  act  creating  a  bureau  of  health 
in  the  Pennsylvania  cities  of  the  second  class,1  the  owner  of  the  vault 
which  has  become  offensive,  is  liable  to  a  fine  of  twenty-five  dollars  a  day  ; 
and  in  New  Mexico2  it  is  required  by  statute  that  water  closets,  vaults 
and  cesspools  must  "  be  kept  in  a  healthful  condition."  The  local  rules 
in  regard  to  vaults  are  often  of  this  same  general  character.  In  Boston 
11  no  person  shall  maintain  a  water  closet,  vault  or  privy  in  an  unwhole- 
some, unclean  or  imperfect  place  or  condition."  More  specific  rules  are, 
however,  frequently  found.  Thus  as  was  shown  on  page  152,  it  is  often 
prescribed  what  shall  not  be  allowed  to  go  into  a  vault,  and  in  Cleve- 
land it  is  expressly  provided  who  shall  be  responsible  for  a  violation  of 
this  rule.  In  New  Bedford  if  garbage  is  found  in  a  vault  it  is  at  once 
cleaned  by  the  board  of  health  at  the  owner's  expense.  A  large  amount 
of  liquid  of  any  kind  in  a  privy  vault  renders  it  particularly  offensive 
and  hence  it  is  often  forbidden.      In  Newark  the  sanitary  code  provides: 

"  That  no  rain  water  leader,  waste-pipe  or  soil-pipe  shall  discharge  or  run  into 
any  privy  vault,  nor  shall  any  slops  or  filthy  water  he  deposited  therein,  unless  said 
privy  vault  shall  be  connected  with  a  sewer.11  3 

The  purpose  is  here  evidently  to  permit  the  discharge  of  liquid  into 
a  vault  if  it  is  at  once  permitted  to  run  out  again  ;  but  this  will  do  little 
to  prevent  the  nuisance,  and  the  rule  in  Cincinnati  is  better ;  "  no  roof 
or  surface  water,  or  kitchen  slops  shall  be  allowed  to  flow  into  any  privy 
vault.'" 

An  ordinary  provision  is  that  a  vault  shall  not  overflow  or  become 
full  to  within  a  certain  distance  of  the  top,  Thus  in  Yonkers,  the  sani- 
tary code  provides  as  follows : 

"  Sec.  71.  No  person  shall  draw  off,  or  allow  to  run  off  into  or  upon  any  ground, 
street  or  place  in  the  City  of  Yonkers,  the  contents  (or  any  part  thereof)  of  any 
vault,  privy,  cistern,  cesspool  or  sink;  nor  shall  any  owner,  tenant  or  occupant  of 
any  building  to  which  any  vault,  sink,  privy  or  cesspool  shall  appertain  or  be  at- 
tached, permit  the  contents  or  any  part  thereof,  to  flow  therefrom,  or  to  rise  within 
two  feet  of  any  part  of  the  surface  of  the  adjoining  ground,  or  permit  said  contents 
to  become  offensive." 


1  Pennsylvania,  Chapter  •i.jS  of  1895,  Sec.  7. 

3  New  Mexico,  Chapter  30  of  1891. 

-  Newark,  Sanitary  Code  (1888),  Sec.  35. 


SPECIFIC    NUISANCES.  1ST 

In  Asbury  Park  and  Fitchburg  the  distance  is  one  foot;  in  Provi- 
dence and  Holyoke  one  and  one-half  feet ;  in  Colorado  Springs,  Denver, 
and  Omaha  two  and  a  half.  In  Philadelphia  when  the  contents  are  three 
feet  from  the  top,  01  when  it  leaks  into  a  cellar,  a  vault  must  be  at  once 
eleaiH-d:  in  Cincinnati  and  other  Ohio  cities,  when  four  feet  from  the 
top. 

When  a  vault  docs  become  offensive  or  a  nuisance,  the  nuisance 
may  be  abated  under  a  general  nuisance  law.  In  the  District  of  Col- 
umbia the  recent  Act  of  Congress  referred  to,  authorizes  the  health 
officer  to  clean  privies  and  assess  the  cost  as  a  tax  against  the  property. 

Ordinances  frequently  require  the  disinfection  of  vaults: 

"Sec.  •">U.  All  putrid  oroffensive  material  of  any  kind  whatsoever  and  the  night 
soil  and  the  contents  of  sinks,  privies,  cesspools,  garbage  cans  and  all  noxious  sub- 
stance in  said  city  and  every  receptacle  of  offensive  matter  shall  be  treated  with  dis- 
infectants of  such  kinds,  and  at  such  times  and  in  such  manner  as  may  be  required 
by  the  health  commissioner."  ' 

In  Fall  River  vaults  must  be  disinfected  often  enough  to  keep  them 
free  from  all  offensive  odors.  Jn  Augusta.  G-a.,  privies  must  be  disin- 
fected every  two  weeks. 

Iii  Charleston  vaults  must  be  cleaned  once  a  year.  In  Camden 
vaults  must  be  cleaned  yearly  before  the  first  of  May.  In  Fall  River 
they  must  be  cleaned  whenever  they  become  offensive.  Probably  the 
general  custom,  if  not  the  law,  is  to  cause  vaults  to  be  cleaned  once 
each  year.  The  reports  from  Ohio  cities  to  the  state  board  of  health  in 
1896  showed  that  some  cities  did  not  require  cleaning  more  than  once 
in  two.  three  and  four  years  and  even  five  years.  A  few  cities  required 
it  twice  a  year  and  one  board  of  health  required  cleansing  monthly,  bul 
earth  closets  were  there  hugely  used.  Many  cities  provide  that  when 
vaults  are  cleaned  they  must  be  cleaned  to  the  bottom. 

In  Atlanta  the  sanitary  inspectors  are  required  during  the  spi-i inl- 
and summer  months  to  inspect  each  privy  weekly,  and  if  it  is  found 
offensive,  to  notify  the  owner  or  occupanl  to  pul  ii  in  order  forthwith. 
Failure  to  carry  oul  the  order  within  six  hours  subjects  the  owner  to  a 
fine  or  imprisonment. 

Removal  and   Destruction  of  Vaults. 

Even  with  the  greatest  care  iii  the  municipal  supervision  of  vaults, 
the\  arc  almost  always  nuisances.  Health  officials  are  without  excep- 
tion, agreed  thai  the  only  way  to  be  rid  of  this  nuisance,  is  to  abolish 
the  vaults;  I  nit  the  dest  ruction  of  j » i  i  \  \  vaults  requires  the  substitution 
of  something  else.     The  general  opinion  is  that  water  closets  connected 


1  Denver.  <  Ordinance  it  of  1898. 


188  SPEC  IFK '   xris.  1  m  1ES. 

with  the  sewers,  are  in  most  cases  the  best  arrangements  for  the  disposal 
of  excreta.  To  he  rid  of  as  many  privy  vaults  as  possible  within  his 
jurisdiction,  and  substitute  water  closets  and  sewer  connections,  is  an 
object  that  every  health  officer  has  in  mind.  The  authority  to  make 
rules  for  the  destruction  of  privy  vaults,  and  for  providing  proper  sewer 
connections,  is  doubtless  included  in  every  general  grant  of  sanitary 
legislative  power,  so  that  there  has  not  been  much  special  legislation  on 
this  subject. 

Nearly  all  cities  that  are  provided  with  a  sewer  system  that  is  at  all 
adequate,  are  making  strenuous  efforts  to  be  rid  of  their  privy  vaults 
and  cesspools,  and  this  is  true  of  the  smallest  towns  as  well  as  of  the 
largest.  Nearly  every  health  report  gives  a  list  of  vaults  abolished 
during  the  year.  This  work  requires  in  the  aggregate  a  large  expendi- 
ture by  the  house  owner,  and  in  many  cases  it  entails  some  hardship. 
It  must  therefore  be  prosecuted  with  judgment  and  some  moderation  in 
times  of  depression,  such  as  prevailed  from  1893  to  1898.  Many  cities 
report  that  not  as  many  vaults  were  abolished  in  1894-7  as  in  the  years 
just  preceding.  Cities  that  have  long  pursued  the  policy  of  getting 
rid  of  their  vaults,  are  now  almost  free  from  these  nuisances.  New  York 
City  is  a  conspicuous  example,  and  there  are  few  vaults  now  remaining 
below  Harlem  River.  Boston  and  some  other  of  the  Massachusetts 
cities,  as  Worcester,  Newton,  and  the  town  of  Brookline,  have  very  few 
vaults.  <  hi  the  other  hand  they  are  very  numerous  in  Baltimore,  Phil- 
adelphia, Chicago,  and  St.  Louis.  In  Chicago  in  1892  there  were 
■40,000.  In  Buffalo  at  that  time  there  were  over  25,000,  but  in  four 
years"  time  12,000  of  them  were  abolished. 

The  desired  end   is  frequently  accomplished   by  local  regulations, 

which  may  take  various  forms.      Thus  the   maintenance  or  construction 

of    vaults   on   sewered    streets   may  be   forbidden.     Sometimes,   as    in 

Bridgeport,  the  prohibition  is  only  to  apply  to  the  future  construction 

of  vaults,  more  often  it  applies  to  all  existing  vaults  as  well  as  to  future 

constructions  : 

"No  privy  vault,  cesspool  or  receptacle  of  filth  of  any  kind  shall  hereafter  be 
constructed,  allowed  or  maintained  upon  any  lot  or  premises  abutting  upon  a  street 
in  which  a  public  sewer  is  laid,  but  proper  water  closets,  school  sinks,  latrines,  or 
some  means  approved  by  this  board,  with  a  properly  laid  pipe,  shall  be  provided, 
which  shall  discharge  into  said  sewer;  and  all  such  water  closets,  latrines,  or  other 
means,  shall  be  provided  with  a  flow  of  water  sufficient  to  wash  all  filth  into  the 
public  sewer,  under  a  penalty  of  twenty  dollars  for  a  violation  of  any  part  of  the 
provisions  of  this  section.1"  1 

In  Milwaukee  the  construction  of  vaults  is  forbidden  only  in  certain 
districts,  which   are  defined  by  the  ordinance.     Sometimes  the  prohibi- 

1  Camden,  Sanitary  Code  (1894),  Sec  2. 


sl'K(  IFH  '    XUISA  X(  Ks.  Ig9 

tion  applies  only  to  vaults,  as  in  Milwaukee  and  Cincinnati,  but  in  most 
cities  cesspools   as  well   as   privy  vaults  arc  forbidden.      In  other  cities. 

as  Newark,  vaults  and    cessj Is  art-  not  to  be  constructed  on  the  line 

of  a  sewered  street  without  a  permit  from  the  board  of  health. 

As  most  cities  require  all  buildings  to  be  supplied  with  either  a 
privy  vault  or  water  closet,  the  rides  just  referred  to  practically  compel 
the  putting  in  of  water  closets.  Other  cities,  as  Atlanta,  Camden, 
Cleveland,  Newburgh,  and  Paterson  have  rules  which  definitely  require 
water  closets  for  all  houses  on  sewered  streets. 

At  other  times  the  local  regulation  takes  the  form  of  a  requirement 
that  the  drainage  of  premises  shall  be  connected  with  the  sewer.  Per- 
haps the  most  complete  rules  governing  this  matter  arc  those  recently 
enacted  for  the  District  of  Columbia.1  As  Congress  reserves  to  itself 
legislative  power  in  such  matters,  this  act  is  practically  a  local  regula- 
tion. According  to  this  ad  every  lot  on  a  sewered  street  must  be  con- 
nected with  the  sewer,  so  that  all  the  drainage  of  such  lot,  except  human 
urine  and  fecal  matter,  shall  flow  into  the  sewer,  but  if  there  is  a  water 
main  in  the  street,  then  all  the  drainage,  whether  water  or  liquid  refuse 
of  any  kind,  shall  flow  into  the  sewer;  but  it  is  further  provided  that 
when  there  is  upon  the  lot  -any  building  used  or  intended  to  be  used 
as  a  dwelling,  or  in  which  persons  are  employed  or  intended  to  be  cm 
ployed  in  any  manufacture,  trade,  or  business,  or  any  stable,  shed,  pen, 
or  place  where  cows,  horses,  mules,  or  other  animals  are  kept,"  the  lot 
shall  be  connected  with  both  sewer  ami  water  main,  but  if  there  is  no 
such  structure  on  the  lot.  it  need  not  be  connected  with  either  unless 
ordered  by  the  health  officer.  The  health  officer  is  to  enforce  this  law 
by  ordering  these  connections  made,  ami  after  thirty  days"  notice  the 
Commissioners  of  the  District  may,  after  proper  notice,  do  the  work  and 
the  cost  is  to  be  included  in  the  tax  Levy. 

Sometimes  the  wording;  of  the  Law  as  to  what  drainage  shall  be  con- 
nected  with  the  sewer  is  general,  as  in  the  Providence  act,  where  it  is 
to  be  ■•the  drainage  of  the  land  and  premises."'  In  the  District  oi 
Columbia  it  is.  us  shown  above,  more  specific.  Many  cities,  however, 
do  not  include  so  much  of  the  drainage  in  their  forced  connections. 
'I'll ns  in  Augusta,  Ga.,  il  is  "all  slops  or  other  matter  as  this  board  shall 
decide. ""  In  .\lb.in\  water  closets  and  sinks  are  to  be  connected  with 
the  sewer;  in  Haverhill  all  "sink  water  mid  waste  water,"  and  in  Pater- 
son "nil  ^lo|».s.  filthy  water  and  Liquid  waste." 

Various  expressions  arc  used  to  define  the  Locations  in  which  vaults 
and  cesspools  are  forbidden,  ns  on   "lots  adjoining  a  sewered   street, 

"abutting   on  a    Streel     in    which    a    public    sewer    is    laid,*'    or   "when    a 
1  An  of  Congress,  L9  May.  1890. 


190  SJPJZC  IFK '    NUISA  X(  JJS. 

public  sewer  abuts  the  estate,"  or  "  on  the  line  of  a  sewered  street,"  or 
"adjacent  to  a  street  in  which  there  is  a  main  or  common  sewer,"  on 
**  lots  bordering  on  a  public  or  private  sewer,"  or  "  situated  on  a  public 
or  private  street,  court  or  passageway,  in  which  there  is  a  public  sewer." 
In  other  cities,  as  Yonkers,  no  vaults  or  cesspools  are  allowed  "  wher- 
ever it  is  practicable  to  connect  any  premises  in  the  city  with  a  public 
sewer,"  or  in  Atlanta,  "  when  sewerage  is  accessible,"  or  in  Little  Falls, 
N.  Y.,  "if  within  a  reasonable  distance  ";  in  Spokane,  "if  within  300 
feet  of  a  street  and  the  land  is  platted";  in  Manchester,  N.  H.,  "within 
100  feet."  This  is  quite  an  important  point,  as  estates  are  not  infre- 
quently situated  only  a  short  distance  from  the  sewer,  when  it  would 
lie  perfectly  feasible  to  connect  by  means  of  a  private  drain.  In  St. 
Louis  the  connection  must  be  made  with  street  drains,  whether  private 
or  public. 

Usually  water  mains  are  laid  wherever  sewers  are,  generally  preced- 
ing the  latter ;  but  there  are  exceptions,  and  in  some  cities  it  is  not 
deemed  wise  to  forbid  the  use  of  vaults  (thus  necessitating  water 
closets),  unless  there  is  assured  a  sufficient  water  supply  to  flush  them. 
The  rule  in  Buffalo  forbids  vaults  and  cesspools  only  on  those  streets 
within  the  city  "  where  there  is  a  sewer,  and  the  city  water  is  in  said 
street." 

Power  to  compel  the  destruction  of  privy  vaults  is  contained  in  the 
general  power  over  nuisances  (provided,  of  course,  that  the  vault  is  a 
nuisance,  as  can  be  shown  of  most  of  them).  In  Fitchburg,  Lowell, 
and  some  other  Massachusetts  cities,  vaults  are  thus  dealt  with.  A  case 
in  Lowell  was  carried  to  the  superior  court,  and  a  decision  favorable  to 
the  city  secured.  In  Philadelphia  also,  vaults  are  abolished  as  nui- 
sances and  the  courts  have  upheld  this  action.1 

At  least  three  states,  Massachusetts,2  Michigan,3  and  New  Jersey4 
have  enacted  general  laws  for  the' removal  of  privy  vaults  and  the  mak- 
ing of  sewer  connections,  and  there  are  special  acts  for  Boston,5  Man- 
chester,'1 and  Providence.7     The  following  is  from  Massachusetts : 

"  No  privy  vault  shall  be  established  in  a  city  which  accepts  this  act  either  upon 
premises  situated  on  a  public  or  private  street,  court  or  passage  way,  where  there  is 


1  Pennsylvania,   Supreme  Court  Reports  3,  p.  239;  John  W.  Adams  vs.  Board  of 
Health. 

2  Massachusetts,  Chapters  74  and  132  of  1890. 

3  Michigan,  Compiled  Laws  (1897),  Sec.  44lit>. 

4  New  Jersey,  Chapter  345  of  1896. 

6  Massachusetts,  Chapter  450  of  1889. 
8  New  Hampshire,  Chapter  165  of  1885,  Sec.  7. 

'•  Rhode  Island,  Chapter  777  of  the  Public  Laws  as  amended  by  Chapter  1407  of 
the  Public  Laws. 


spE<  IF1  ( '    XI  rIS,  1  N(  JJs.  19] 

a  public  sewer  opposite  thereto,  or  upon  premises  connected  with  a  public  or  private 
sewer,  without  permission  in  writing  first  obtained  from  the  board  of  health  <>f  such 
city.  And  whenever  there  is  in  such  city  a  privy  vault  so  situated  which,  in  the 
opinion  of  the  hoard  of  health  of  such  city,  is  injurious  to  the  public  health,  said 
board  shall  declare  the  same  to  be  a  nuisance,  ami  forbid  its  continuance,  and  sec- 
tions twenty-one  t<>  twenty-three  inclusive  of  chapter  eighty  of  the  Public  Statutes 
shall  apply  to  such  nuisances  so  declared.'"  ' 

As  will  be  seen  from  the  above,  tin-  act  must  be  accepted  by  a  city 
before  it  becomes  operative  in  that  city.  A  number  of  the  Massachu- 
setts cities  have  accepted  this  ad  and  are  removing  their  vaults  under 
it.     The  form  of  order  used  in  Cambridge  is  shown  in  Appendix  38. 

The  Massachusetts  law  also  compels  connection  with  the  sewer: 

••  Every  building  situated  on  a  public  or  private  street,  court  or  passageway,  in 
which  there  is  a  public  sewer,  shall,  when  required  by  the  hoard  of  health  of  the 
city  or  town  in  which  it  stands,  he  connected  by  a  good  and  sufficient  particular 
drain  with  such  public  sewer.'"  2 

The  Providence  act   is  as  follows: 

"  The  Hoard  of  Aldermen  of  the  City  of  Providence  may  compel  any  abutting 
owner  or  occupant  of  laud  upon  any  street  in  said  city  in  which  there  is  a  sewer,  t" 

connect  the  drainage  of  his  land  and  premises  with  such  sewer,  and  may  direct  said 
owner  or  occupant  to  lill  up  and  destroy  any  cesspool,  privy-vault,  or  ether  arrange- 
ment for  the  reception  of  drainage." 

The  law  also  provides  for  the  service  id'  the  orders  and  for  an  appeal, 
hut  even  during  the  pendency  of  the  appeal  the  hoard  of  aldermen  "may 

cause  ;iii\  cissj 1,  privy  vault,  or  other  arrangement   for  the  reception 

of  drainage  to  lie  filled  up  and  destroyed."  The  hoard  id'  aldermen 
acting  under  this  law  caused  a  certain  vault  to  lie  filled  after  the  appeal 
from  the  order  was  taken.  This  ease  was  argued  at  Length  before  the 
appellate  division  of  the  supreme  court  and  a  somewhat  length}  decision 
amply  affirmed  the  hoard's  pow er.8 

The    Boston   act    requires  the  construction  of  water  closets  ;is   well  as 

a  connection  with  the  sewer,  and   iii  a  case  where  a  vault  was  connected 

with  the  sewer  and  occasionally  Hushed  with  water,  the  intent  of  the 
law   to  require  true  water  closets,  was  affirmed    in  the  superior  court.1 

A  special  limit  of  time  is  given  l»\  some  rules  for  getting  rid  of  vaults 
on  streets  in  which  new  sewers  are  built  In  1'atersoii  this  is  si\t\  days. 
As  the  burden  of  sewer  assessments  is  quite  heavy  in  some  cities  a  much 
Longer   time   is  often    allowed.     In    Providence  over  a    year's   time   is 


Massachusetts,  Chapter  74  oi   L890,  Sec.  L. 
Massachusetts,  Chapter  182  of  L890,  Sec.  1. 

Rhode  Island  Reports,  Vol.  20,  Pari  1..  \>.  285.     Harrington  vs.  Board  .a   Alder 
men  "i  i'p.\  idence. 

'•  155  Massachusetts,  p.  281,  Commonwealth  vs.  Mercy  Roberts. 


192  SPECIFIC    NUISANCES. 

usually  granted  after  the  building  of  a  sewer,  unless  the  vault  is  par- 
ticularly offensive. 

A  penalty  in  the  form  of  a  fine  is  usually  imposed  for  violations  of 
rules  requiring  sewer  connections.  In  St.  Louis  the  fine  is  from  fifty 
dollars  to  two  hundred  dollars  per  day.  Besides  a  penalty  for  failure 
to  make  sewer  connection  as  provided  by  law  it  is  sometimes  as  in 
Yonkers  prescribed  that  "  no  house  hereafter  erected  shall  be  inhabited 
or  used  by  any  person  before  the  same  shall  be  connected  with  a  public 
sewer  if  practicable." 

Filling  Vaults. 

When  privy  vaults  and  cesspools  are  no  longer  in  use  or  are  ordered 
destroyed,  it  is  quite  necessary  that  the  entire  contents  should  be  removed 
and  they  be  tilled  up  with  some  clean  material  as  earth,  sand,  gravel 
or  ashes.  Some  rules  require  that  they  shall  be  disinfected,  and  that 
they  shall  be  filled  under  the  supervision  or  direction  of  the  board  of 
health. 

Private  Sewage  Disposal. 

For  the   District  of  Columbia  the  following  provision  has  recently 

been  enacted  : 

■L  Sec.  13.  That  no  person  shall,  in  said  district,  construct  or  maintain  any  sys- 
tem of  sewage  disposal  by  means  of  broad  irrigation,  sub-soil  irrigation  or  other- 
wise, except  upon  a  permit  issued  by  the  commissioners  of  said  district.  Applica- 
tions for  said  permit  shall  be  in  writing  to  said  commissioners  and  shall  be  accom- 
panied by  detailed  plans  of  the  system  which  it  is  proposed  to  construct  and  main- 
tain; and  no  permit  shall  be  issued  under  this  section  until  said  commissioners  are 
satislied  that  said  system  can  be  maintained  without  nuisance  or  danger  to  public 
health."  J 

Filthy  Shores. 

A  peculiar  form  of  nuisance  has  received  special  attention  in  Brook- 
lyn and  is  liable  to  be  found  in  any  seaboard  city,  though  the  conditions 
for  its  development  are  much  more  favorable  in  Brooklyn  than  else- 
where. For  a  number  of  years  past  Brooklyn  has  had  a  regular  patrol 
of  its  shore  line  for  the  purpose  of  keeping  it  free  from  offensive  material 
cast  upon  it  by  the  tides.  Brooklyn  has  nearly  fifty  miles  of  shore 
front,  much  of  which  is  of  great  value  for  recreative  purposes.  Three 
inspectors  and  a  force  of  shore  laborers  are  employed  during  the  sum- 
mer months.  From  two  to  five  laborers  are  employed  for  each  inspector, 
the  largest  number  during  the  very  hot  weather.  The  following  table 
shows  the  work  of  the  Coney  Island  district  force  for  eight  months 
beginning  April  1,  1895  :  2 

1  Act  of  Congress  25  January,  1898. 

2  Brooklyn,  Report  of  Department  of  Health,  1895. 


spei  'if  n  ■  m  'is.  i  m  fs. 


193 


Table     by     Months.    Showing    the     Wokk    Accomplished    fob    the    Eight 
Months  Beginning  April  1,  1895. 


April 

May 

June 

July 

August  .  .  . 

September 

ber..  .  . 

November  . 


180 
129 

144 
52 
68 
53 
40 
7.-. 


-  r. 

- 


169     170 

167     128 
lit;      94 


03  - 

:—  jj 


82 

171 

116 

38 

56 


147 

14:1 

203 

29 

58 


60  100 

120  20 

147  220 

76  600 

107  669 

191  413 

lit:;  IMS 

255  58 


0 

'— 

20 

36 

9 

•JO 

14 

0 

6 

15 

40 

23 

2 

298 

29 

7 

249 

41 

0 

95 

4 

70 

255 

23 

10 
154 

79 
1,025 

166 

0  74S 

0  001 

2  1,286 

0  1,536 

0  1.110 

1  769 
1  610 


Totals 741     915     972|1,239|2,218     106     154  1,025      28         4    7,462 

Human  bodies,  one  each  in  May,  July,  August  and  November 4 


Gr^nd  total 7.466 

The  inspectors  showed  that  a  very  considerable  number  of  the  dead 
animals  came  from  the  shores  in  and  about  New  York  Bay,  but  a  large 
part  of  the  garbage  and  most  of  the  nuisance  was  due  to  the  illegal 
dumping  of  garbage  from  the  garbage  scows  of  the  various  cities  and 
towns.  Newport  has  had  some  trouble  from  garbage  on  the  beach,  but 
the  matter  of  prevention  lies  in  the  city's  own  hands,  as  all  the  garbage 
dumped  at  sea  is  from  that  municipality.  Trouble  has  occurred  from 
other  sources,  and  it  became  necessary  to  forbid  the  burial  upon  the 
beach  of  dead  animals  and  garbage. 

In  Cambridge,  at  one  time,  a  boat  was  kept  on  the  river  for  eight  or 
ten  months  of  the  year,  to  bury  or  send  down  stream  offensive  matters 
that  floated  onto  the  shore.1 

Public  Dumps. 

The  disposal  of  refuse  will  be  considered  in  another  chapter,  but 
there  is  a  form  of  refuse  nuisance  which  perhaps  had  best  be  mentioned 
here;  and  thai  is  the  nuisance  arising  from  dumps.  Tins  is  no  new 
cause  of  offence,  for  hanciaiii-  has  given  a  very  vivid  description  of  the 
dumping  grounds  of  ancient  Rome.  From  that  time  till  the  present, 
wherever  there  have  been  cities  there  has  probably  been  t  rouble  from  those 

spots  which  ale  sel    aside   for.  0T  ale  unconsciously  selected  as    the    com- 
mon   place    of   deposit    for    indiscriminate  refuse.       Vacant   lots  or  lands 

wherever  they  are  found   in  a  eit\  are  very  attractive  to  the  eyes  of  all 

scavengers  and  all  others  who  have  an)  material  whatever  thai   is  use- 

and   an   encumbrance.     Even  in  those  cities  in  which  the  inunici- 


;  Cambridge,  Report  of  the  Board  of  Health  1892,  p.  7. 
Boston  Medical  and  Surgical  Journal  1886,  Vol.  (  \\\.  p.  541, 

13 


194  SPECIFIC    NUISANCES. 

pality  removes  garbage,  night  soil,  ashes  and  rubbish,  such  lots  in  a  sur- 
prisingly short  time  become  covered  with  all  sorts  of  litter  which  private 
parties  find  more  convenient  to  dispose  of  hi  that  way  than  to  retain  upon 
their  premises  until  the  stated  calls  of  the  official  scavengers.  Thus 
nuisances  arise,  although  the  city  may  be  doing  its  best  to  promptly 
remove  all  refuse  and  dispose  of  it  without  injury  to  its  citizens.  In 
those  cities  in  which  the  removal  of  any  of  the  above  specified  forms  of 
waste  is  left  to  the  individual,  and  is  accomplished  through  the  agency 
of  private  scavengers  the  dump  nuisance  is,  of  course,  much  worse. 
When  much  organic  matter  in  the  shape  of  garbage,  decayed  vegetables, 
dead  animals  and  the  like  find  their  way  to  a  dump,  the  stench  in 
warm  weather  becomes  almost  unbearable ;  but  even  a  small  amount  of 
such  matter  on  the  surface  of  the  ground  is  a  serious  annoyance  to 
neighbors.  Moreover,  the  papers,  straw  and  fine  ashes  which  are  con- 
stantly in  dry  weather  blown  from  the  surface  of  a  dump  render  it 
almost  impossible  to  keep  clean  premises  in  the  vicinity.  Dumps  are 
the  resort  of  children  and  others  seeking  coal,  kindling  wood,  junk,  etc., 
and  the  temptation  to  set  fire  to  the  paper  and  other  inflammable  material 
is  very  great,  so  that  smouldering  fires  are  an  almost  constant  adjunct  to 
a  dump,  and  the  smoke  of  a  slowly  consuming  mass  of  rubbish  brings  a 
still  larger  area  under  the  influence  of  the  nuisance.  Hence  dumps  have 
received  much  official  notice.  The  best  remedy  is  an  efficient  removal 
and  destruction  of  refuse  by  the  city.  Next,  and  in  addition  to  this,  is 
a  control  of  the  dumps  by  rules  and  supervision.  New  York  and 
Brooklyn  where  there  was  formerly  much  trouble  from  dumps  forbade 
the  deposit  of  offensive  material  on  vacant  lots  by  the  following: 

"  That  no  animal  or  vegetable  substance  nor  street  sweepings,  muck  or  silt,  nor 
dirt  gathered  in  cleaning  yards,  buildings,  docks  or  slips,  nor  waste  of  mills  or  fac- 
tories, nor  any  materials  which  are  offensive,  or  tend  by  decay  to  become  putrid,  or 
to  render  the  atmosphere  impure  or  unwholesome  shall  be  deposited  or  used  to  fill 
up  or  raise  the  surface  or  level  of  any  lot,  grounds,  dock,  wharf,  or  pier,  in  or  ad- 
jacent to  the  built-up  portions  of  said  city,  or  any  ground  tilled  for  the  purpose  of 
building  thereon,  unless  pursuant  to  a  special  permit  from  the  department  of 
heal  tlu 

"  That  no  ground  or  material  filled  with  offensive  matter  or  substance,  or  that 
will  emit  or  allow  to  arise,  through  or  from  the  same  any  offensive  smell  or  dele- 
terious exhalation,  shall  (adjacent  to  or  within  the  built-up  portion  of  said  city)  be 
opened  or  turned  up  or  the  surface  thereof  removed,  between  the  first  day  of  May 
and  the  first  day  of  October  of  any  year,  except  according  to  permit  first  therefor 
obtained  from  the  department  of  health."  x 

A  somewhat  similar  provision  is  found  in  the  charter  of  the  City  of 
New  York.  In  Providence  the  duty  of  preventing  nuisance  from  the 
deposit  of  such  material  on  vacant  lots  is  placed  upon  the  owner : 


1  City  of  New  York,  Sanitary  Code  (1899),  Sees.  103  and  104. 


SPECIFIC    NUISANCES.  195 

11  Whenever  land  is  used  as  a  dumping  ground,  the  owner  or  owners  of  such 
ground  or  the  agent  of  said  owner  or  owners,  shall  cause  all  offensive  or  decaying 
matters  to  be  completely  covered  with  earth  or  clean  ashes  immediately  upon  the 
deposit  of  such  matter.1' x 

Iii  Jersey  City  sunken  lots  must  be  fenced  for  the  same  reason,  and 
also  to  prevent  persons  falling  in.  In  Cambridge  it  is  also  provided 
that  if  the  owner  of  a  vacant  lot  wishes  to  raise  the  grade  he  must 
obtain  a  permit  from  the  board  of  health: 

••  No  person  owning  or  occupying  any  premises  within  the  limits  of  the  City  of 
Cambridge,  and  no  city  officer  controlling  or  in  charge  of  city  premises,  shall  cause 
any  ashes,  or  refuse  material  to  be  placed  thereon,  or  shall  allow  such  premises  to 
be  used  as  a  public  dump  for  ashes,  refuse  or  other  material  without  a  permit  from 
the  board  of  health,  and  only  in  accordance  with  such  permit. 

lcAny  person  owning  or  occupying  any  premises  with  this  city,  and  desiring  to 
fill  such  premises  with  dry  waste,  ashes,  or  rubbish,  shall  make  written  application 
to  the  board  of  health  describing  the  land  and  the  filling  material  proposed,  and  also 
the  sources  from  which  he  proposes  to  obtain  the  material. 

■■A  copy  of  Sections  46,  47.  48,  and  49  of  these  regulations  shall  be  posted  con- 
spicuously on  each  clumping  ground  in  this  city. 

•  The  permits  named  in  Section  46  shall  be  in  force  for  three  months,  and  may  be 
renewed  thereafter  for  periods  not  exceeding  one  month  each  by  the  Clerk  of  this 
Board."  - 

In  Cleveland  similar  permission  is  required  and  the  director  of 
public  works  can  order  the  lot  drained  before  it  is  filled. 

Providence  has  special  regulations  to  stop  the  nuisance  caused  by 
flying  and  burning  papers: 

••  No  person  shall  dump  or  deposit,  or  set  fire  to  any  waste  paper  or  other  inflam- 
mable material,  except  upon  land  owned  or  rented  by  such  person."8 

It  is  easy  enough  to  make  such  rules,  but  difficult  enough  to  enforce 
them.  To  enforce  them  absolutely  it  would  require  an  officer  day  and 
night  on  every  place  in  the  city  which  is  used  as  a  dump.  Constant 
supervision  is  necessary.  In  Brooklyn  there  were  in  1895  sixteen 
regular  inspectors  of  the  dumps,  but  the  results  were  far  from  satisfac- 
tory. Notwithstanding  the  sixteen  inspectors  the  dumps  of  Brooklyn 
cannot  be  in  ;i  \er\  sa  \  <  >ry  <•<  >nd  it  ion  if  one  can  judge  from  the  nine 
photographs  following  page  -'1\  of  the  reporl  of  the  health  department 
for  1895. 

A  better  plan  than  mere  inspection  is  the  employment  by  the  city 
of  a  mart  or  men  on  the  dump  to  keep  ii  iii  order.  Level  it  off,  prevent 
the  dumping  of  offensive  matter,  put  out  fires  and  cover  the  decompos. 
ing  matter  which  is  certain  to  find   its  \\a\    there  somehow  or  other,  no 

1  Providence,  Ordinances  (1900),  Chaptei  19,  Sec.  6. 

'Cambridge,  Regulations  of  the  Board  of  Health  (1897),  Sees.  16,  19,  and  51. 
Providence,  Ordinances  (1900),  Chapter  19,  Sec.  9. 


1  96  SPEt  'IF It '    N I  7&  l  x<  'US. 

matter  how  strict  the  supervision.     Of  course  when  a  city  does  the 

removing  of  ashes  and  rubbish  with  its  own  teams,  it  should,  and  usually 

does  take  care  of  its  dumps  if  it  has  any  within  the  limits  of  the  city  ; 

but  even  when  the  scavenging  is  left  to  private  endeavor  it  is  also  often 

considered  a  duty  to  look  after  the  dumping  places.     In  Providence  the 

city  employs  a  man  to  look  after  a  large  dump  on  private  land  near  the 

centre  of  the  city,  and  all  parties  are  encouraged  to  use  this  as  a  dump 

in  order  that  the  material  may  be  as  well  cared  for  as  possible.     Dumps 

are  at  the  best,  a  nuisance  to  all  who  live  or  do  business  near  them ;  but 

those   cities  which  do  not  insist  rigidly  on   the  separation   of  different 

kinds  of  refuse,  and  which   have  no  crematory  for  combustible  rubbish, 

are   liable  to   have  trouble  from  dumps  as  long  as  vacant   lots  exist   to 

tempt  deposits.     In  this  connection  may  be  quoted  the  following  rule 

of  the  board  of  health  of  Fitchburg : 

"  No  person  shall  burn  on  premises  occupied  by  him  any  garbage,  refuse  woolen, 
silk,  leather  or  india  rubber  goods  or  other  substances  so  that  the  same  shall  evolve 
offensive  odors  and  gases  while  burning."  1 

Not  only  is  the  filling  of  lots  with  rubbish  and  offensive  matters 
forbidden  or  controlled  as  above,  but  the  opening  or  disturbing  of  such 
lots  is  also  regulated.  This  is  included  in  the  New  York  rules  quoted, 
and  in  similar  rules  in  other  cities. 

Lot*  Covered  with  Stagnant  Water. 

Town  or  city  lots  covered  with  stagnant  water  require  quite  a  dif- 
ferent treatment  from  large  areas  of  swampy  land  in  agricultural  dis- 
tricts. The  area  of  such  city  lots  is  not  usually  great,  they  do  not  as 
a  rule  need  draining,  but  simply  filling,  and  the  cost  of  making  the 
improvement  is  generally  offset  by  a  corresponding  gain  in  the  value  of 
the  property.  Such  lots  are  often  serious  nuisances  for  they  may  not 
only  help  the  spread  of  malarial  disease,  but  they  often  are  depositories 
of  all  sorts  of  filth ;  in  fact  "  dumps,"  and  hence  are  offensive  because 
of  the  foul  odors  that  come  from  them.  It  would  seem  reasonable  to 
deal  with  such  conditions  by  means  of  the  power  given  in  general  nui- 
sance laws.  Stagnant  pond-holes  can  be  abated  as  are  other  nuisances. 
The  case  of  the  City  of  Salem  vs.  Eastern  Railroad  Co.2  demonstrates 
this.  Nevertheless  it  is  sometimes  deemed  advisable  to  make  special 
statutory  provision  for  this  form  of  nuisance  : 

"  The  board  of  health  shall  have  full  power  and  authority  to  make  such  by-laws 
and  ordinances  as  said  board  shall,  from  time  to  time,  deem  necessary  and  proper, 
for  the  filling,  draining  and  regulating  of  any  grounds,  yards  or  cellars,  within  the 
city,  that  may  be  sunken,  clamp  or  unwholesome,  or  which  it  may  deem  proper  to- 


1  Fitchburg,  Rules  of  the  Board  of  Health  (1897),  p.  4,  Rule  3. 
-  Massachusetts  Reports,  Vol.  98,  p.  431. 


SPECIFIC    NUISANCES.  197 

fill,  drain,  raise,  lower  or  regulate,  and  also,  for  causing  all  such  lots  of  ground  in 
the  city  adjoining  the  Hudson  river  or  the  East  river,  or  Long  Island  sound,  as  it 
may.  from  time  to  time,  think  proper,  to  he  filled  with  wholesome  earth  or  other 
solid  materials,  so  far  into  the  said  rivers  respectively  as  said  board  shall,  from  time 
to  time,  derm  expedient  for  promoting  the  health  of  the  said  city.'"  ' 

See  also  ( )hi<>  Annotated  Statutes  ( 1  900  ).  Section  -l\  i9.  In  Boston2 
the  board  of   health  may,  when  the  public  health  demands,  order  any 

lots  not  on  tidewater  filled  to  a  height  of  eleven  foot  above  mean  low 
water.  Considerable  opposition  was  manifested  by  the  owners,  but  bills 
in  equity  were  brought  in  the  superior  court  and  decrees  obtained,  and 
since  then  many  areas  have  been  filled.  In  very  many  cities  rules  art- 
adopted  in  relation  to  lots  covered  with  stagnant  water  without  any 
such  statutory  provision,  for  there  is  little  doubt  that  power  to  legislate 
in  this  direction  is  included  in  any  general  grant  of  sanitary  legislative 
power. 

The  damming  or  obstructing  the  flow  of  water  so  as  to  cause  this 
nuisance  is  forbidden  in  Atlanta  and  Youngstown,  where  a  line  with  a 
maximum  of  $500  is  to  be  imposed.  In  Denver,  Omaha,  Paterson,  and 
Rending  a  pond  of  stagnant  water  on  a  lot  is  declared  a  nuisance  and 
the  owner  of  the  lot  is  therefore  subjected  to  a  fine.  In  other  cities,  as 
Augusta,  Ga.,  District  of  Columbia,  Jersey  City,  New  Orleans,  and 
Rochester,  the  owner  of  such  a  lot  is  to  lie  ordered  to  lill  or  drain  it  and 
on  rieglecl  so  to  do  is  lined.  'J 'he  time  given  varies  from  three  days  in 
.Jersey  City  to  sixty  in  New  Orleans.  In  Newark  it  was,  however,  found 
necessary  to  forbid  the  filling  of  lots  in  the  summer  on  account  of  the 
mixed  garbage  that  was  dumped.3 

In  Atlanta,  Camden,  Charleston,  Cleveland,  Hartford,  and  St.  Louis, 
an  order  to  till  or  drain  wet  and  sunken  lots  may  be  issued  by  the  eit\ 
council  in  Hartford,  city  marshal  in  Atlanta,  the  inspector  in  Camden, 
and  the  hoard  of  health  in  the  other  cities.  If  the  order  to  till  is  not 
obeyed,  the  proper  authorities  can  do  the  work  and  collect  the  costs  from 
the  owners,  and  in  Charleston  it  is  expresslj  provided  that  the  owners 
shall  in  addition  be  subject  to  a  line. 

Swampy  Lands. 

For  centuries  wet,  swampy,  and   boggj  lands   have  been  considered 

nnhe;dtli\  :  ami   there  is  most   excellenl  reason  for  believing  that   such 

localities  are  indeed  fertile  fields  lor  the  developmenl  of  malarial  dis- 
ease. It  is  natural  that  the  dread  of  malaria  should  cause  \er\  great 
efforts  to  be  made  by  communities  to  get    rid  of  such  dangerous  nui- 


New  York.  Chapter  :;7-  ol  L897,  Sec.  121  I. 

Massachusetts,  Chapter  842  of  1898. 

Newark,  Report  of  the  Board  of  Health  (1897),  p.  it. 


198  SPECIFIC    NUISANCES. 

sances.  A  score  of  centuries  ago  extensive  works  were  undertaken  in 
Italy  for  the  purpose  of  draining  marshes  and  rendering  the  surrounding 
region  healthful,  as  well  as  for  bringing  new  areas  under  cultivation. 
Similar  undertakings  have'  been  carried  out  as  occasion  arose  in  all 
civilized  lands. 

The  fens  of  England  have  thus  been  largely  freed  from  malarial  dis- 
ease, as  have  numerous  areas  in  our  own  country.  When  extensive 
drainage  works  are  undertaken  for  improving  a  considerable  territory,  it 
is  almost  always  with  the  chief  purpose  in  view  of  obtaining  a  pecuniary 
reward  in  the  shape  of  large  areas  of  fertile  land.  A  secondary  purpose 
of  rendering  the  region  more  salubrious  may  or  may  not  be  in  mind, 
and  in  any  event  it  is  usually  considered  of  less  importance  than  that 
first  mentioned. 

At  least  seventeen  states  and  territories  have  laws  which  provide 
for  the  drainage  of  wet  and  swampy  lands.  In  very  many  of  these 
states,  especially  those  in  which  there  are  large  areas  of  inarshes  which 
are  likely  to  repay  in  agricultural  products  the  cost  of  drainage,  very 
elaborate  and  comprehensive  laws,  often  covering  many  pages,  provide 
for  the  drainage  of  these  lands  on  a  large  scale.  Such  laws  provide  for 
the  appointment  or  election  of  township  or  county  drainage  commis- 
sioners who  are  to  exercise  control  and  supervision  of  drainage  opera- 
tions within  their  respective  jurisdictions.  The  township  commissioner 
has  jurisdiction  over  drains  which  begin  and  end  in  the  township  ;  the 
county  commissioner  controls  drains  which  extend  from  one  township 
to  another.  Usually  the  inception  of  the  work  lies  with  the  land 
owners,  some  number  of  whom  even  as  small  as  five,  may  petition  for 
the  commissioner.  The  commissioner  then  may  investigate,  and  if  in 
his  opinion  the  proposed  improvement  will  conduce  to  public  health 
or  convenience,  he  may  make  a  survey  and  lay  out  the  course  of  the 
drain  or  drains. 

Cases  arise  which  are  not  as  simple  as  the  filling  of  city  lots  and 
which  do  not,  on  the  other  hand,  require  such  extensive  treatment  as  is 
necessary  for  the  draining  of  large  areas.  It  frequently  happens  that  in 
the  country,  and  sometimes  too  within  the  city  limits,  considerable  areas 
of  swampy  land  are  found  which  would  never  be  drained  for  agricultural 
purposes,  and  yet  it  may  not  be  deemed  advisable  to  let  their  improve- 
ment depend  upon  a  routine  nuisance  order  of  a  board  of  health.  In 
Massachusetts1  there  are  special  statutory  provisions  in  regard  to  just 
such  "  wet,  rotten,  or  spongy  lands  covered  with  stagnant  water,"  which 
are  declared  to  be  nuisances.     On  petition  in  regard  to  such  lands,  the 

1  Massachusetts,  Public  Statutes  (1882),  Chapter  80,  Sees.  28-35,  and  Chapter  338 
of  1887. 


SPECIFIC    NUISANCES.  199 

board  of  health  shall  investigate,  and  if  they  deem  action  advisable,  give 
a  hearing  and  notify  all  interested  parties  to  be  present.  The  board  of 
health  may  thereupon  order  the  nuisance  abated  and  abate  the  same, 
and  the  damages  awarded  shall  be  paid  by  the  town,  and  assessments 
shall  be  made  upon  the  town  or  others  for  benefits ;  but  any  person 
aggrieved  by  the  order  may  appeal  to  the  superior  court,  and  during  the 
pendency  of  such  appeal  all  proceedings  in  abatement  are  stayed.  This 
law  has  been  found  so  unsatisfactory  that  the  city  of  Boston  secured  the 
passage  of  the  special  act  referred  to  on  page  197.  In  several  other 
states,  as  New  Hampshire,  Oregon,  Pennsylvania,  Tennessee,  Virginia, 
and  West  Virginia,  there  are  somewhat  similar  laws  providing  for  the 
abatement  of  nuisances  of  this  character  and  the  assessment  of  the  costs 
of  abating  them.  In  several  of  these  laws  special  attention  appears  to 
be  given  to  the  relief  of  those  owners  of  such  unwholesome  property 
who  desire  to  drain  it;  but  are  prevented  b}~  a  lack  of  proper  outlet,  the 
natural  outlet  being  controlled  by  parties  who  will  not  co-operate.  In 
New  Hampshire  the  selectmen  or  aldermen  are  given  authority  to  act 
in  such  cases,  but  in  most  other  states  commissioners  are  to  be  appointed. 
In  the  City  of  New  York1  the  board  of  health,  when  in  its  opinion  the 
public  health  requires  such  drainage  of  lands,  may  prepare  and  adopt 
plans  for  the  same,  acquire  right  of  way,  and  cause  a  commissioner  to 
make  the  necessary  estimates  and  assessments  as  in  the  case  of  the  lay- 
out of  streets.  In  Connecticut,2  "  when  there  shall  exist  upon  any  prem- 
ises contiguous  to  any  dwelling  house,  swampy  or  wet  places  or  de- 
pressions in  which  a  foul  and  unhealthy  condition  permanently  exists 
arising  from  natural  causes,"  the  health  officer  may  cause  them  to  be 
filled  at  the  cost  of  the  town,  but  unless  expressly  authorized  by  the 
town,  only  $300  can  he  spent  in  any  one  year.  In  New  York,3  if  the 
state  board  of  health  shall  find  that  overflow  from  any  canal  is  the  cause 
of  unhealthy,  swampy  places,  it  shall  report  to  the  superintendent  of 
public  works,  who  shall  forthwith  abate  the  same. 

Offensive  Trades. 

As  was  stated  in  chapter  I.  the  earliest  colonial  legislation  in  regard 
to  offensive  trades  was  in  .Massachusetts  in  1692.     Unfortunately,  the 

necessit)  for  such  legislation  remaining  on  the  statute  hooks  has  eon- 
tinned  to  the  present  day,  and  such  laws  are  found  no!  in  Massaehu- 
set  ts  alone,  hut  in   \  er\    man  y  ot  I  ier  st  ates.       Besides    sneh    general    laws 

relative  to  offensive  trades  this  subject   is  considered   in  charters  and 


1  \.u  Fork,  Chapter  878  01  L897,  Sees.  L214  1218. 

( lonnecticut,  Chapter  L62  oi  L895. 
'  New  Fork,  General  Laws  (1896),  p.  2418,  Public  Health  r.aw.  Sec.  7. 


200  SPECIFIC    NUISANCES. 

special  legislation,  as  in  New  York,  Philadelphia,  Memphis,  and  some 
other  places.  Many  cities,  perhaps  the  majority,  provide  by  means  of 
local  regulations  for  the  control  of  offensive  trades.  Even  those  cities 
which  have  charter  provisions  relating  to  this  subject  or  which  are 
situated  in  states  which  have  legislated  upon  it,  nevertheless  seek  fur- 
ther restrictions  by  means  of  their  own  rules.  Thus  although  there  is 
statutory  legislation  in  New  York  in  regard  to  offensive  trades  both  in 
the  general  laws  and  in  the  charter  for  New  York  City,  yet  the  sanitary 
code  of  the  latter  city  has  a  score  or  more  of  provisions  relating  to  this 
subject.  Most  of  the  local  regulation  of  nuisances  of  this  kind  is  based 
upon  the  grant  of  general  legislative  power  on  sanitary  subjects.  The 
courts  thus  seem  to  uphold  the  notion  of  the  close  relationship  between 
noisome  trades  and  unhealthy  conditions  of  life.  In  Brooklyn  where 
the  broad  terms  of  the  act  simply  authorize  legislation  "  in  regard  to  all 
matters  pertaining  to  public  health"  there  has  been  much  local  legisla- 
tion of  this  kind.  References  to  some  of  the  statutes  relating  to  offen- 
sive trades  are  shown  below.1 

There  are  several  ways  of  dealing  with  offensive  trades :  they  ma}' 
be  relegated  to  some  locality  where  little  or  no  harm  may  be  done,  they 
may  be  controlled  by  some  sort  of  official  supervision,  or  lastly,  they 
may  be  suppressed. 

I. 

•  The  Massachusetts  colonial  law  of  1692  provided   for  the   location 

•of  offensive  trades  and  this  provision  has  been  retained  till  the  present 

time  : 

tl  The  board  of  health  of  a  town  shall  from  time  to  time  assign  certain  places  for 
the  exercise  of  any  trade  or  employment  which  is  a  nuisance  or  hurtful  to  the  inhabit- 
ants, or  dangerous  to  the  public  health,  or  the  exercise  of  which   is  attended  by 


1  Arizona.     Chapter  52  of  1895. 
Colorado.     Act  of  17  April,  1893,  Sees.  51-53. 
Kansas.     General  Statutes  (1897),  Sees.  340-1. 
Massachusetts.     Public  Statutes  (1882),  Chapter  80,  Sees.  84-95. 

Chapter  106  and  193  of  1889. 

Chapter  428  of  1897. 
Michigan.     Compiled  Laws  (1897),  Sees.  445(3-8. 
Minnesota.     Statutes  (1894),  Sees.  1489-97. 

Chapter  175  of  1899. 
Missouri.     Revised  Statutes  (1899),  Sees.  2234-9. 

Chapter  96  of  1899. 
New  York.     Revised   Statutes    (1896),    p.    917,    Domestic    Commerce    Law,    Sec. 

38a-c. 
Ohio.     Annotated  Statutes  (1900),  Sees.  6919-27. 
Pennsylvania.     Brightly's  Purdon's  Digest  (1894),  p.  1612. 
Rhode  Island.     General  Laws  (1896),  Chapter  93. 
Vermont.     Statutes  (1894),  Sec.  4604. 


SPECIFIC    NUISANCES.  201 

noisome  and  injurious  odors,  or  is  otherwise  injurious  to  their  estates,  and  may  pro 
hihit  the  exercise  of  such  trade  or  employment  in  places  not  so  assigned;  the  board 
may  also  prohibit  such  exercise  within  the  limits  of  the  town  or  in  any  particular 
locality  thereof.     All  such  assignments  shall  be  entered  in  the  records  of  the  town, 
and  may  be  revoked  when  the  board  shall  think  proper."  ' 

The  phraseology  of  this  act  also  appears  in  the  laws  of  Colorado, 
Illinois,  .Maine.  Michigan,  Minnesota,  Rhode  Island,  and  Wisconsin,  and 
perhaps  other  states.  Sometimes  the  statute  is  mandatory  as  in  Mas- 
sachusetts, and  sometimes  permissive  as  in  Rhode  Island.  Usually 
every  noxious  trade  is  included  in  the  operation  of  the  law,  but  in  some 
states  only  specified  trades.  In  Wisconsin  the  law  only  provides  for  the 
location  of  slaughter-houses  in  cities.  The  Rhode  Island  law  names 
"the  business  of  boiling  hones,  depositing  filth,  keeping  swine,  or 
slaughtering  cattle  or  other  animals,"  and  "the  business  of  expressing 
oil  from  fish,"  but  a  later  section  provides  as  follows: 

"The  provisions  of  sections  eight,  nine,  ten  and  eleven  of  this  chapter  shall 
extend  to  tlie  place  of  any  manufacture  of,  or  of  working  in  any  article  or  substance 
the  manufacture  of  which  shall  he  deleterious  t<>  the  health  of  the  neighborhood."2 

While  the  promotion  of  public  health  is  the  main.purpose  of  these 

laws  governing  offensive  trades,  yet  they  are  often  intended  to  have  a 
rather  broader  scope  as  is  shown  by  both  the  Massachusetts  and  Rhode 
Ishmd  statutes.  The  Massachusetts  law  contemplates  municipal  con- 
trol in  trades  which  are  not  only  "hurtful  to  the  inhabitants  or  danger- 
ous to  the  public  health,"  hut  also  such  as  are  ••otherwise  injurious  to 
their  estates,"  and  in  Rhode  Island  the  city  government  may  forbid 
trades  when  "the  public  health  or  the  public  comfort  and  convenience  " 
so  require. 

Sometimes  the  state  law  prescribes  where  offensive  trades  may  not 
be  located.  Thus  the  Ohio  law8  forbids  such  trades  within  a  certain 
distance  of  state  instil iitions. 

This  control  of  offensive    trades    is    usually    placed    in    the    hands    of 

the  board  of  health,  but  sometimes,  as  in  Rhode  [sland,  where  the  town 

council  and  its  e<|  nivalent  the  board  of  aldermen  of  cities  is  ex-officio 
the    hoard    of    health,  ami    where    nevertheless    the    towns    and   cities  arc 

authorized  to  establish  independent  hoards  of  health  ami  have  in  many 
case-  done  go,  the  right  tn  locate  offensive  trades  is  still  vested  ill  the 

town  council.  In  Maine  where  independent  hoards  of  health  are  obli- 
gator} ,control  of  this  class  of  nuisances  is  si  ill  vested  iii  t  he  "municipal 
offices."     Sometimes,  as  in    Denver,  where  permits  for  offensive  trades 

1  Massachusetts,  Public  Statutes  i  L882),  Chapter  80,  Sec.  84. 
-  Rhode  [sland,  General  Laws  (1896),  Chapter  91,  Sec.  19. 
<  'hi...  Revised  Statutes  1 1900),  Se< ,  8924. 


202  «P  E(  IFK '    NUISAm  Ks. 

are  granted  by  the  city  council,  they  can  only  be  granted  with  the 
approval  of  the  health  commissioner.  In  Chicago  slaughter-house  per- 
mits are  issued  by  the  mayor.  In  Cleveland  the  permit  is  to  be  issued 
by  the  director  of  police.  In  Rochester  the  ordinance  requires  that 
"  such  permit  must  be  applied  for  in  writing,  specifying  the  nature  and 
precise  location  of  the  business  or  proposed  business,  and  such  applica- 
tion shall  not  be  acted  upon  until  the  second  regular  meeting  after  snch 
application."     In  Philadelphia : 

"No  permit  shall  be  granted  to  any  person  or  persons  to  carry  on  the  business  of 
boiling  bones  and  dead  animals  until  after  a  careful  inspection  of  the  locality,  build- 
ings, apparatus,  and  the  plans  for  conducting  the  business,  and  the  approval  of  the 
sanitary  committee."  J 

To  the  power  to  locate  offensive  trades  is  usually  added  the  power 
to  revoke  the  order  granting  such  location.  Such  power  of  revocation 
lies  with  the  board  of  health  or  other  board  locating  the  trade,  but  in 
some  states,  as  in  Colorado,  Massachusetts,  Michigan,  and  Minnesota, 
provision  is  made  for  the  revocation  of  the  permit  by  the  proper  court.2 

In  Rhode  Island  the  withdrawal  of  the  right  to  slaughter  must  only 
be  after  giving. two  months'  notice  to  the  owner  in  writing.  In  that 
state  damage  may  by  proper  action  be  obtained  from  the  town  for  any 
loss  "  resulting  from  such  suspension  or  withdrawal "  of  location  of 
slaughter-houses,  but  curiously  enough  a  later  provision  removes  an}7 
such  liability  on  the  part  of  the  town  in  the  case  of  the  fish  oil  business. 

As  the  only  object  of  this  location  of  offensive  trades  is  to  secure 
their  removal  from  parts  of  the  town  or  city  where  they  would  consti- 
tute a  nuisance,  the  board  of  health  may  forbid  their  continuance  in  all 
other  sections  than  those  in  which  they  have  been  located.  In  Rhode 
Island  this  prohibition  is  contained  in  the  statute  and  also  the  penalty, 
which  for  most  trades  is  fixed  at  $50  per  day. 

II. 

A  second  method  of  dealing  witli  noxious  trades  is  by  the  exercise 
of  some  control  over  their  management.  Such  control  assumes  that  the 
nuisance  arising  from  the  business  is  not  necessary,  but  arises  from 
defective  construction  of  buildings,  or  apparatus,  or  from  its  negligent 


1  Philadelphia,  Rules  of  the  Board  of  Health  (1895),  Sec.  182. 
-Massachusetts,  Public  Statutes  (1S82),  Chapter  80,  Sec.  85: 

"  When  it  appears  on  a  trial  before  the  superior  court  for  the  couuty  upon  a  com- 
plaint made  by  any  person,  that  a  place  or  building  so  assigned  has  become  a  nui- 
sance by  reason  of  offensive  smells  or  exhalations  proceeding  from  the  same,  or  is 
otherwise  hurtful  or  dangerous  to  the  neighborhood  or  to  travellers,  the  court  may 
revoke  such  assignment  and  prohibit  the  further  use  of  such  place  or  building  for 
the  exercise  of  either  of  the  aforesaid  trades  or  employments,  and  may  cause  such 
nuisance  to  be  removed  or  prevented.'11 


S  P EC  IFir   xrisA m  <jES.  203 

operation.  It  is  hoped  that  when  the  necessity  for  better  methods  is 
felt  through  pressure  brought  by  the  community  the  business  may  be 
conducted  without  nuisance. 

One  way  of  securing  better  methods  of  conducting  such  trades  is  by 
licensing  them.  The  theory  of  the  license  (when  it  is  really  a  license 
and  not  used  chiefly  as  a  means  of  raising  a  revenue)  is  that  the  license 
will  only  be  issued  under  such  conditions  as  will  secure  a  reasonable 
conduct  on  the  part  of  those  to  whom  the  license  is  granted.  The  so- 
called  offensive  trades  are  thus  often  granted  permits  by  boards  of 
health,  the  board  of  health  presumably  requiring  the  fulfilment  of  such 
conditions  as  will  render  the  trade  inoffensive,  or  comparatively  so 
Sometimes  the  granting  of  such  permission  or  license  is  provider!  for  by 
statute  as  in  New  Hampshire  '  and  Vermont. 

More  often  the  licensing  of  offensive  trades  is  exercised  by  town 
and  city  governments  simply  as  one  of  their  sanitary  functions,  without 
the  grant  of  special  authority.  In  most  ordinances  the  offensive  trades 
to  be  licensed  are  specified;  more  rarely  as  in  Albany  and  Lynn  the 
ordinance  is  framed  in  general  terms  only.2 

Among  the  trades  specified  as  requiring  permits  in  various  cities 
may  be  mentioned  the  tanning,  skinning,  scouring  or  dressing  of  hides, 
or  of  leather,  the  storing  of  green  hides,  the  making  of  varnish  or  boil- 
ing of  oil,  distilleries,  the  making  of  lamp  black,  turpentine,  or  tar,  the 
boiling  of  offal,  bones,  or  swill  fat,  bone  crushing,  boiling,  grinding, 
burning;  shell  burning,  gut  cleaning,  glue  making,  the  beating,  drying, 
storing,  shipping,  or  transporting  of  blood  scrap,  grease  or  offensive 
animal  or  vegetable  matter;  the  manufacture  of  materials  for  manure, 
the  maintenance  of  stock  yards  and  pens,  slaughter-houses,  soap,  coal- 
oil  and  vitriol  factories:  the  storing  of  fertilizers ;  gas  works,  blacksmith 
shops,  potters'  shops,  pottery  kilns,  vinegar  yards,  and  depositories  of 
dead  animals,  manufactures  of  asphalt,  breweries,  fonnderies.  the  smoking 


1  New  Hampshire,  Public  Statutes  (1891),  Chapter  108,  Sec.  15: 
■•If  a  person  shall  use  or  occupy  a  building  or  place  near  a  dwelling-house  or 
schoolhouse,  or  in  the  compact  pari  of  a  town  Cor  a  slaughter-house,  a  pla 
deposit  "i  green  pelts  or  skins,  or  for  trying  tallow,  currying  leather,  or  carrying 
>.ii  any  other  business  thai  is  offensive  to  the  public,  without  the  written  permis- 
sion of  the  health  officers  of  the  town,  he  shall  forfeit  ten  dollars  for  each  month 
such  building  or  place  shall  be  so  used  or  occupied,  to  be  recovered  for  the  use  of 

t  lie   tt>\\  II." 

Llbany,  Sanitarj  Ordinances  (1892),  Sec.  B: 
■•  No  person  or  company  si  mil  erect  or  maintain  anj  manufactory  "i  place  of  busi- 
ness dangerous  to  life  or  detrimental  to  health,  or  where  unwholesome,  offensive  or 
deleterious  "<l'»rs,  gas,  smoke,  deposit  or  exhalations  are  generated,  without  the 
permit  of  the  board  of  health,  and  all  such  establishments  shall  be  kept  clean  and 
wholesome,  bo  ;ts  no!  n>  i>e  offensive  or  prejudicial  to  public  health/1 


204  SPEl  IFIC    milSANt  Es. 

of  fish,  or  meat ;  manufactures  of  starch,  leather,  chemicals,  fertilizers ; 
the  buying,  selling,  or  storing  of  skins,  hides,  rags,  bones,  or  similar 
articles  :  making  egg  dressing,  candle  factories,  hemp  factories,  pork 
houses,  sausage  houses,  acid  restoring,  manufacturing  copperas  from 
sludge  acid,  distilling  sludge  acid,  making  potassic  cyanide,  stone  quarries, 
and  brick  kilns. 

Hogpens  and  the  collection  and  removal  of  waste  products,  as  soap 
grease,  night  soil,  and  garbage,  often  require  licenses,  but  these  subjects 
are  considered  in  another  connection. 

Usually  no  fee  is  charged  for  the  licenses  granted  for  this  purpose, 
but  in  Philadelphia  and  Cleveland  a  charge  of  $10  per  annum  is  made, 
and  in  Chicago  the  fee  for  a  slaughter-house  license  is  $100  per  annum, 
and  for  a  tannery,  $50  per  annum.  In  Arizona  a  $10  fee  must  be  paid 
for  the  preliminary  inspection  of  a  slaughter-house.1  Usually  a  record 
must  be  kept  of  all  such  licenses. 

In  Wilmington,  Del.,  offensive  trades  located  within  one  mile  of  the 
city  must  obtain  a  license. 

The  licensing  of  trades  to  be  of  value  as  ameans'of  preventing 
nuisance,  implies  the  affixing  of  conditions  either  understood  or  expressed, 
under  which  the  trade  shall  be  followed,  and  sometimes,  as  in  New  York 
and  Illinois,  the  power  to  do  so  is  specifically  granted.  In  Cincinnati 
a  regulation  of  the  board  of  public  improvement  requires  the  attach- 
ment of  conditions  to  the  permit.  In  Pennsylvania  bone  boiling  and 
other  offensive  trades  can  only  be  carried  on  "  subject  to  the  supervision 
and  under  the  regulation  of  the  state  board  of  health."  2 

A  very  large  number  of  cities  and  some  states  have  adopted  more 
or  less  extensive  rules  for  the  regulation  of  offensive  trades.  Such  regu- 
lations are  sometimes  of  a  very  general  character,  as  in  Indiana,  Ten- 
nessee, and  the  cities  of  Albany,  Chicago,3  Lynn,  Memphis,  Mobile,  and 
Scranton.4 


1  Arizona,  Chapter  52  of  1895. 

2  Pennsylvania,  Act  of  19  May,  1897. 

8  Chicago,  Ordinances  (1881),  Sec.  1380: 

"  That  no  person  shall  permit  or  have  any  offensive  water  or  other  liquid  or  sub- 
stance on  his  premises  or  grounds  to  the  prejudice  of  life  or  health,  whether  for  use 
in  any  trade  or  otherwise.  And  every  such  establishment  now  existing  shall  be  kept 
cleanly  and  wholesome,  and  be  so  conducted  in  every  particular  as  not  to  be  offen- 
sive or  prejudicial  to  life  or  health.11 

4  Scranton,  Rules  and  Regulations  of  Board  of  Health,  Sec.  7 : 

"  And  all  such  establishments  shall  be  kept  clean  and  wholesome  so  as  not  to  be 
offensive  or  prejudicial  to  public  health;  nor  shall  any  offensive  or  deleterious  or 
waste  substance,  refuse  or  injurious  matter  be  allowed  to  accumulate  upon  the 
premises,  or  be  thrown  or  allowed  to  run  into  any  public  waters,  streams,  water- 
courses, street,  road,  or  public  place,  unless  by  sewer  connection.     And  every  person 


spK(  l/V(  ■    JSTl  rIS,  1  X<  E&  -j  ( )  5 

In  place  of  or  in  addition  to  such  general  prescriptions  as  to  the 
conduct  of  offensive  trades  many  cities  have  made  specific  rules  for  the 
regulation  of  special  kinds  of  business.  Of  all  trades  thai  of  slaughter- 
ing animals  appears  to  be  the  most  productive  of  nuisance.  Other 
offensive  trades  may  be  localized  in  certain  sections  of  the  country  or 
in  a  few  cities  or  even  in  a  single  city  :  but  slaughter-houses  are  very 
numerous  in  all  sections  of  the  land,  and  are  found  in  the  largest  cities 
and  in  the  smallest  villages,  and  even  in  the  open  country.  The  nature 
of  the  business  is  such  that  without  great  care  a  most  serious  nuisance 
at  once  arises.  Hence  slaughtering  has  received  more  attention  than 
other  trades.  The  Massachusetts  law  of  1692  mentions  "slaughter- 
houses,'" and  many  a  modern  ordinance  deals  with  "slaughter-houses 
and  other  establishments  from  which  noisome  odors  may  arise." 

Effort  is  sometimes  made  to  secure  a  concentration  of  the  slaughter- 
ing  business  and  thus  obtain  a  better  control. 

In  18701  the  Brighton  abattoir  was  incorporated.  This  association 
could  condemn  hind  within  two  miles  of  a  certain  point  in  the  town  of 
Brighton  (adjoining  Boston)  "as  the  board  of  health  of  the  city  of 
Boston  shall  by  vote  determine  to  be  suitable  for  the  carrying  on  of 
said  business."  This  land  was  to  be  paid  for  by  condemnation  proceed- 
ings. A  slaughter-house  was  then  to  be  erected:  "but  no  bunding 
shall  be  erected  until  the  plans  thereof  with  all  details  of  construction 
shall  have  been  submitted  to  and  approved  by  said  board  of  health 
of  the  city  of  Boston  or  some  person  designated  by  said  board  to  examine 
said  plans."  In  18762  slaughtering  was  forbidden  in  Boston  excepl  on 
the  property  of  the  Butchers'  Slaughtering  and  .Melting  Association 
(Brighton  Abattoir),  and  the  members  were  required  to  slaughter  all 
animals  brought  to  them  for  thai  purpose,  the  Boston  board  of  health 
in  cases  of  disagreement   to  appoint  inspectors  and  make  regulations. 

New  Orleans  by  ordinance  of  31  March,  1891,  and  by  a  charter  granted 

in  1895,  has  also  established  a  modern  abattoir.  The  abattoir  at  Terre 
Ilante  is  under  municipal  control  and  all  other  slaughter-houses  are 
abolished.  In  L8748  a  general  law  was  enacted  to  promote  the  for- 
mation of  Swine  Slaughtering  Associations.  Under  this  law  a  corpo- 
ration with  a  capital  of  $100,000  to  $500,000  can  condemn  not  over 
100    acres  of   land    for  the    purpose  of   conducting    its    business,  but    the 


or  company  conducting  such   manufacture  or  business  shall  use  the  best  approved 

ami  all  reasonable  means  to  prevent    il sea] t  smoke,  gases,  and  odors,  and  to 

protect  the  health  ami  safety  of  all  operatives  employed  therein.11 

1  Massachusetts,  Chapter  365  of  1870. 
-  Massachusetts,  Chapter  I  it  of  1876. 
Massachusetts,  Public  Statutes  1 1882),  Chapter  197. 


206  SPECIFIC    NUISANCES. 

location  must  be  approved  by  the  state  board  of  health  and  the  alder- 
men of  the  city  or  the  selectmen  of  the  town  in  which  it  is  situated. 
The  land  damages  are  to  be  determined  by  prescribed  legal  proceedings 
before  the  superior  court.  The  corporation  may  erect  buildings  for  its 
business,  but  "  no  such  buildings  shall  be  erected  until  the  plans  thereof, 
with  all  details  of  construction  have  been  submitted  to  and  approved 
by  said  state  board  of  health  or  some  person  designated  to  examine 
them."  Each  member  of  the  corporation  may  conduct  a  slaughtering 
business  on  the  premises  and  permits  may  be  granted  others  to  do  so. 

Rules  for  the  location,  arrangement,  and  construction  of  slaughter- 
houses are  often  found.  In  the  City  of  New  York  it  is  forbidden  to 
kill  any  animal  in  a  market,  and  no  slaughter-house  can  be  on  the  same 
lot  with  a  dwelling.  All  slaughter-houses  must  have  adequate  connec- 
tion with  the  sewer.  A  water-tight  floor  is  essential,  and  in  Cincinnati 
there  "  must  be  no  breakage  of  joints  nor  openings  of  any  kind  except 
into  the  sewer."  It  is  often  required  that  swine  shall  not  be  kept  in  or 
about  a  slaughter-house.  The  reason  is  that  the  swine  always  create  a 
nuisance  and  that  they  are  very  liable  to  become  infected  with  tuber- 
culosis, trichinosis  or  other  contagious  disease.  It  is  frequently  pre- 
scribed that  no  blood  pit  or  dung  pit  shall  be  allowed  in  a  slaughter- 
house.    Cleanliness  is  essential  and  is  prescribed  by  the  following: 

"  Tliat  every  butcher  and  every  person  owning,  leasing  or  occupying  any  place, 
room  or  building  where  any  cattle  have  been  or  are  killed  or  dressed,  and  every  per- 
son being  the  owner,  lessee  or  occupant  of  any  room  or  stable  where  any  cattle  may 
be  kept,  or  market,  public  or  private,  and,  having  power  and  authority  so  to  do, 
shall  cause  such  place,  room,  building,  stall  (and  market,  being  private),  and  their 
yards  and  appurtenances  to  be  thoroughly  cleansed  and  purified,  and  all  offal,  blood, 
fat,  garbage,  refuse  and  unwholesome  or  offensive  matter  to  be  tberefrom  removed 
at  least  once  in  every  twenty-four  hours  after  the  use  thereof  for  any  of  the  purposes 
herein  referred  to;  and  shall,  also,  at  all  times  (unless  some  public  authority  pre- 
vents), keep  all  woodwork,  save  floors  and  counters,  in  any  building,  place  or  pre- 
mises aforesaid,  thoroughly  painted  or  whitewashed.1'  1 

The  following  is  a  rule  of  the  Pennsylvania  state   board  of  health  : 

tlThe  owners,  agents  or  occupiers  of  all  slaughter-houses  are  required  during 
the  months  of  June,  July,  August  and  September,  to  distribute  twice  in  each  week 
not  less  than  twenty-five  pounds  of  chloride  of  lime  about  the  premises,  and  also 
to  remove  the  contents  of  any  manure-pit  or  manure-pile  on  the  premises,  once  in 
each  week,  the  said  premises  and  contents  of  manure-pits  being  hereby  declared  to 
be  nuisances  prejudicial  to  the  public  health,  unless  subject  to  frequent  disinfection 
and  cleaning  as  herein  indicated." 

A  most  elaborate  set  of  regulations  is  found  in  Boston  concerning 
the  Brighton  abattoir.2 


'New  York,  Sanitary  Code  (1899),  Sec.  83. 

2  Boston,  Manual  of  the  Health  Department  (1890),  p.  28. 


SPECIFIC    NUISANCES.  207 

The  sanitary  code  of  the  City  of  New  York  provides  for  the  driving 
.of  animals  to  the  slaughter-house  : 

"And  no  pigs,  swine  or  cattle  shall  be  unloaded  from  any  cars  upon  any  street  or 
public  place  in  the  City  of  New  York,  except  pursuant  to  a  written  permit  from  this 
Department. 

Nor  shall  any  cattle,  pigs,  swine  or  sheep  be  driven  to  any  slaughter-house  in  the 
Borough  of  Brooklyn,  except  between  the  hours  of  eight  of  the  evening  and  one 
hour  after  sunrise  of  the  next  morning:  nor  shall  more  than  twenty  cattle,  or  more 
than  one  hundred  pigs  or  swine,  or  more  than  one  hundred  and  fifty  sheep,  be  driven 
together;  and  they  shall  be  driven  in  streets  and  avenues  (leading  toward  their  desti- 
nation), where  they  will  least  endanger  the  lives  of  human  beings,  as  the  Depart- 
ment (if  Health  may  designate,  provided,  that  when  the  landing  or  transportation  of 
cattle  shall  have  been  delayed  or  prevented  by  ice,  fog  or  unavoidable  accident,  the 
Department  of  Health  may.  at  its  discretion,  give  a  permit  to  land  and  drive  such 
cattle  at  other  hours  than  those  herein  designated. 

Hut  in  no  case  shall  cattle  he  driven  past  any  school  or  church."1 

Rules  are  of  no  avail  without  frequent  inspection,  and  in  Wilming- 
ton the  ordinance  provides  that  the  inspector  shall  visit  each  slaughter- 
house once  a  week,  and  for  neglect,  shall  he  fined  S$5. 

The  rendering-  of  grease  is,  unless  carried  on  with  great  care  a  fer- 
tile source  of  nuisance.  The  rendering  of  dead  animals  also  is  especially 
liable  to  become  a  nuisance,  and  hence  is  absolutely  forbidden  within  the 
limits  of  a  number  of  cities.  The  rendering  of  other  materials,  even 
when  perfectly  fresh,  has  to  he  carefully  guarded,  and  in  many  places 
rules  governing  this  business  have  been  incorporated  in  the  sanitan 
regulations.  The  most  important  points  to  he  controlled  are  the  con- 
struction of  the  works,  the  care  and  cleanliness  with  which  they  are 
conducted,  and  the  materials  treated.  The  rules  adopted  in  New  York 
and  Philadelphia,  lien    given,  illustrate  these  points: 

"  That  no  person  shall  boil  any  offal,  swill,  hones  or  fat  in  the  built  up  portions 
of  said  city,  save  in  ordinary  cooking,  .  .  .  except  with  a  permit  from  the 
depart  menl  of  health. 

•l  That  all  persons  engaged  in  the  business  of  boiling  or  rendering  of  Eat,  lard  or 
animal  matter,  shall  cause  tin-  scrap  or  residuum  to  be  so  dried  or  otherwise  pre- 
pared as  effectually  to  deprive  such  material  of  all  offensive  odors,  ami  to  preserve 
t  he  same  cut  irely  inoffensive  immediately  after  t  he  removal  thereof  from  t  he  recept- 
acles in  which  the  rendering  process  maj  he  conducted, 

-■   Thai   no  fat,  tallow  or  lanl  shall  be  melted  or  rendered,  except  when  fresh  from 

the  slaughtered  animal,  ami  taken  directly  from  the  places  of  slaughter  in  the  Cit] 

■  ■I    New    York,  and  in  a  condition  free  from  sourness  and  taint  ami  all  ot  her  causes  Of 

offense  at  the  time  of  rendering,  and  that  all  melting  and  rendering  are  to  be  in 
Bteam-tighl  vessels,  the  gases  and  odors  therefrom  to  he  destroyed  bj  combustion  or 
other  means  equalrj  effective,  and  according  to  the  best  and  most  improved  means 
and  processes;  and  everything  preceding,  following,  and  in  connection  with  such 
melting  and  rendering,  and  the  premises  where  the  same  shall  be  conducted,  must 
be  free  fr all  offensive  odor,  and  other  cause  of  detriment   to  the  public  health. 

1  New  York.  Sanitarj  (ode  (1899),  Sec.  69. 


208  s  PEC  IFK '    XI rISA  m  1E8. 

No  fat,  lard  or  tallow,  shall  be  brought  into  the  City  of  New  York  to  be  rendered  or 
melted,  and  none  is  to  be  rendered  or  melted  that  has  come  from  any  place  outside 
of  said  city,  except  as  part  of  the  living  animal  and  except  such  fat  as  is  suitable  for" 
food  purposes,  and  is  handled  in  accordance  with  the  terms  of  a  special  permit  in 
writing  from  the  Department  of  Health.11  1 

"  The  floors  of  all  bone  boiling  establishments  and  depositories  of  dead  animals 
shall  be  paved  with  asphalt,  or  with  brick  or  stone  well  laid  in  cement,  or  with  some 
other  impervious  material,  and  shall  be  well  drained.  All  such  establishments  shall 
have  an  adequate  water  supply,  and  a  proper  arrangement  of  hose  or  pipes,  as  will 
enable  thorough  cleanliness  to  be  maintained. 

"  The  boiling  of  bones  and  dead  animals,  etc.,  shall  be  conducted  in  steam-tight 
kettles,  boilers  or  cauldrons,  from  which  the  foul  vapors  shall  first  be  conducted 
through  scrubbers  or  condensers,  and  then  into  the  back  part  of  the- ash-pit  of  the 
furnace  fire,  to  be  consumed,  or  by  other  apparatus  equally  efficient  in  preventing  or 
counteracting  the  offensive  effluvia. 

"  When  bones  are  being  dried  after  boiling  they  shall  be  placed  in  a  closed  cham- 
ber, through  which  shall  be  passed,  by  means  of  pipes,  large  volumes  of  fresh  air, 
the  outlet  pipe  terminating  in  the  fire-pit.1'  2 

These  rules  embody  the  essentials  of  good  rendering ;  steam-tight 
apparatus,  the  proper  disposal  of  steam  and  gases,  and  cleanliness. 

Special  acts  have  recently  been  passed  in  Pennsylvania3  and  Minne- 
sota4 in  regard  to  rendering,  and  other  methods  of  disposing  of  material 
from  dead  animals.  The  Pennsylvania  law  requires  that  all  establish- 
ments used  for  such  purposes  shall  be  licensed  by  the  board  of  health 
and  shall  be  conducted  in  accordance  with  the  rules  of  the  state  board 
of  health.  Such  rules  the  state  board  has  adopted,  and  it  has  also  pre- 
pared a  model  form  for  the  license.  The  Minnesota  law  is  apparently 
designed  primarily  to  prevent  the  use  of  parts  of  dead  animals  for  human 
food,  and  this  is  very  explicitly  forbidden.  Any  method  of  disposing 
of  dead  animals  and  parts  thereof  to  make  any  article  of  commerce, 
requires  an  annual  permit  from  the  state  board  of  health,  for  which  $10 
is  paid :  but  butchers  may  render  the  materials  produced  on  their  own 
premises. 

Dealing  in  hides  is  frequently  the  subject  of  sanitary  legislation. 
In  New  Orleans  it  is  forbidden  to  bring  into  the  city  airy  hides  "  which 
may  tend  to  produce  infection  or  in  any  way  to  injure  or  endanger 
health."  In  Philadelphia  the  vessel  inspector  on  application  being 
made  for  a  permit  to  land  hides  is  to  "  examine  said  hides  and  report  as 
to  their  condition.  Should  they  be  found  sound  the  permit  so  applied 
for  shall  be  issued ;  but  should  they  be  reported  unsound,  the  applica- 


1  New  York,  Sanitary  Code  (1899),  Sees.  99,  101,  106. 

2  Philadelphia,  Kules  of  the  Board  of  Health  (1895),  Sees.  184-6. 

3  Pennsylvania,  Chapter  56  of  1897. 

4  Minnesota,  Chapter  175  of  1899. 


s  pecifk  '  isruis.  i  m  ies.  2  < )  9 

fcion  shall  be  referred  to  the  board  for  action.*"  Other  regulations  are 
here  shown  : 

■•  No  person  shall  keep  for  more  than  twenty-four  hours  any  uncured  hides, 
except  at  the  place  where  the  same  are  to  be  manufactured. 

"No  person  shall  cause,  or  suffer  or  permit  any  skunk  or  coon  skins,  or  other 
skins  of  any  kind,  or  the  skins  of  any  other  animals,  which  emit  an  offensive  odor, 
or  are  in  a  condition  detrimental  to  the  public  health,  to  be  dressed,  cleaned,  kept, 
stored  or  received  in  or  upon  the  premises  owned  or  occupied  l>y  him  or  them.''1  ' 

In  St.  Louis  the  time  during  which  hides  may  be  kept  is  six  hours. 
The  Boston  rule  reads  as  follows: 

••  No  green  or  green-salted  hides  or  skins,  or   horns,  shall  be  cured,  stored,  or 

suffered  to  remain  within  the  limits  of  the  city,  except  upon  floors  which  shall  be 
made  tight  and  impervious  to  liquids,  with  a  proper  pitch,  so  that  all  liquids  and 
tilth  shall  readily  escape  from  the  floor  into  a  suitable  drain,  the  floors  to  he  kepi  at 
all  times  in  a  neat  and  cleanly  condition,  and  so  disinfected  that  no  offensive  odors 
shall  arise  therefrom.  No  such  hides  or  skins  shall  at  any  time  be  suffered  to  remain 
in  or  upon  any  street,  place,  or  sidewalk.  All  horns  shall  be  immediately  removed 
and  placed  in  brine,  or  under  a  cover  of  salt.  If  the  hides,  skins,  or  horns  are 
stored  in  the  basement  of  any  building,  there  shall  lie  such  ventilation  as  shall 
secure  the  remainder  of  the  building  and  t  he  public  from  offensive  odors.11  '-' 

The  charter  of  the  City  of  New   York3  gives   the  board  of  health 

power  to  determine  where  hides  shall  he  stored  and  if  necessary  to 
order  their  removal  or  destruction  or  to  remove  and  destroy  them  if  the 
order  is  not  obeyed. 

The  sale  of  guano  or  fertilizers  is  sometimes  regulated.  In  Atlanta 
guano  is  not  to  he  kepi  for  sale  within  three  hundred  yards  of  a  dwell- 
ing or  place  of  business.  In  Fall  River  "no  person  shall  he  allowed  to 
keep  for  sale,  or  other  purpose,  any  guano  or  fertilizer  of  am  kind  in 
any  place  within  the  city,  unless  by  permission  of  the  hoard  id'  health." 
(  )n  certain  parts  of  the  Atlantic  seaboard  fish  are  spread  upon  the 
land  as  a  manure.  In  Newport,  \\.  I.,  the  following  was  the  rule  adopted 
to  prevent  nuisance  from  this : 

••  No  fish  intended  tor  manure  shall  be  deposited  or  spread  upon  any  land  within 
one  mile  of  the  compact  part  of  the  city,  or  within  fiftj  rods  from  anj  public  high- 
way or  road,  in  any  other  part  of  said  city,  unless  such  tish  shall  he  so  covered  with 
earth,  sand    or   other    materials,  that    no   offensive   smell    shall    arise    therefrom;    nor 

shall  any  person  cause  any  such  fish  to  he  conveyed  into  or  through  any  public  street 
of  said  city  in  anj  wagon,  art,  or  other  vehicle,  unless  the  same  he  perfect  Ij  water- 
tight." ' 

(01s  works  are  often  a  nuisance,  and    New     York    and    Chicago    have 

the   following  rule  : 

••  'I' hat  no  person  ..r  company  being  a  manufacturer  of  gas,  or  engaged  about  the 
manufacture  thereof,  shall  throw  or  deposit  or  id  low  to  run.  or  having  the  right  or 

'  Cleveland,  Ordinances  (1892),  Chapter  30,  Sees.  503   i. 

Boston,  lodes  of  Board  of  Health  1 1890). 

New  York,  Chapter  378  of   1897,  Sees.  L207,  1209,  1211. 
■  Newport,  Ordinances,  Chapter  24,  Sec.  I. 

1 1 


210  SPECIFIC    NUISANCES. 

power  to  prevent  the  same,  shall  permit  to  be  thrown  or  deposited  in  any  public 
waters,  river,  canal,  slip,  or  into  any  sewer  therewith  connected,  or  into  any  street 
or  public  place,  any  gas-tar  or  any  refuse  matter  of  or  from  any  gas-house,  works  or 
manufactory;  nor  shall  any  such  person  or  company  allow  any  substance  or  odor  to 
escape  from  such  house,  works  or  manufactory,  or  make  any  gas  of  such  ingredients 
or  quality  that  any  substance  shall  escape  therefrom,  or  be  formed  in  the  process  of 
burning  any  gas,  which  shall  he  offensive  or  dangerous,  or  prejudicial  to  life  or 
health.  Nor  shall  any  such  person  or  company  fail  to  use  the  most  approved  or  all 
reasonable  means  for  preventing  the  escape  of  odors."  1 

Tanneries  are  a  source  of  nuisance  from  various  causes,  but  par- 
ticularly from  the  wastes  of  various  kinds  that  are  produced.  The  fol- 
lowing are  the  rules  in  regard  to  tanneries  in  force  in  Lowell,  Maine : 

"It  shall  be  the  duty  of  every  owner,  agenl  or  superintendent  of  a  tannery  to 
prevent  the  accumulations  of  fleshings  or  other  offensive  waste  matter  in  or  about 
the  tannery  over  which  he  has  ownership  or  authority.  All  fleshings  shall  be  re- 
moved daily,  and  buried  at  the  time  of  removal. 

•'No  fleshings  shall  be  deposited  near  enough  to  any  highway  to  be  offensive  to 
persons  travelling  in  said  highways,  nor  near  enough  to  dwellings  or  places  of  busi- 
ness to  be  offensive  to  persons  dwelling  or  staying  therein. 

11  The  removal  of  fleshings  and  other  waste  matters  of  tanneries,  and  the  disposal 
of  them  shall  be  only  in  strict  accordance  with  the  orders  of  the  local  board  of 
health."  '- 

The  dealing  in  second-hand  clothing  is  not  exactly  an  offensive 
trade  in  the  sense  in  which  that  term  is  generally  used,  but  it  is  often  ;t 
nuisance  and  is  sometimes  regulated.  Recent  experiments  by  William 
(i.  Bissell,  bacteriologist  of  the  Buffalo  health  department,  have  demon- 
strated that  second-hand  clothing  may  lie  the  bearer  of  tubercular 
bacilli,  as  it  doubtless  may  of  other  pathogenic  organisms/1  The  Atlanta 
regulation  in  regard  to  second-hand  clothing  was  doubtless  adopted  as  a 
precaution  against  yellow  fever  : 

"No  license  shall  issue  to  any  merchant  or  dealer  in  second-hand  clothing  until 

the  applicant  shall  file  with  the  city  clerk  an  affidavit  in  writing,  stating  that  the 
applicanl  does  not  have  on  hand,  directly  or  indirectly,  and  will  not,  during  the 
period  covered  by  the  license  applied  for,  buy,  receive,  keep  on  hand,  sell  or  deal, 
directly  or  indirectly,  in  any  second-hand  clothing  imported  into  said  city  which  has 
not  been  properly  disinfected,  and  certified  and  registered  as  required  by  law  of 
Georgia.  For  making  a  false  affidavit  to  obtain  the  license  aforesaid  the  affiant  shall 
be  subject  to  the  penalty  prescribed  in  fourth  section  of  this  ordinance. 

"  It  shall  not  be  lawful  for  any  merchant  or  dealer  in  this  city  to  sell,  expose  or 
offer  for  sale,  at  his  place  of  business  or  elsewhere  in  said  city,  any  second-hand 
clothing,  or  to  open  any  package,  case,  or  lot  of  second-hand  clothing  shipped  into 
said  city,  or  for  any  railroad  employee  or  other  person  to  remove  the  same  when  so 
shipped  here  from  the  depot  or  express  office,  without  first  obtaining  a  written  per- 
mit from  a  sanitary  inspector,  which  permit  shall  only  be  given  upon  its  being  made 
to  appear  to  such  inspector  by  such  merchant  or  dealer  that  he  has  a  certificate  from 


1  Chicago,  Ordinances  (1881),  Sec.  1392. 

2  Lowell,  Me.,  Rules  of  Board  of  Health  (1802),  Sees.  1,  2,  3. 

3  Buffalo,  Monthly  Report  of  the  Department  of  Health,  March,  1899. 


SPEC  IFK  ■    NZTIS.  1  N't  'A'S.  211 

the  proper  officer  of  the  board  of  health  of  the  place  from  which  said  clothing  may 
have  been  shipped,  which  certificate  shall  set  forth  the  charactei  and  number  of 
garments  to  which  it  refers:  that  they  have  been  properly  disinfected  and  when,  and 
that  there  is  no  danger  of  spreading  contagious  diseases  therefrom:  Provided,  the 
certificate  presented  of  the  officer  of  the  place  shipped  from  shall  not  be  conclusive 
on  the  health  officer  here,  but  the  sanitary  inspector  or  board  of  health  here  may 
inspect  the  same,  and  if  found  to  be  contagious,  such  clothing  shall  be  condemned 
and  notallowed  to  be  sold  until  properly  disinfected.  Such  merchant  or  dealer  shall 
pay  to  said  sanitary  inspector  a  fee  of  one  dollar  for  each  shipment  of  such  clothing 
examined  and  certified  as  above  provided,  which  said  fee  shall  be  turned  into  the 
city  treasury  through  the  clerk  of  council.  Such  inspector  shall  also  file  with  the 
clerk  of  council  a  duplicate  of  each  certificate  given.'"  ' 

The  following  regulations  arc  found  in    regard    to    the   storage    and 

use  of  rags  : 

••  Hereafter  no   rays  or  other  dangerous  material  shall  be  sold  or  manufactured 
into  articles  to  be  sold  for  personal  use.  unless  such  rags  or  material  shall  havi 
previously  so  thoroughly  disinfected  as  to  destroy  all  genus  of  disease  in   a    manner 
satisfactory  to  the  board  of  health."'  - 

■•  No  rags,  old  paper,  or  other  refuse  material,  gathered  or  recovered  from  any 
BOUrce,  shall  be  broughl  into  or  allowed  to  remain  within  any  building  used  as  a 
dwelling."  ; 

The  following  rule  is  found  in  New  York: 

•■That  the  owners,  lessees,  tenants  and  managers  of  every  blacksmith  or  other 
shop,  forge,  coal-yard,  foundry,  manufactory  and  premises  where  any  business  is 
done,  shall  cause  all  ashes,  cinders,  rubbish,  dirl  and  refuse  to  be  removed  to  some 
proper  place,  so  thai  the  same  shall  not  accumulate  at  any  of  the  above-mentioned 
premises,  or  in  the  appurtenances  thereof,  nor  the  same  become  filthy  or  offensive, 
nor  shall  any  smoke,  cinders,  dust,  gas,  or  offensive  odor  be  allowed  to  escape  from 
an\  such  building,  place  or  premises,  to  the  detrimeni  or  annoyance  of  any  person 
not  being  therein  or  thereupon  engaged.'1 4 

III. 

While  some  noxious  trades  may  properly  !»•  conducted  in  sparsely 
settled  sections  of  a  township  or  city,  and  while  all  the  so  called  offen- 
sive trades  need  regulation  and  supervision,  there  are  certain  trades  that 
must  he  absolutelj  forbidden  in  some  municipalities.  Moreover,  any 
trade  may  he  so  managed,  either  through  the  ignorance  or  wilfulness 
of  the  operators,  thai  it  is  hopeless  to  exped  an\  abatement  id'  the  nui- 
sanee  except  by  the  complete  suppression  of  the  husiiicss.  The  prohi- 
bition id'  trades  is  sometimes  found  in  statute  law.  as  in  the  charter  of 
the  (   it  \    of  New    York  : 

■'  It  shall   nol   be  lawful   for  an]  person  or  persons,  incorporated  or  unincorpor 
a  ted,  to  carry  on.  establish,  prosecute,  or  continue,  within  the  borougli  of  Manhat- 

1  At lauta.  Sanitarj  < lode,  Sec,  i  1 1. 

•  olorado,  An  ,,t    i;,  April.  L893,  Sec.  16. 

Boston,  Hoard  of  Health  Regulations,  28  February,  1899. 
1  New   \  ork,  Sanitarj  Code  1 1899),  S'<  ■ .  mi. 


2  1  '2  SP E(  JFK  '    XI  Vs.  i  N'(  'ES. 

tan,  the  occupation,  or  trade,  or  business  of  bone  boiling,  bone  burning,  bone  grind- 
ing, horse  skinning,  cow  skinning,  or  skinning  of  dead  animals,  or  the  boiling  of 
offal,  and  any  such  establishment  or  establishments,  or  place  of  such  business  exist- 
ing within  said  borough,  shall  be  forthwith  removed  out  of  said  borough,  and  such 
trade,  occupation,  or  business  shall  be  forthwith  abated  and  discontinued,  provided 
that  nothing  in  this  section  contained  shall  apply  to  the  slaughtering  or  dressing  of 
animals  for  sale  in  said  city.  It  shall  be  the  duty  of  the  board  of  health  to  ascertain 
whether  any  such  trade  or  business  is  carried  on,  or  continued,  or  established,  within 
the  limits  aforesaid,  and  to  make  and  cause  an  order  to  be  served,  in  the  same  man- 
ner as  other  orders  of  said  department  are  made  and  served,  directing  the  discon- 
tinuance of  said  trade  or  business,  and  the  removal  of  all  offensive  or  unwholesome 
materials  or  things  appertaining  to  said  trade  or  business.  Any  such  business  car- 
ried on  elsewhere  within  the  city  of  New  York  shall  be  subject  to  reasonable  regu- 
lations to  be  prescribed  by  the  board  of  health,  and  may,  upon  its  recommendation, 
be  prohibited  in  any  borough  or  part  of  any  borough  by  the  municipal  assembly.1'1 

More  often,  however,  it  is  the  authority  to  prohibit  that  is  given  to 
the  local  government,  as  in  the  Massachusetts  law.-  A  very  large  num- 
ber of  municipalities  have  taken  advantage  of  the  power  thus  conferred 
and  have  prohibited  certain  offensive  trades  within  their  limits  or  in 
some  cases,  as  in  Chicago,  within  a  certain  area  outside  their  limits. 
hi  Atlanta  slaughter-houses  are  forbidden  within  the  city  and  upon  the 
water  shed  from  which  the  city  obtains  its  water.  Sometimes  the  pro- 
hibition is  made  to  apply  only  to  trades  to  be  established  in  the  future, 
as  in  Wilmington,  Del. 

If,  notwithstanding  the  prohibition,  the  trade  is  still  followed,  the 
remedy  is  found  in  a  penalty  in  the  form  of  a  line,  which  may  be  col- 
lected for  each  day  during  which  the  offense  is  persisted  in.  The  fine 
for  violations  of  these  laws  is  usually  somewhat  greater  than  for  ordinary 
nuisance  laws:  $50  is  a  common  amount,  but  in  Ohio  it  is  $500.  In 
Bridgeport.it  is  $20  per  day.  But  the  imposition  of  a  line  is  not  a  very- 
satisfactory  way  of  abating  a  nuisance,  especially  such  a  nuisance  as  is 
caused  by  offensive  trades.  Considerable  pecuniary  interests  are  usually 
involved,  and  often  the  business  creating  the  nuisance  is  of  great  magni- 
tude. In  such  cases  every  possible  appeal  will  lie  taken  and  all  the 
tactics  known  to  the  legal  profession  will  be  made  use  of  to  perpetuate 
the  nuisance.  Hence  has  been  felt  the  need  of  some  summary  method 
of  dealing  with  such  nuisances.  In  1855  in  Massachusetts3  it  was  pro- 
vided that  the  board  of  health  could  take  all  measures  necessary  to  sup- 
press the  trade.  Recently  in  Wisconsin  the  mayor  or  other  municipal 
executive  is  required  to  remove  such  slaughter-houses  as  are  forbidden 
by  the  statute,  and  if  such  officer  fails  in  this  duty  he  is  to  lie  lined  from 
$15  to  $50.      The  Rhode  Island  law  is  here  given: 


1  New  York,  Chapter  378  of  1897,  Sec.  1212. 
-Massachusetts,  Public  Statutes  (1882),  Chapter  80,  Sec.  84. 
::  Massachusetts,  Public  Statutes  (1882),  Chapter  80,  Sec.  87. 


SPECIFIC    NUISANCES.  213 

••  Section  1.  When  any  building  or  premises  in  any  city  in  this  state  are  occu- 
pied or  nsed  for  carrying  on  the  business  of  slaughtering  cattle,  sheep  or  other 
animals.  or  for  a  melting'  or  rendering  establishment,  or  for  other  noxious  or  offen- 
sive trades,  occupations  or  employments,  the  board  of  aldermen,  sitting-  as  a  board 
of  health,  after  appointing  a  time  and  place  for  a  hearing,  and  after  giving  notice 
thereof  to  all  persons  interested,  by  public  advertisement  or  otherwise,  and  after 
such  notice  and  hearing,  if  in  its  judgment  the  public  health  or  the  public  comfort 
and  convenience  so  require,  may  prohibit  by  its  order  or  decree  the  exercise  of  such 
trade,  occupation  or  employment  in  such  building  and  on  such  premises,  indefinitely, 
or  for  such  time  as  it  shall  find  that  the  public  health  or  the  public  comfort  and 
convenience  shall  require. 

"Sec.  2.  A  copy  of  the  order  or  decree  of  prohibition  under  the  preceding 
tion  shall  he  served  by  the  city  sergeant  upon  tire  occupant  or  person  having  charge 
of  such  building  and  premises  where  such  trade,  employment  or  occupation  is  exer- 
cised. If  the  party  upon  whom  snch  order  is  served,  for  twenty-four  hours  after 
such  service  refuses  or  neglects  to  obey  said  order  or  de<  ree,  the  board  of  aldermen 
in;i\  take  all  necessary  measures  to  prevent  such  exercise,  and  any  person  thereafter 
continuing  so  to  occupy  or  use  such  building  and  premises  shall  forfeit  the  sum  of 
two  hundred  dollars  for  every  month  of  such  occupancy  and  use.  and  in  like  propor- 
tion for  a  longer  or  shorter  time,  to  be  recovered  by  the  city  treasurer  in  tin  action 
of  t  he  case. 

•■  Sec.  ■'!.     Any  person  aggrieved  by  the  order  or  decree  of  the  board  of  aldermen 

under  section  one  of  this  chapter  may.  within  three  days  from  the  service  aforesaid 
thereof  upon  him,  appeal  to  the  common  pleas  division  of  the  supreme  courl  within 
and  for  the  county  where  such  city  is  situated,  by  filing  his  reasons  of  appeal,  to- 
1  with  an  attested  copy  of  the  whole  proceedings  appealed  from,  in  the  clerk's 
office  of  said  court,  and  said  court  if  in  session  shall,  or,  if  not  in  session,  any  justice 
of  the  supreme  courl  upon  application  made  to  him  shall,  forthwith  hear  said 
appeal;  and  either  party  to  the  proceedings  may  have  a  trial  by  jurj  of  all  questions 
of  fact,  by  filing  with  the  clerk  of  said  court  a  demand  for  the  same  at  least  two 
days  before  the  clay  assigned  for  hearing.  In  case  of  such  demand,  if  said  common 
pleas  division  of  the  supreme  court  shall  not  be  in  session  for  the  purpose  of  jury- 
trials,  the  clerk  shall  immediately  issue  a  writ  of  venire  facias  directed  to  the  sheriff 
of  t  he  county  or  his  deputy,  ret)  Hiring  him  to  summon  twelve  jurors,  being  good  ami 
lawful  men  of  the  county,  to  try  such  issue;  and  if  there  shall  not  be  a  sufficient 
number  of  jurors  attending  in  pursuance  of  such  writ  from  which  a  jury  may  be 
impaneled,  such  court  or  justice  shall  direct  the  issuing  of  other  writs  of  venire 
facias  to  complete  a  jury.     If  any  person  aggrieved  shall,  by  reason  of  accident   or 

mistake,  fail  to  appeal  as  aforesaid   ir :un  such  order  or  decree,  and  shall  make 

it  appear  to  such  court  or  justice  that  such  failure  was  caused  by  accident  or  mis- 
take, he  may  at  any  tine  within  i  Inn  \  days  from  the  service  of  t  he  copy  of  t  he  on  lei 
or  decree  aforesaid  upon  bim,  appeal  from  such  order  or  decree  and  prosecute  the 
same  as  aforesaid,  with  t  he  same  effect  as  if  done  within  the  said  three  days. 

liSec.    I.     During  the  pendency  of  the  appeal  such  trade,  occupation  or  eniploj 
men  i  shall  uot  he  exercised  con  i  rary  to  such  order  or  decree ;  ami  upon  any  violation 
of  such  order  or  decree,  the  appeal  shall  forthwith  he  dismissed. 

S]  ■  .    ■">.      Sucb  court    or  justice,   upon    the  trial  of   an\    appeal,  shall    give   judg 
nieiil .  agreeable  to    law   anil  in  accordance  with  t  he  fact  as   found,  (hat  such  order  >  r 

decree  he  affirmed  or  annulled,  or  such  court  or  justice  maj   alter  or  modify  the 

order  or  decree,  or  u] a  jury-trial  the  jury  may  alter  or  modify  t  he  order  ordi 

and   thereupon  the  verdict  and  judgment  shall  have  the  authoritj  and  .  : 

original    order    from    which  no    appeal    had    been    taken.      If   ll rder  or   d. 

affirmed,  altered,  oi  modified,  the  citj   shall  recover  its  costs  against  the  appellant: 


2  ]  4  SPEC  IFK  '    m  7  a  .  J  X<  h's. 

if  it  is  annulled,  damages  by  reason  of  obeying  such  order  or  decree  of  the  board  of 
aldermen  may  be  recovered  by  such  appellant  against  the  city,  in  any  court  of  com- 
petent jurisdiction,  in  an  action  of  the  case.7' 1 

Under  ihis  law  it  appears  to  be  possible  to  promptly  suppress  any 
noxious  or  offensive  trade.  Yet  ample  provision  is  made  for  the  owners 
of  the  property  to  obtain  as  prompt  justice  as  possible  at  the  hands 
of  the  highest  legal  tribunal. 

In  most  cities  the  sanitary  inspectors  or  the  executive  head  of  the 
department  manage  the  regulation  of  the  offensive  trades:  but  in  New 
York  special  inspectors  are  employed  for  this  purpose.  In  189b,  the 
last  year  in  which  a  report  of  the  health  department  was  printed,  there 
were  two  such  inspectors,  and  an  interesting  account  of  their  work  may 
be  found  on  pp.  204-210  of  thai  report. 

Smoke. 

The  following  (ities  have  anti-smoke  legislation:  Boston,  Buffalo, 
Chicago,  Cincinnati,  Cleveland,  Denver,  Detroit,  District  of  Columbia, 
Indianapolis,  Kansas  City,  Louisiana  cities  of  over  5,000  inhabitants, 
Memphis,  Milwaukee,  Minneapolis,  the  City  of  New  York,  Omaha,  St. 
Louis,  St.  Paul,  Toledo,  Pittsburgh,  and  Yonkers. 

The  abatement  of  the  smoke  nuisance  is  usually  placed  in  the  hands 
of  the  health  department.  This  is  quite  natural,  as  most  nuisances  are 
referred  to  that  department,  but  the  engineering  department  with  its 
superior  knowledge  of  mechanical  processes  might  perhaps  be  better 
entrusted  with  it.  The  health  department  has  jurisdiction  in  Chicago, 
Cleveland,  Denver,  District  of  Columbia,  Kansas  City,  Memphis.  Mil- 
waukee, Minneapolis,  New  York,  and  Yonkers.  In  Cincinnati,  Omaha, 
and  New  <  Weans  it  is  the  city  engineer,  in  Indianapolis  the  inspector  of 
buildings;  in  Buffalo,  St.  Louis,  and  Pittsburgh,  the  department  of 
public  works.  The  Boston  act  authorizes  the  mayor  to  name  the  officer 
who  shall  be  entrusted  with  its  enforcement.  It  is  now  in  the  street 
department. 

There  are  several  types  of  smoke  laws.     New  York  City  acts  under 

the  following  rules  of  the  sanitary  code  : 

"Sec.  134.  That  the  owners,  lessees,  tenants,  and  managers  of  every  blacksmith 
or  other  shop,  forge,  coal  yard,  foundry,  manufactory,  and  premises  where  any  busi- 
ness is  done,  or  in  or  upon  which  an  engine  or  boilers  are  used,  shall  cause  all  ashes, 
cinders,  rubbish,  dirt  and  refuse  to  be  removed  to  some  proper  place,  so  that  the 
same  shall  not  accumulate  at  any  of  the  above-mentioned  premises  or  in  the  appur- 
tenances thereof,  not  the  same  become  filthy  or  offensive.  Xor  shall  any  owner, 
lessee,  tenant,  manager,  engineer,  fireman,  or  any  other  person,  cause  or  allow  any 
smoke,  cinders,  dust,  gas,  steam  or  offensive  odor  to  escape  or  be  discharged  from 
any  such  building,  place  or  premises;  and  every  furnace  employed  in  the  working  of 


i  Rhode  Island.  General  Laws  (1896),  Chapter  93. 


S  PEC  TFK  ■    Xf  T.s .  1  m  '  ES.  2 1 5 

engines  by  steam,  or  in  any  mill,  factory,  printing  house,  dye  factory.  iron  foundry, 
glass  bouse,  distillery,  brew  house,  sugar  refinery,  bake  house,  gas  works,  or  in  any 
other  buildings  used  for  the  purposes  of  trade  or  manufacture  shall  be  so  con- 
structed as  to  consume  or  burn  the  smoke  arising  therefrom."  ' 

Chicago,   Detroit,   Omaha,    Milwaukee,   Minneapolis,   St.   Paul,  and 

[ndianapolis  have  ordinances  very   much  alike.     The   following  is  the 

Chicago  ordinance  and    tinder  it  the  health  department    lias  done  ranch 

to  suppress  the  smoke  nuisance  : 

"The  emission  of  dense  smoke  from  the  smoke  stack  of  any  boat  or  locomotive, 
or  from  any  chimney  anywhere  within  the  city,  shall  be  deemed  and  is  hereby 
declared  to  be  a  public  nuisance:  Provided,  that  chimneys  of  buildings  used  exclu- 
sively for  private  residences  shall  not  In-  deemed  within  the  provisions  of  this  ordi- 
nance. 

•The  owner  or  owners  of  any  boat  or  locomotive  engine,  and  the  person  or 
persons  employed  as  engineer  or  otherwise  in  the  working  of  the  engine  or  ei  a 
in  said  boat  or  in  operating  sucb  locomotive,  and  the  proprietor.  Lessee,  and  occu- 
pant of  any  building  who  .shall  permit  or  allow  dense  smoke  to  issue  or  be  emitted 
from  the  smoke  stack  of  any  such  boat  or  locomotive  or  the  chii iy  of  any  build- 
ing within  the  corporate  limits,  shall  be  deemed  and  held  guilty  of  creating  a  nui- 
sance, and  shall  for  every  such  offense  be  lined  in  a  sum  noi  less  than  live  dollars. 
nor  more  than  fifty  dollars."  1 

The  Detroit3  ordinance  forbids  "  dense  smoke  or  smoke  containing 
s<>ot  or  other  substances  in  sufficient  quantity  to  permit  the  deposits  of 
such  sooi  or  other  substances  on  any  surface  within  the  corporate  limits 
of  the  city."  The  [ndianapolis  ordinance  requires  the  building  inspec- 
tor to  >ei\o  a  ten  days'  notice.  The  Buffalo  ordinance  is  somewhat 
re  explicit  in  the  Language  employed  : 

••It  shall  not  be  lawful  within  the  limits  of  the  City  oi  Buffalo  for  any  person  or 
persons,  firm  or  corporation,  or  any  servant,  agent,  or  employee  of  any  person,  linn, 
or  cor  |  .oral  ion,  to  permit  or  allow,  or  cause  to  be  permitted  or  allowed,  the  discharge 
or  escape  into  the  open  air  of  large  quantities  of  smoke,  soot,  dust,  gas,  steam,  or 
offensive  odor,  or  to  permil  or  allow  any  smoke,  soot,  dust,  gas,  steam,  or  offensive 
odor  to  escape  in  such  manner  or  in  sucb  quantities  as  to  cause  or  have  a  natural 
tendency  to  cause  injury,  detriment,  or  annoyance  to  any  person  or  persons  or  the 
public,  or  to  endanger  the  public,  or  to  endanger  the  comfort,  repose,  health,  or 
safeis  of  any  person  or  persons,  or  the  public,  or  in  such  manner  as  to  cause  or  to 
have  a  rial  oral  tendency  to  cause  injury  or  damage  to  business  or  property." 

Section  -J.  forbids  any  person,  etc.,  to   permit  the  above.     Section  3 

forbids   the  discharge  of  •■  fine  ■sand,  dirt,  or  particles  of  earth  or  other 

material."*     Section    I   makes  ii    the   duty   of  all   street   inspectors  and 

police  to  report  violations  and  procure  evidence  and  witnesses. 

The  Milwaukee  ordinance  provides  thai  : 

''Hereafter,  before  approving  plans  ami  specifications  for  the  erection  ol  anj 
business  building  or  factory  within  the  limits  aforesaid,  it  shall  be  the  duty  of  the 

\ew  y.,rk  City,  Sanitarj  Code  (1899),  Sec.  134  as  amended  2  November,  1899. 
(  hicago,  Ordinances  (1881),  sees.  1650  and  1651. 
Detroit,  Rei  ised  I  Ordinances  1 1895),  Chapter  90. 
;  Buffalo,  Ordinances,  Chapter  i_.  2-'.  February,  1897. 


216  8PM  IFIi '    NUISANCES. 

inspector  of  buildings  of  the  City  of  Milwaukee  to  see  that  proper  provision  is 
made  in  said  plans  and  specifications  to  prevent  the  emission  of  dense  smoke  from 
the  chimney  <>f  said  building." 1 

The  Minneapolis  ordinance  especially  mentions  not  only  the  engineer 
but  the  "  general  manager,  superintendent,  yardmaster,  or  other  officer 
of  any  railroad  company  having  charge  or  control  of  the  operation  of 
any  locomotive  "  as  responsible  for  smoke  from  the  same.  The  Cleve- 
land ordinance  is  somewhat  different  from  those  just  referred  to.  It 
was  only  adopted  in  that  city  after  some  adverse  decisions  under  former 
ordinances  : 

"  Be  it  ordained  by  the  council  of  the  City  of  Cleveland,  That  whoever,  as  owner, 
agent,  lessee,  engineer,  fireman,  or  employe,  having  charge  or  control  of,  or  operat- 
ing any  boat,  locomotive,  stationary  engine  or  boiler,  manufactory,  building  or 
premises  within  the  corporate  limits  of  the  City  of  Cleveland,  and  who  shall  causes 
permit,  or  allow  smoke  containing  unconsumed  particles  of  matter  commonly  called 
soot,  of  such  density  and  volume  as  to  he  injurious  to  health  or  property.  Ot 
annoying  to  the  inhabitants  of  said  city,  or  any  part  thereof,  to  issue  from  any  smoke- 
stack or  chimney  of  such  boat,  locomotive,  stationary  engine  or  boiler,  manufactory, 
building  or  premises,  or  from  any  smokestack  or  chimney  connected  therewith,  for 
more  than  ten  (10)  minutes  in  any  one  hour  shall  be  deemed  guilty  of  a  misde- 
meanor and  shall  upon  conviction  thereof  be  lined  not  less  than  ten  dollars  nor  more 
than  fifty  dollars  for  the  first  offense,  and  not  less  than  twenty-five  dollars  nor  more 
than  one  hundred  dollars  for  each  subsequent  offense."'  - 

The  Denver  ordinance  authorizes  the  health  commissioner  to  order 
the  abatement  of  the  smoke  nuisance  whenever  he  finds  that  practicable 

methods  for  doing  so  have  been  devised: 

"  Whenever  in  the  opinion  of  the  health  commissioner,  such  apparatus  is  obtain- 
able as  may  seem,  after  a  fair  trial,  to  be  capable  of  effectually  and  economically 
consuming  or  destroying  smoke  from  chimneys  or  other  outlets  and  from  furnaces 
or  tires,  or  when  any  device  for  abolishing  such  smoke  shall  have  been  satisfactorily 
established,  the  health  commissioner  shall  have  power  to  cause  the  abatement  of 
such  smoke  nuisance  whenever,  in  his  opinion,  it  interferes  with  the  comfort  OT 
endangers  the  health  of  any  of  the  inhabitants  of  the  City  of  Denver." 

The  Kansas  City  ordinance  is  as  follows: 

"That  dense  black  or  thick  gray  smoke,  issuing  from  any  chimney,  tlue.  smoke- 
stack, or  from  any  other  source  within  the  corporate  limits  of  Kansas  City  in  such 
quantities  or  in  such  manner  as  to  be  deleterious  or  offensive  to  health,  or  productive 
of  physical  discomfort,' or  as  to  detract  from  the  ordinary  enjoyments  of  life,  or  be 
damaging  to  property,  or  impair  the  comfortable  enjoyment  thereof,  is  hereby  de- 
clared to  be  a  nuisance. 

•'That  no  person,  firm  or  corporation,  shall,  within  the  corporate  limits  of 
Kansas  City,  make,  use.  keep  or  maintain  any  fire  in  any  furnace,  engine  or  device 
in  which  fires  are  used,  kept  or  maintained  for  any  purpose  whatever,  in  such  man- 
ner as  to  cause  dense  black  or  thick  gray  smoke  to  issue  in  such  quantities  or  in  such 


1  Milwaukee,  Ordinance  of  3  February,  1896,  Sec.  •".. 

2  Cleveland  Ordinance  Xo.  20,550,  Sec.  1. 
Denver.  Ordinance  Xo.  44  of  1893,  Sec.  149. 


8PE(  IFK  '    XI  ISAX<  Ks.  21 7 

manner  as  to  be  deleterious  or  offensive  to  health,  or  productive  of  physical  discom- 
fort, or  as  to  detract  f  rniii  the  ordinary  enjoyment  of  life,  or  be  damaging  to  property  . 

or  impair  the  comfortable  enjoyment  thereof. "'  1 

The  Louisiana  statute  requires  that  within  twelve  months  after 
passage  all  steam  plants  of  over  ten  horse-power  shall  provide  an 
appliance  which  shall  consume  seventy-five  per  cent,  of  the  smoke. 

The  act  for  Boston  is  as  follows: 

"In  the  City  of  Boston,  the  emission  into  tin-  open  air  of  dark  smoke  or  thick 

graj   S ke  for  more  than  live  minutes  continuously,  or  the  emission  of  such  smoke 

during  more  than  twenty-five  per  cent,  of  any  continuous  period  of  twenty-foui 
hours  is  hereby  declared  a  nuisance."2 

This  law  applies  to  whoever  commit  or  suffer  the  same  on  any 
premises  owned  or  occupied  by  them  mid  upon  anyone  who  in  an\  way 
participates  in  permitting  it. 

The  Brooklyn  act  pursued  a  different  method  from  any  thus  far 
gi  ven  : 

"  No  factory,  engine  room  or  electrical  station  shall   use   what   is  known  as  soft 

coal  for  fuel  in  the  furnaces  of  such  factories,  engine  room  or  electrical  stations 
Within  a  radius  of  four  miles  of  the  City  Hall  in  the  City  of  Brooklyn,  except  for  the 
purpose  of  heating  or  welding  iron  or  steel;  any  violation  of  this  act  shall  subject 
the  proprietors  or  corporation  that  shall  violate  it  to  a  fine  of  not  more  than  one 
hundred  dollars,  the  same  to  he  collected  h\  the  proper  city  authorities  and  placed 
in  the  county  treasury,  and  such  authorities  shall  see  that  this  law   is  enforced." 

This  act  has  recently  (  L899)  been  sustained  by  the  supreme  court 
in  a  suit  brought  againsi  the  Nassau  Electric  Railway  Co. 

The  penalties  tor  violations  of  these  laws  are  often  very  considerable, 
not  to  exceed  $250  in  Buffalo,  $50  in  .Milwaukee.  $25  per  day  in 
Louisiana.  #10  to  $100  per  week  in   Boston. 

Smoke  ordinances  are  of  no  use  unless  continued  attention  is  given 
to  their  enforcement,     [n  Chicago  for  a  dozen  years  there   lias   been   a 
special    detail    of   inspectors    for    this  class  of  nuisances.      There  ai 
inspectors  at   a  salary  of  $1,000  per  year  :    also  a  chief  inspector.      Smoke 

is  considered  to  he  dense  if  the  inspector  cannot  sec  through  it. 

The  great  trouble  reported  in  Chicago4  is  that  the  boiler  capacitj  oi 
st    of   the   plants   is  greatlj    overtaxed.     This   renders   rapid    firing 

nei  essan     and     makes     the     application     of    consumers    difficult.       The 

greatesl  difficult}  was  experienced  with  locomotives  and  tow-boats;  bul 
h\  persistenl    Labor  in   1896,  of  the  1,408  locomotives  entering  Chioago 

l.l'sl    had  keen  equipped  with  smoke  consumers.      The  child    inspector. 


Kansas  <  itj .  ( Ordinance  No.  LO,  168. 
Massachusetts,  <  lhapter  389  ot   18 
V.uk.  Chapter  322  of  1895. 
1  Chicago,  Report  ot  Departme i  Health.  1895  6,  p 


2 1 8  SPEC  TFIC    JSTl  TISA  N~OMS. 

however,  reported  that  no  successful  consumer  had  been  devised  for 
marine  engines.  This  form  of  smoke  producer  is  especially  annoying 
in  Chicago  where  the  river  passes  through  such  a  crowded  part  of  the 
city. 

Cincinnati  is  another  city  which  has  given  much  attention  to  the 
abatement  of  the  smoke  nuisance.  This  work  is  in  that  city  in  the 
hands  of  the  city  engineer.  A  special  report  published  by  him  in  1893 
stated  that  the  previous  year,  the  first  of  the  enforcement  of  the  law, 
was  chiefly  devoted  to  litigation.  The  regularity  with  which  offenders 
were  convicted  soon  produced  a  spirit  of  compliance  and  smoke  pre" 
venting  methods  were  rapidly  adopted.  No  smoke  consuming  device  is 
recommended,  but  the  law  is  enforced  and  owners  of  boilers  have  to 
select  their  own  methods  of  prevention. 

The  following  recommendations  are  printed  in  a  circular  issued  by 
the  engineer: 

"1.  Have  a  hot  fire.  Give  the  gas  sufficient  space  and  time  to  burn  before  the 
fire  is  below  a  red  heat. 

"2.  Fire  in  small  quantities  over  one  part  of  the  grate  at  a  time.  The  other 
parts  should  be  closely  watched  and  promptly  attended  to. 

L'  3.  Keep  a  clean  fire  all  the  time.  Never  keep  a  set  of  bare  grate-bars  in  ser- 
vice that  are  warped  and  burned,  because  the  air-spaces  become  closed.  Keep  the 
side  walls  of  furnace  in  good  repair,  ash-pit  free  from  ashes,  and  bridge-wall  clean 
and  in  repair.     Do  not  permit  deposits  to  accumulate  back  of  the  bridge-wall. 

•;  4.  '  Clean  Hues  or  tubes  at  least  once  each  day. 

"5.  Do  not  delay  if  draught  is  not  good,  but  attend  to  it  immediately,  as  good 
draught  is  important  in  attaining  good  combustion." 

In  Cleveland  the  smoke  ordinance  was  first  adopted  in  1893.  One 
hundred  and  twenty  notices  to  abate  the  nuisance  were  issued  and  mostly 
complied  with.  The  health  officer  reported  that  the  manufacturers  were 
overrun  with  agents  for  smoke  consumers.  The  market  was  flooded  with 
numberless  contrivances,  most  of  them  worthless.  Mechanical  stokers 
were  largely  introduced  and  found  very  satisfactory.  In  some  cases  the 
evaporation  was  raised  from  six  and  one-half  to  ten  and  one-half  pounds 
of  water  per  pound  of  coal.1  In  January,  1895,  a  court  decision  declared 
the  law  unconstitutional,  and  an  appeal  was  made  to  the  legislature  for 
authority  to  declare  what  is  a  nuisance,  and  a  new  ordinance  was  adopted 
in  September,  1896,  and  the  health  officer  at  once  proceeded  to  enforce 
it.  Again,  in  1897,  the  ordinance  was  thrown  out  as  unconstitutional, 
and  the  present  ordinance,  which  was  given  on  another  page,  was 
adopted. 

All  of  the  cities  hitherto  referred  to  have  attempted  to  get  rid  of  the 
smoke  nuisance   by  encouraging  the  use  of  some  so  called    smoke  con- 


1  Cleveland,  Report  of  Health  Division  (1895),  p.  7. 


spK<  IFK '   NT/ISA  m  /:s.  2 1 9 

suniing  or  smoke  preventing  device.  In  1894  the  New  York  City 
board  of  health  caused  a  systematic  inspection  to  be  made  of  all  places 
within  the  city  limits  where  coal  was  used  for  steaming  purposes.  It 
was  found  that  while  the  majority  who  used  bituminous  coal  were  offend- 
ers, yet  some  who  used  this  coal  produced  little  smoke,  although  they 
did  not  use  smoke  consuming  devices.  The  engineers  of  these  firms 
were  able  to  so  manage  their  fires  as  to  wholly  consume  their  fuel. 
The  engineer  was  made  to  burn  all  his  coal  or  leave: 

■■  An  examination  of  the  method  of  firing  by  which  all  the  bituminous  coal  was 
consumed  was  made.  The  fireman  shoveled  the  coal  into  the  front  of  the  fire-box, 
w  here  he  left  it  for  a  short  time.  Here  the  more  volatile  gases  were  driven  off  and 
the  dense  smoke  resulting  from  the  firsl  combustion  was  produced.  The  gases  and 
the  smoke  had  then  to  i>ass  over  the  bed  of  live  coals,  extending  to  the  l  ire- wall,  and 
in  this  passage  to  meet  the  fresh  air  coming  up  from  the  ash-pit  through  the  grate- 
bars  As  a  result,  the  inflammable  gases  and  the  smoke  were  wholly  consumed. 
The  fireman  then  opened  the  door,  and  with  his  rake  moved  the  now  glowing  coals 
hack  toward  the  fire-wall  and  once  more  shoveled  fresh  coal  to  the  front  of  the  lire- 
box,  where  the  process  was  repeated.  This  method  of  firing  made  the  fireman 
work  harder  and  tire  more  frequently,  bul  with  it  every  particle  of  the  coal  was 
consumed,  and  neither  the  dense  smoke  nor  the  "blacks'1  were  produced  from  the 
stack."  ' 

The  board  of  health,  through  its  inspectors,  urged  this  method  of 
smoke  prevention  in  preference  to  the  use  of  "preventers,"  and  it  is 
claimed  met  usually  with  a  favorable  reception.  It  is  said  that  the 
majority  of  plants  in  New  York  City  now  emil  little  smoke.  .More 
trouble  was  found  in  dealing  with  the  planing  nulls  and  other  establish- 
ments burning  shavings  and  sawdust.  Smoke  will  arise  from  such  even 
with  the  most  careful  firing. 

In  St.  Louis,  of  2,453  boilers  in  1896  7  there  were  only  1:23  not 
provided  with  smoke  consumers,  and  these  were  mostly  low  pressure 
boilers  used  for  beating. 

■New  Fork,  Report  of  Board  of  Health  (1894),  p.  58. 


CHAPTER  V. 

PLUMBING. 

THE  municipal  control  of  plumbing  in  the  United  States  dates  back  less 
than  twenty  years.  This  control  was  urged  primarily  by  boards  of 
health  or  persons  interested  in  sanitation,  and  therefore  the  enforcement 
of  the  earlier  plumbing  rules  was  entrusted  to  the  local  sanitary  author- 
ities. While  it  would  be  more  logical  to  vest  this  function  in  another 
department,  that  of  the  inspection  of  buildings,  the  earlier  practice  has 
been  adhered  to,  and  at  present  the  control  of  plumbing  is  in  most  cities 
in  the  hands  of  the  health  department.  This  custom  is  doubtless  due 
both  to  precedent  and  to  the  popular  notion  of  the  very  intimate  con- 
nection between  poor  plumbing  and  disease.  Of  over  one  hundred 
cities  which  have  plumbing  rules,  in  all  but  about  twenty  they  are 
administered  by  the  health  department. 

( )f  all  the  important  cities  considered,  only  the  following  have  no 
plumbing  code  or  inspection:  Augusta,  (la.,  Bridgeport,  Concord. 
Dayton,  Evansville,  Indianapolis,  Louisville,  Macon,  New  Orleans, 
and  Wheeling. 

A  few  cities,  as  Lowell,  Mass.,1  in  1878,  Providence,2  1878,  and  St. 
Louis,3  in  1880,  had  some  simple  plumbing  regulations,  but  the  first 
complete  plumbing  codes  were  adopted  in  1881.  During  that  year  sets 
of  plumbing  rules  were  adopted  by  Lawrence,  Mass.,  District  of  Colum- 
bia, Brooklyn,  and  probably  Chicago.  The  first  of  these  adopted  were 
those  of  Lawrence,  22  July,  1881.4 

Some  of  the  plumbing  codes  were  adopted  in  pursuance  of  statutes 
enacted  for  this  purpose.  The  first  of  these  acts  was  Chapter  133  of 
the  Massachusetts  laws  of  1877,  and  the  act  of  30  May,  1881,  of  Illi- 
nois, empowered  cities  of  over  50,000  to  regulate  their  plumbing  and 
drainage.  By  the  act  of  4  June,  1881,  of  New  York,  the  cities  of  Newr 
York  and  Brooklyn  were  authorized  to  adopt  plumbing  rules.  Most  of 
the   plumbing   codes   have,   however,  been    adopted    under  the   general 


i  Report  of  Board  of  Health  (1878),  p.  7. 

-  Rhode  Island,  Public  Laws,  Chapter  G88,  Sec.  28. 

3  Sanitary  Engineer  (1880),  p.  85. 

i  6th  Report  of  Lawrence  Board  of  Health. 


PLUMBING.  221 

statutory  provisions  which  confer  power  on  local  governments  to  legis- 
late on  sanitary  affairs.  Some  of  the  Massachusetts  cities,  as  Lowell, 
Lawrence,  and  New  Bedford,  adopt  their  plumbing  rides  under  Public 
Statutes.  Chapter  80,  Section  18,  which  authorizes  a  hoard  of  health  to 
••make  such  regulations  as  it  judges  necessary  for  the  public  health  and 
safety."  In  .Maine  they  are  adopted  as  by-laws  "necessary  and  proper 
for  the  preservation  of  life  and  health."  In  New  Hampshire  plumbing 
rules  are  made  in  pursuance  of  the  statute,  which  authorizes  the  health 
officers  to  make  rules  such  "as  the  health  and  safety  of  the  people  may 
require."  In  Baltimore  plumbing  rules  are  adopted  as  " necessary  for 
the  preservation  of  the  health  of  the  city." 

Although  it  appears  to  he  perfectly  competent  lor  cities  to  regulate 
plumbing  under  such  general  provisions,  nevertheless,  there  have  been 
quite  a  number  of  acts,  both  special  and  general,  conferring  this  power, 
and  in  several  instances  the  local  regulations  are  made  a  part  of  the 
legislative  act.  Tims  the  plumbing  of  Boston1  and  Cincinnati2  is  con- 
trolled directly  by  statute,  and  Albany,  Brooklyn,  Detroit.  New  York. 
Pawtucket,  and  Providence  adopted  plumbing  rules  in  accordance  with 
special  acts.  At  the  present  time  the  following  states  have  laws  which 
provide  tor  the  local  control  of  plumbing:  California,3  Illinois  forcities 
of  over  .",0.000. '  Massachusetts."'  New  Jersey,6  New  York,7  Ohio,8 
Pennsylvania,9  South  Carolina,10  Washington,11  and  Wisconsin.1-  The 
following  is  the  Massachusetts  law: 

■  Each  city  and  town  of  five  thousand  inhabitants  or  more  in  this  Commonwealth, 
;m<l  every  town  having  a  system  of  water  supply  or  sewerage,  shall  by  ordinance  or 
by-law,  within  six  months  from  the  passage  of  this  net  prescribe  rules  and  regula- 
tions t'"i  tin'  materials,  construction,  alteration,  and  inspection  of  pipes,  tanks. 
faucets,  calves,  and  other  fixtures  by  and  through  which  waste  water  or  sewage  is 
used  and  carried,  and  provide  thai  no  such  pipes,  tanks,  faucets,  valves,  or  other 
fixtures  shall  be  placed  in  any  building  in  such  city  or  town  excepl  in  accordance 
with  [dans  which  shall  be  approved  by  the  in. aid  of  health  of  such  city  or  town,  or 


1  Massachusetts,  Chapter  119  of  1892. 

-ohio.  Annotated  Statutes  (1900),  Sees.  25751  53)  to  I    L23). 
i  lalifornia,  Chapter  1  I  of  1885. 

1  Illinois,  Annotated  Statutes  1 1896),  Sec.  - 

■  Massachusetts,  Chapter  177  of  1893,  Sec.  6. 

■  w  Jersey,  General  Statutes  (1895),  pp.  1642,  Sec.  39,   1643 
49  (XI). 

Now  York.  Revised  Statutes  (1895),  p.  135. 
Ohio,  Annotated  Statutes  (1900),  Sec.  1238  I    10). 
1  Pennsylvania,  Chapter  186  of  1895,  and  Chapter  133  of  i  - 
it  h  ( larolina,   \<\  of  5  Januarj .  L895,  Sec.  3. 
1 '  Washington,  (  ode  i  1899)    Si  i  s.  1248  54. 

Wisconsin,  Statutes  (1898)     Sees.  959 (  23)  <  59),  1418a. 


222  PLC  MB  IN '(,. 

such  person  or  persons  as  said  board  of  health  may  designate;  and  shall  further  pro- 
vide that  lid  plumbing  work  shall  be  done  except  in  the  case  of  repair  of  leaks,  with- 
out a  permit  being  first  issued  therefor  upon  such  terms  and  conditions  as  such  city 
and  town  shall  prescribe.  The  provisions  of  this  section  shall  not  apply  to  the  city 
of  Boston  or  to  any  officer  or  board  thereof."  l 

\\\  New  Jersey  all  local  boards  of  health,  except  township  boards, 
have  a  similar  power,  and  township  boards  also  when  there  is  a  public 
water  supply,  but  this  statute  is  permissive,  not  mandatory.  In  New 
York  there  must  be  established  in  cities  an  examining  board  for 
plumbers,  and  this  board  may  formulate  in  conjunction  with  the  local 
boards  of  health  a  code  of  plumbing  rules.  In  Ohio  the  boards  of  health 
of  cities  of  5,000  or  of  those  having  a  water  supply,  shall  make  a  plumb- 
ing code  which  shall  be  approved  by  the  council.  The  remaining  state 
laws  present  no  Aery  different  features.  In  Pennsylvania  the  law  is 
mandatory,  but  is  not  to  apply  to  cities  or  boroughs  having  no  public- 
water  supply  or  system  of  sewerage. 

Plumbing  (Odes. 

In  accordance  with  the  various  statutory  provisions,  plumbing  regu- 
lations have  been  adopted  in  almost  all  the  larger  cities  of  the  United 
States,  and  also  in  very  many  of  the  smaller  cities,  towns,  and  villages 
which  are  provided  with  a  sewerage  system.  The  intention  in  the  fol- 
lowing pages  is  to  present  a  summary  of  the  local  regulations  govern- 
ing plumbing  and  drainage.  The  first  rule  printed  under  each  heading 
may  be  considered  to  lie  typical  of  the  majority  of  cities  or  of  the  codes 
most  recently  adopted.  In  a  general  way  it  may  be  affirmed  that  small 
towns  and  villages  do  not  appear  to  need  as  elaborate  a  set  of  rules  as 
larger  places  ;  but  of  communities  that  have  attained  the  size  of  20,000 
or  over  there  does  not  seem  to  be  much  difference  in  the  character  of 
the  rules  adopted,  except  that  in  almost  all  cases  the  most  recent  rules 
are  the  most  stringent  and  complete.  Some  of  the  state  boards  of  health 
have  issued  model  plumbing  laws  applicable  to  the  smaller  places  which 
may  not  lie  able,  through  their  local  boards,  to  give  the  subject  the  study 
required  to  formulate  a  good  set  of  rules. 

The  following  are  issued  by  the  state  board  of  health  of  Maine: 

"•  1. —  Before  proceeding  to  construct  any  portion  of  the  drainage  system  of  a 
building,  the  owner,  builder,  or  person  constructing  the  same  shall  hie  with  the 
hoard  of  health  a  plan  thereof  showing  the  whole  drainage  system,  from  its  connec- 
tion with  the  common  sewer  to  its  terminus  in  the  house,  together  with  the  location 
and  sizes  of  all  branches,  traps,  ventilating  pipes  and  fixtures;  and  no  such  work 
shall  be  done  in  any  building  without  the  approval  of  said  Board  of  Health  (Health 
<  >fficer  or  Inspector). 

2. —  Tlie  sewage  from  each  building  on  every  street  provided  with  a  common  sewer 
shall  be  conducted  into  said  se^er;  and,  if  such  sewer  is  not  provided,  the  sewage 

:  Massachusetts,  Chapter  477  of  1893,  Sec.  6. 


PLUMBING.  223 

shall  be  disposed  of  in  a  manner  satisfactory  to  the  Board  of  Health  i Health  Officer 
or  Inspector). 

"3. —  That  portion  <>f  the  house  drain  which  is  outside  of  the  building  and  more 
than  five  feet  from  the  foundation  walls  shall  be  constructed  of  iron  pipe  or  sail 
glazed  vitrified  dram  pipe. 

■•4. —  That  portion -of  the  drain-pipe  within  the  building,  and  outside  within  five 
feet  of  the  foundation  walls,  together  with  the  soil  pipe,  shall  he  constructed  oi 
cast  iron  with  leaded  joints,  or  of  wrought  iron  with  screw  couplings.  The  waste 
pipe  connected  with  the  conductors  from  the  roofs  and  other  pipes  inside  the  build- 
ing, or  outside  and  within  live  feet  of  the  foundation  walls,  shall  he  constructed  of 
iron  with  leaded  joints,  or  screw  couplings. 

■•  .">. —  The  house  drain  and  other  pipes  for  the  conveyance  of  sewage  shall  he  laid 
with  uniform  grade  and  with  a  fall  of  not  less  than  one  inch  in  four  feet,  except  in 
those  eases  where  the  Board  of   Health  may  permit  otherwise. 

••  'i. —  Tin'  main  bouse  drain  shall  he  provided  with  a  trap,  which  shall  he  located 
just  outside.,]'  just  inside  the  house  walls  and  beyond  all  house  connections.  All 
pipes  connecting  a  water-closet  with  a  soil  pipe  shall  he  trapped,  each  separately, 
ami  close  to  the  connection  with  each  water-closet.  All  waste  pipes  shall  be  trapped, 
ea<-h  separately,  and  eh.se  to  the  connections  with  each  bath,  sink,  bowl,  set  of  tubs, 
or  other  fixture. 

••  T —  All  soil  pipes  shall  he  carried  to  their  full  size  through  ami  at  least  two  feet 
above  the  roof  and  left  open.  A.  provision  shall  also  he  made  for  admitting  air  to 
the  house-drain  side  of  the  main  trap. 

"8  -The  joints  in  the  vitrified  pipe  shall  be  carefully  cemented  under  and  around 
the  pipe,  and  the  joints  in  the  cast-iron  pipe  shall  he  run  ami  calked  with  lead.  Con- 
nection of  lead  pipes  with  iron  pipes  shall  he  made  with  brass  ferules  properly 
soldered  and  calked  to  the  iron. 

11 9-  A.11  changes  in  direction  shall  be  made  with  curved  pipes,  and  all  connections 
shall  be  made  with  V  branch  pipes.  All  joints  and  pipes  shall  be  made  air-tight. 
The  whole  work  shall  be  done  by  skillful  mechanics  in  a  thorough  and  workmanlike 
ma  line!-,  and  sat  isfactorihj   i"  t  he  Board  of   Health  (Health  Officer  or  Inspector). 

"  10. —  All  drains  now  built  shall  be  reconstructed,  whenever  in  the  opinion  of 
tlie  Board  of    Health  it   may  be  necessary. 

The  state  board  of  health  of  Connecticut  litis  formulated  a  some- 
what   more  elaborate  code  which    may   be   found  mi    page  298  id'  their 

report    for    1894.     New    Jersej    has  a  del   code   for  which   sec  state 

board  of  health  circular   L.W.     Pennsylvania  and  Ohio  also   liav< 
of  mode]  rules. 

The  following  is  u  summary  of  the  plumbing  regulations  of  the  more 
important  cities : 
PI, his  ,i ,nl  Spt  cification%. 

■'  Before  the  construction,  reconstruction,  alterati ■  repair  (excepl  as  herein 

after  providi  d)  of  anj  portion  of  the  plumbing  and  drainage  system  of  anj  bunding, 
suitable  plans  of  all  work  proposed  to  be  done  shall  be  filed  at  the  office  of  the 
•  inissioner  of  Health  bj  the  architect,  or  by  the  owner  or  agenl  of  the  property."  : 

The  builder  or  other  dul}    authorized  person,  or  plumber,  or  ever} 
person  doing  plumbing  work,  are  occasionally  named    and    sometin 

Brook  l\  n.  Sec.  I. 
This  chaptei  was  written  before  Brooklyn  became  a  pari  ol    Ne\>    \->ik.  and  al  that  timi 
plumbing  code  ol  l". klyn  u.i    of  the  mosl  i plete. 


224  PLUMBING. 

is  not  specified  who  shall  file  plans,  but  the  requirement  is  impersonal, 
"  plans  shall  be  filed." 

Plans  and  Drawings. 

"  For  the  best  interests  of  all  parties  concerned,  the  architects  are  required  to 
notify  the  inspector  of  plumbing,  whenever  they  have  any  plans  completed  for 
buildings  to  be  erected  in  the  city,  so  that  the  inspector  may  examine  the  plans  and 
approve  or  alter  them  before  the  plumbers  figure  on  the  plumbing  work."  l 

"  Plans  will  not  be  required  in  cases  of  removal  of  stoppages,  repairs  of  leaks,  and 
repairs  of  broken  fixtures,  tanks,  kitchen  boilers  or  faucets.'2 

"  Plumbing  work  which  does  not  add  additional  fixtures  or  cause  the  entire 
renewal  or  remodeling  of  any  soil  or  waste  pipes  or  changing  of  the  system  of  using 
such  pipes  shall  be  considered  a  repair."  3 

Such  arc  exempt  from  the  requirement  of  plans.  In  Somerville  the 
work  which  requires  plans  and  is  subject  to  the  provisions  of  the  rnles 
is  more  exactly  defined  : 

tl  The  rules  and  regulations  in  this  ordinance  contained  are  prescribed  for  the 
materials,  construction,  alteration  and  inspection  of  all  pipes,  fittings,  tanks,  faucets? 
valves,  and  other  fixtures  by  and  through  which  waste  water  or  sewage  is  used  and 
carried,  and  no  such  pipes,  tanks,  faucets,  valves,  materials,  or  other  fixtures  shall 
be  placed  in  any  building  in  this  city  except  in  accordance  with  plans  which  shall 
before  such  placing  of  any  such  fixtures  be  submitted  to  and  approved  by  the  inspec- 
tor of  buildings,  and  which  shall   conform   to  the   provisions  of   this  ordinance."4 

"  Where  a  number  of  buildings  are  situated  together  on  one  street,  and  the 
plumbing  is  the  same  in  each  and  to  be  done  under  the  same  contract,  one  plan  will 
be  permitted  for  all  the  buildings.  In  such  case  a  general  plan  must  be  submitted, 
showing  all  the  houses,  and  the  location  of  the  main  drain  for  each  house."  5 

In  Asbury  Park  the  "plans  and  drawings  shall  be  drawn  to  scale  in 
ink  on  cloth,  or  they  must  be  cloth  prints  of  such  scale  drawings."  The 
Albany  rule  requires  that  the  drawings  shall  be  of  a  uniform  size, 
8  x  12}  inches,  or  16  x  12}  inches. 

"  Drawings  and  descriptions  of  the  drainage  of  buildings  erected  prior  to  1886 
may  be  placed  on  file  in  the  office  of  the  Board  of  Health. 

"  When  the  drainage  of  buildings  erected  prior  to  1886  lias  been  inspected  and 
condemned,  plans  must  be  filed,  and  the  new  work  or  alterations  shall  be  executed 
in  accordance  with  these  rules  and  regulations."" 

In  the  City  of  New  York  and  a  few  other  cities,  actual  plans  drawn 
to  scale  are  required  and  are  kept  on  file.  In  many  others,  perhaps  in 
the  majority  of  cities,  the  inspectors  claim  that  the  requirement  of  such 


1  Milwaukee,  Sec.  5. 
-  Brooklyn,  Sec.  •'!. 
:i  Cincinnati,  Sec.  48. 

4  Somerville,   Sec.  10. 

5  Brooklyn,   Sec.  4. 

6  Philadelphia,  Rules  5  and  7. 


plumb  IX  a.  225 

plans  is  an  unnecessary  hardship,  and  that  the  inspector  can  understand 
the  essentials  of  the  scheme  perfectly  well  without  them.  Moreover, 
it  is  claimed  that  even  with  the  best  plans  slight  deviations  will  be  made 
in  the  arrangement  of  pipes  so  that  for  purposes  of  future  reference 
such  plans  have  much  less  value  than  was  hoped  for.  Hence  in  many 
cities,  even  where  plans  are  called  for  by  the  rules,  the  letter  of  the 
rule  is  not  enforced  and  specifications  only  are  required. 

In  Appendix  39  is  shown  the  form  of  specification,  or  rather 
description,  which  is  one  of  the  simplest,  and  is  used  in  Denver.  The 
more  elaborate  Providence  specification  also  is  shown  in  Appendix  40. 
In  other  cities  the  printed  specifications  provided  for  the  use  of  plumbers 
are  much  more  complete.  In  Asbury  Park  a  pamphlet  four  by  eight 
inches  of  forty  pages  is  provided  with  much  printed  description  of  the 
plumbing,  specifying  construction  in  accordance  with  the  city  regula- 
tions and  leaving  few  blanks  to  be  filled  by  the  plumber.  All  of  these 
plans  and  specifications  have  spaces  for  the  approval  of  the  inspector  or 
other  officer. 

Approval  of  Plans  and  Permits. 

••  Plans  and  specifications  will  be  approved  or  rejected  within  a  reasonable  time 
from  the  date  of  riling.  In  case  of  disapproval,  the  one  filing  the  plan  will  be  noti- 
fied, in  writing,  of  the  reasons  for  such  disapproval.1' i 

The  time  for  approval  or  disapproval  is  often  fixed,  from  twenty-four 
hours  in  Pittsburgh  to  ten  days  in  Philadelphia.  Usually  it  is  forty- 
eight  hours. 

"If  the  work  is  not  begun  under  the  approved  plans  within  sis  months  from  the 
date  of  approval,  such  plans  must  be  again  presented  for  approval.  Plans  are  ap- 
proved miller  the  condition  that  such  approval  expires  by  its  own  limitations  within 
■ix  months  from  the  date  of  approval;  and  where  one  plan  has  been  submitted  Eor 

inure  than  one  building,  this  rule  shall  apply  as  to  each  of  s;iiil  buildings  as  it  s;iiil 
plan  had  been  tiled  for  Mich  building  only. 

■  No  change  or  modification  of  the  approved  plans  will  lie  permitted  unless  such 
change  or  modification  be  authorized  by  the  owner  or  agent,  submitted  to  the 
Commissioner  of  Health  and  approved  and   placed  on  file  as  in  the  case  of  original 

work. 

••  \o  portion  of  i  he  plumbing  or  drainage  work  shall  he  executed  until  the  a  hove 
mentioned  plans  and  description  thereof  shall  bave  been  approved  bj  the  Commis- 
sioner of  I  halt  li."  -' 

Besides  the  approval   endorsed   on   the   plans   and  specifications,  a 

notice  of  approval  or  a  permit  fur  work  is  issued  in  many  cities,  and  in 
some  .iiies  a   lee    is  charged    for  these.      The  lee    varies  from  lift\    cents 

in  Sun  Francisco  to  two  dollars  in  New  Jersey  cities.  In  Philadelphia 
tin-  ire  is  uiie  dollar,  and,  owing  to  the  Large  number  of  plans  of  old 
plumbing  filed,  the  department    is  self-sustaining,  813,756  having  been 

1  Brooklyn,  See.  6. 

x  Brook  Ij  n.  Sims.  8,  0,  and  7. 
16 


226  PLUMBING. 

received   in  1899.     In  Providence  the  "approval"  is  in  the  form  of  a 
postal  which  is  mailed  to  the  plumber. 

Some  system  must  be  followed  in  the  inspector's  office  in  keeping 
run  of  the  work.  In  Providence  all  plans  of  work  in  course  of  con- 
struction are  kept  in  a  cabinet  indexed  under  the  name  of  vlie  plumber. 
When  the  work  is  completed  the  plans  and  all  other  papers  are  filed 
numerically.  Besides  this  four  record  books  are  kept.  In  the  first 
book  the  plans  are  entered  consecutively,  numbered,  with  name  of  street, 
name  of  plumber,  dates  of  filing,  approval  or  rejection  of  plan,  applica- 
tion for  inspections,  and  inspection,  page  of  street  index,  and  remarks. 
A  second  book  is  simply  a  street  index.  In  a  third  book  is  recorded 
the  daily  work  of  the  office  in  inspections,  etc.  In  the  last  book  the 
description  and  application  with  endorsement  are  entered  as  a  permanent 
record. 
Materials  and  Workmanship. 

"All  materials  used  in  the  work  of  plumbing  and  drainage  must  be  of  good 
quality  and  free  from  defects;  the  work  must  be  executed  in  a  thorough  and  work- 
manlike manner."  x 

Deviation  from  Mules  Permitted. 

"  Deviations  and  variations  from  these  rules  will  be  allowed  when  desired  if  in 
the  opinion  of  the  board  of  health  they  will  not  be  or  be  liable  to  become,  a  source 
of  danger  to  the  public  health."  2 

In  the  District  of  Columbia,  Section  15,  such  permission  may  only 
be  given  in  writing. 

"  The  plumbing  inspector  shall  use  his  discretion  and  his  decision  shall  be  final  in 
regard  to  work  in  old  and  new  buildings  which  cannot  be  governed  by  the  rules."  3 

In  Somerville,  Mass.,  deviations  are  not  allowed  in  buildings  to  be 
used  as  dwellings  or  places  of  business. 

Connection  with  Sewer. 

11  Every  house  and  building  must  be  separately  and  independently  connected 
with  the  street  sewer,  except  in  cases  where  there  may  be  a  house  in  the  rear  of 
the  lot  where  it  may  be  connected  with  the  sewer  of  the  house  in  front.  A  house 
or  building  shall  be  defined  as  an  architectural  structure  covered  by  one  roof  and 
enclosing  walls. 

"  Porches  or  the  continuation  of  porch  roofs  from  building  to  building  shall  not 
be  considered  as  a  portion  of  the  main  structure."  4 

11  Every  building  provided  with  water  from  the  city  or  other  water  supply  shall 
have  a  waste  pipe,  for  the  conveyance  of  waste  water  and  sewage,  connected  with 
the  public  sewer  or  with  a  particular  sewer,  or,  if  there  is  no  such  sewer,  with  a 
cesspool,  constructed  as  aforesaid  as  the  inspector  of  buildings  or  board  of  health 
shall  require.  No  drain  or  sewer  from  any  building  shall,  without  the  approval  of 
the  inspector  of  buildings,  pass  under  another  building."  5 

1  Brooklyn,  Sec.  14. 

2  Hartford,  Sec.  49. 
*  Cleveland,  Sec.  27. 

4  San  Francisco,  Sec.  4. 

5  Somerville,  Mass.,  Sec.  13. 


PLUMBING. 


227 


In  Portland  and  Reading  a  separate  connection  must  be  made  if 
feasible.  In  Scranton,  in  case  there  are  two  buildings  on  one  lot,  a 
single  sewer  connection  may  be  allowed  if  there  is  a  separate  trap  and 
fresh  air  inlet  for  each  building.  In  Somerville,  Mass..  "a  block  of  two 
houses  may  be  connected  with  the  public  sewer  through  one  pipe,  con- 
nections being  made  five  feet  outside  of  the  building." 

The  control  of  the  drain  in  the  street  to  the  lot  or  curb  line  is 
usually  in  the  hands  of  the  department  which  builds  and  maintains  the 
sewers,  and  as  this  is  rarely  the  health  department,  and  as  the  regula- 
tions governing  this  work  are  not  often  found  in  plumbing  codes,  they 
will  not  here  be  considered. 
§  ..   of  Drain. 

11  House   sewers  shall  be  of  not  less  than  the  following  sizes,  and  no  sewer  shall 
lie  smaller  than  the  soil-pipe  it  serves: 


When  fall  is  \  inch 
to  a  foot. 


When  fall  is  4  inch 
to  a  foot. 


Area  of  Li  A 

to  hf 
Drained. 

Size  of 

Sewer. 

Area  of  Lot 

to    111' 

Drained. 

size  of 
s.'\ver. 

2,000    sq.  ft. 

3,000 

5,000 

4  inches. 

•>;. 500  sq.  ft. 

4,500 

7.  •■.mi       " 

4  inches. 
6 

••  No  house  sewer  shall  be  larger  than  six  indies  in  diameter.  Where  the  area  to 
in-  drained  is  larger  than  given  in  the  table,  several  sewer  connections  shall  lie 
used."  ' 

•  Each  house  sewer  shall  consist  of  a  separate  drain  pipe  of  iron  or  vitrified 

stone  ware  of  the  size  specified  in  the  following  table  for  the  various  a  leas,  the  total 
area  of  the  lol  to  he  drained  being  taken  to  determine  the  size  uf  the  house  sewer: 

-i/i    or   BOUSE   -i:v\  I  a;. 


Area 

Inside  diameter  of 

Least    fall. 

to     be    drained. 

house  sew er. 

Square  feet. 

1  loll. 

Vitrified  Pipe. 

loo  to  2,500 

4" 

1  "    III    lo 

■_',". 1,1 

;," 

:," 

1"  in    1- 

i.oi 10,000 

r," 

1   "     Mi 

11  No  house  sewer  greatei  than  six  inches  inside  diameter  shall  be  allowed   with- 
i, ut  the  written  approval  of  the  superintendent  "i  sewers.11  • 

1  Brooklyn,  Sec.  16. 

2  Districl  of  Columbia.  Sec.  To. 


228  PLUMBING. 

Other  cities,  as  Buffalo,  Cleveland,  Lawrence,  and  Portland,  Me., 
make  six  inches  a  minimum  instead  of  a  maximum  limit,  except  that  in 
Cleveland  it  may  be  four  inches  if  there  are  no  water-closets.  In  Hart- 
ford, Lawrence,  and  New  Bedford  the  minimum  limit  is  five  inches.  In 
Philadelphia  the  maximum  limit  is  ten  inches.  Four  inches  is  invari- 
ably the  minimum  limit  and  it  is  also  sometimes  specified  that  it  shall 
not  be  smaller  than  the  soil  pipe  which  it  serves.  In  Lawrence  it  must 
be  one  inch  larger.  In  New  York  City  the  diameter  is  to  be  such  as 
the  board  of  health  may  approve. 

Material  and  Construction  of  Drain. 

In   most  regulations  a  tile  drain   is  permitted   up  to  within  a  short 

distance  of  the  house,  but  in  some  cities  this   is  not   allowable  except 

under  certain  conditions  : 

"  Where  the  ground  is  made  or  filled  in,  the  house  sewer,  by  which  is  meant  the 
portion  of  the  drain  extending  from  the  public  sewer  to  the  front  wall,  must  be  of 
extra  heavy  iron  pipe  of  such  diameter  as  the  Board  of  Health  may  approve.  Such 
pipes  must  be  laid  with  the  joints  properly  caulked  with  lead."  1 

In  Albany  the  drain  must  be  iron  if  the  land  has  been  filled  within 

five  years. 

"  Sewer  pipes  in  yards  may  be  of  the  best  quality  vitrified  pipe,  with  cemented 
joints,  with  the  following  restrictions:  They  shall  not  be  laid  closer  than  ten  feet 
to  any  exterior  wall  of  a  building,  or  less  than  three  feet  below  the  surface  of  the 
ground,  or  when  the  sewer  passes  near  a  well,  nor  will  they  be  allowed  in  bad  or 
made  ground.  In  all  other  cases  sewers  beneath  the  ground  must  be  of  extra  heavy 
cast  iron  pipe."  '2 

111  New  York  City  and  Rochester  it  is  permitted  to  lay  the  tile  drain 
up  to  the  foundation  wall,  but  in  most  rules,  as  in  Brooklyn  above,  it 
must  not  lie  laid  within  a  certain  distance  of  the  house.  This  distance 
is  two  feet  in  Bridgeport  and  Fall  River,  three  feet  in  Providence  and 
San  Francisco,  four  feet  in  Scranton,  five  feet  in  Lawrence,  New  Bed- 
ford, the  District  of  Columbia,  and  Philadelphia,  six  feet  in  the  large 
New  Jersey  cities,  all  of  which  have  a  similar  code,  and  ten  feet  in  Somer- 
ville  and  Brooklyn.  In  Milwaukee  the  drain  must  be  iron  if  less  than 
eighteen  inches  below  the  surface  of  the  ground.  In  the  District  of 
(  olmnbia  tile  pipe  can  only  be  used  if  connection  is  made  towards  the 
rear. 

Most  cities  require  extra  heavy  iron  pipe  within  the  cellar  walls,  but 
sometimes,  as  in  Providence  and  Cincinnati,  tile  is  allowed  under  certain 
conditions.  In  Cincinnati  it  may  be  used  when  the  soil  is  a  natural 
bed  of  loam,  sand  or  rock,  and  in  Providence  the  joints  must  be  made 
to  withstand  the  water  test.  The  manner  of  laying  is  well  specified  in 
Pittsburgh,  Sec.  10 : 

1  City  of  Xew  York,  Sec.  9. 

2  Brooklyn,  Sec.  17. 


PLUMBING.  229 

'  Outside  of  building,  where  the  ground  is  of  sufficient  solidity  for  a  proper 
foundation,  cylindrical  terra-cotta  pipe  of  the  best  quality,  free  from  tiaws,  splits  or 
cracks,  perfectly  burned  and  well  glazed  over  the  entire  inner  and  outer  surfaces, 
may  be  used  if  laid  on  a  smooth  bottom  with  a  special  groove  cut  in  the  bottom  of 
the  trench  for  each  hub,  in  order  to  give  the  pipe  a  solid  bearing  on  irs  entire  length, 
and  the  soil  well  rammed  on  each  side  of  the  pipe.  The  spigot  and  hub  ends  shall 
be  concentric.  The  space  between  the  hub  and  the  pipe  must  be  thoroughly  filled 
•with  cement  mortar,  made  of  equal  parts  of  the  best  American  natural  cement  and 
bar  sand,  thoroughly  mixed  dry  and  enough  water  afterward  added  to  give  it 
proper  consistency.  The  mortar  must  be  mixed  in  small  quantities  and  used  as  soon 
as  made. 

"The  joints  must  be  carefully  wiped  out  and  pointed,  and  all  mortar  that  may 
be  lefc  inside  removed,  and  the  pipe  left  clean  and  smooth  throughout,  for  which 
purpose  a  swab  must  be  used.'" 

In  Albany  the  drains   must   be  laid   with  the  hub  end  up  hill.      In 

Asbury  Park  the  drain  must   he  laid  on  hoards  six   inches  by  one  inch, 

or  if  over  eight  inches  in  diameter,  the  plank  must  be  six  inches  by  two 

inches.      In  Milwaukee   "  hack   filling   is  to  be  first    hand    packed   with 

care  and  then  well  rammed  to  prevent  the  slightest  setting  of  the  drain."' 

In    Lawrence  a  drain  cannot   he   laid   in  the   same  trench   as  a   sewer  or 

water  pipe  or  within  four  feet  of  the  line  of  the  same.      In  Milwaukee 

the  distance  is  eighteen  inches. 

■■  Old  sewers  or  In, use  drains  can  lie  used  for  new  houses  only  when  found  h\  ;m 
Inspector  of  this  Department  to  conform  in  all  respects  to  the  regulations  governing 
new  sewers  and  drains.""  l 

Soil  'im/   Waste  Pipes,  Size. 

Soil  pipes  are  never  to  he  less  than  four  inches  in  diameter.  In 
Lawrence,  if  there  are  four  water-closets,  and  in  New  Bedford,  if  three 
or  more  closets  discharge  into  it,  the  soil  pipe  must  lie  five  inches  in 
diameter. 

■■  In  all  buildings  having  three  (3)  stories  the  diameter  of  vertical  s..il  pipes  shall 
in-  one  (1)  inch  greater  from  a  point  one  (1)  foot  below  the  roof  than  that  of  the 
pipe  proper,  and  the  increased  size  of  pipe  shall  continue  through  ami  above  the 
roof. 

•In  buildings  having  more  than  three  (.".(stories,  vertical  soil  pipes  shall  be 
Increased  one  (1)  inch  in  diameter  at  each  twenty-five  (25)  feel  oi  elevation  above 
the  third  story."  - 

•■  Traps  ami  branch  waste  pipes  shall  he  ..t'  t lie  following  si/.es : 

For  lias iiis  and  pant  ry  sinks 1  '.  inches. 

Slop  sinks :l        " 

Kitchen  sinks 1     or  2 

Ba1  b  tubs it.  or 2 

Crinals I     or  'J 

Laundry  tuhs l  :.  or  2 

Water-closets t 

1  Citj    Of    New    York.   See.    17. 

I  >is1  rid  of  <  Jolumbia,  Sec.  88. 
•  Brooklyn,  Sec.  86. 


230  PLUMBING. 

In  Scranton  and  Reading  one  and  one-quarter  inches  is  allowed  for 
basins,  pantry,  and  kitchen  sinks.  In  Hartford  basins  may  have  one 
and  one-quarter  inch  pipes.  In  Lawrence  it  is  specified  that  these  are 
inside  measurements,  and  pipe  must  be  gauged  by  the  plumbing  inspec- 
tor. In  Cleveland  a  stack  for  wastes  must  never  be  less  than  two 
inches.  In  Hartford  two  fixtures  require  a  one  and  one-half  inch  pipe. 
In  Haverhill  and  New  Bedford  two  fixtures  require  a  two-inch  pipe, 
and  in  Fitchburg  two  to  six  fixtures  a  two-inch  pipe,  and  over  six  fix- 
tures a  three-inch  waste  pipe.  In  the  New  Jersey  cities  five  sinks 
require  a  three-inch  pipe.  In  Brooklyn  eight  fixtures  require  a  three- 
inch  pipe,  three  to  seven  fixtures  a  two-inch  pipe,  and  three  fixtures 
one  and  a-half  inch  pipe.  In  New  Bedford  and  Hartford  horizontal 
waste  pipes  for  sinks  must  be  three  inches  in  diameter. 

Soil  and  Waste  Pipes,  Material. 

"Sewer  pipes  above  the  ground  and  all  soil,  waste,  and  vent  pipes  sliall  be  of 
extra  heavy  cast  iron  or  heavy  wrought  iron  or  steel  pipe.  Wrought  iron  pipe  shall 
be  asphalted,  galvanized  or  otherwise  made  rustless.  Lead  pipes  will  be  allowed 
only  in  short  lengths  and  when  they  are  exposed  to  view.  If  nickel-plated  or 
polished  brass  pipes  are  used,  they  shall  be  of  iron-pipe  size  and  of  heavy  pipe.  No 
brass  pipe  less  than  fa  of  an  inch  in  thickness  will  be  allowed.'1  l 

"All  drain  and  anti-syphon  pipes  of  cast-iron  shall  be  sound,  free  from  holes, 
and  of  a  uniform  thickness,  and  shall  conform  to  the  following  relative  weights: 


Standard. 

Extra  Heavy. 

2  inch 

pipe 

4  lbs. 

per  foot. 

2 

incl 

i  pipe 

5i  lbs. 

per 

foot. 

3     " 

" 

6    " 

" 

b 

" 

" 

91    " 

" 

4     " 

" 

9    " 

I  I 

4 

" 

'l 

13      tl 

" 

5     " 

" 

12    " 

" 

5 

" 

11 

17      " 

tl 

6     lt 

" 

15    " 

" 

6 

lb 

" 

20      " 

" 

7     " 

" 

20    " 

" 

7 

" 

" 

27      " 

l' 

8     " 
0     " 

it 

25    " 
35    " 

tt 

8 
10 

L 

tt 

33*    lt 
45      " 

' 

2     " 

" 

45    tl 

lt 

12 

" 

" 

54      " 

tt    2 

Ordinary  iron  soil  pipe  is  permitted  in  place  of  the  extra  heavy 
under  certain  conditions  in  many  cities.  Thus  in  Providence,  Somer- 
ville,  New  Haven,  and  Philadelphia,  only  soil  pipe  below  ground  need 
be  extra  heavy.  In  Cleveland  and  San  Francisco  extra  heavy  is  required 
in  buildings  of  over  four  stories.  In  Manchester,  N.  H.,  soil  pipes  carry- 
ing discharges  from  water-closets  must  be  extra  heavy.  In  Cleveland 
and  Providence  the  thickness  of  standard  ordinary  pipe  is  specified, 
four-inch  pipe  one-eighth  of  an  inch  thick,  five  to  six-inch  pipe  five- 
thirty-seconds  of  an  inch  thick,  and  a  proportional  thickness  for  greater 
diameters. 


1  Brooklyn,  Sec.  25. 
a  Philadelphia,  Rule  23. 


PLUMBING.  231 

"All  wrought-iron  and  steel  pipe  must  be  equal  in  quality  to  "standard,'1  and  be 
properly  tested  by  tbe  manufacturer.  All  sucb  pipe  must  be  lap-welded,  and  shall 
be  galvanized.  Xu  plain  black  pipe  will  be  permitted.  Each  length  of  said  pipe 
shall  have  the  weight  per  foot  and  maker's  name  stamped  upon  it.  Fittings  for 
wrought  iron  or  steel  vent  pipes  may  be  cast  or  malleable  steam  and  water  fittings. 
Fittings  for  waste  or  soil  pipes  must  be  the  special,  extra  heavy  cast-iron  recessed 
and  threaded  drainage  fittings,  with  smooth  interior  water-way,  so  as  to  give  a  uni- 
form grade  to  branch  of  not  less  than  one-quarter  of  an  inch  per  foot.  All  joints 
shall  be  screwed  joints,  made  up  with  red  lead,  and  the  burr  formed  in  cutting  must 
be  carefully  reamed  out.  The  pipe  shall  not  be  less  than  the  following  average 
thicknesses  and  weight  per  lineal  foot: 

Weight  per 
Diameters.  Thicknesses.  lineal  foot. 
\\  inches         .14  inches  2.68  pounds 

2  inches        .15  inches  3.61  pounds 
2£  inches         .20  inches  5.74  pounds 

3  inches         .21  inches  T..")4  pounds 
34  inches         .22  inches           9.00  pounds 

4  inches         .23  inches         10.66  pounds 
44  inches         .24  inches         12.34  pounds 

5  inches         .25  inches         l-t.r><i   pounds 

6  inches         .28  inches         18.76  pounds  l 

In  Detroit  "wrought  iron  or  steel  pipe  of  one  and  a  half  inch  or 
more  in  diameter  must  be  but-welded  and  smaller  sizes  lap-welded." 

"All  cast-iron  pipe  used  shall  have  cast  upon  it,  directly  back  of  the  hub  of  each 
section,  the  weight  per  lineal  foot  and  the  name  of  the  manufacturer,  in  characters 
not  less  than  one-half  (i)  inch  in  length.1'  2 

Iii  Philadelphia  considerable  pipe  lias  recently  been  found  which  was 
of  less  weight  than  indicated  by  the  figures  upon  it. 

The  question  of  tarring  cast-iron  pipe  is  treated  differently  in  differ- 
ent cities.  Often,  as  above,  it  is  merely  required  that  iron  pipe  shall  be 
asphalted  or  tarred.  In  Cincinnati,  Milwaukee,  Providence,  and  Roches- 
ter the  pipe  niiisi  be  tarred  before  putting  up: 

"Cast-iron  soil,  waste,  or  vent  pipes  before  being  put  in  place  shall  be  coated 

inside  and  out  with  coal-tar  pitch  applied   hot." 

■  I  ion  pipes  used  in  plumbing  shall,  before  being  put  iii  place,  be  first  tested  by 

the  water  or  kerosene  test  and  tlien  coated  inside  and  out  witb  coal-tar  pitch  applied 

hot,  or  with  paint,  or  with  some  equivalent  substance.'1  ' 

There  is  a  similar  rule  in  the   District  of  Columbia  and    Baltimore. 
Iii   New  York  city  and  Asluirv   Park,  on  the  other  band,  no  tar- 
coated  cast-iron  pipe  is  allowed. 


1  Asbury  Park,  Sec.  31. 

a  I  )|  }|  lict   oi    <  'olumbia,   See.    1  10. 

Proi  idence,  Sec.  7. 
•  Boston,  Sec.  127. 


232  PLUMBING. 

Metal  pipes  are  not  always  admissible,  hence  in  Providence  : 

"  Soil  and  waste-pipes  and  their  branches  shall  be  of  iron,  lead,  or  brass,  except 
in  manufacturing  establishments  where  acids  are  used,  in  which  case  such  material 
shall  be  used  as  shall  be  approved  by  said  inspector.1"  1 

In  the  City  of  New  York  all  fittings  used  with  iron  pipe  "  shall  cor- 
respond with  it  in  weight  and  quality." 

"All  lead  pipes,  bends,  and  traps  must  be  drawn  and  of  not  less  than  the  follow- 
ing weights  per  lineal  foot: 

1^  inches 3+  pounds 

2  "      5 

3  "      (5  " 

4  "     8         "  a 

In  Hartford  and  Providence  one  and  one-half  inch  pipe  may  weigh 
three  pounds,  and  in  New  York  City  and  Scranton  two-inch  pipe  may 
weigh  four  pounds. 

"All  brass  pipe  for  waste  and  vent  pipes  and  solder  nipples  must  be  thoroughly 
annealed,  seamless  drawn  brass  tubing  of  standard  iron  pipe  guage.  Connections 
with  said  brass  pipe  and  between  brass  pipe  and  traps,  or  between  brass  pipe  and 
iron  pipe  must  not  be  made  with  slip  joints  or  couplings.  Threaded  connections  on 
brass  pipe  must  be  of  the  same  size  as  iron  pipe  threads  for  the  same  size  of  pipe 
and  be  tapered.  The  following  average  thicknesses  and  weights  per  lineal  foot  will 
be  required: 

Weights  per 

Diameters.  Thickness.  lineal  foot. 

1|  inches  .14  inches  2.84  pounds 

2  inches  .15  inches  3.82  pounds 
24  inches  .20  inches  6.08  pounds 

3  inches  .21  inches  7.92   pounds 
34  inches  .22  inches  9.54  pounds 

4  inches  .23  inches  11.29  pounds  * 

As  shown  in  rule  25  of  Brooklyn,  given  above,  lead  waste  pipe  is 
usually  allowed  in  short  lengths.  In  San  Francisco  it  may  "  be  used 
only  as  branches  to  connect  with  cast  or  wrought  iron  ;  said  branches 
shall  not  exceed  five  feet  in  length."  In  Hartford  the  length  may  be 
six  feet.  In  Lowell  waste  pipes  over  two  inches  must  be  iron.  In 
Reading  "  lead  wastes  may  be  used  for  horizontal  lines  that  are  two 
inches  or  less  in  diameter." 

Joint*  in  J'/'pes. 

"Joints  in  earthen  pipe  shall  be  made  with  pure  cement. 

11  Joints  in  cast  iron  pipe  shall  be  made  with  pure  lead,  well  caulked,  and  no 
paint,  varnish  or  putty  will  be  allowed  until  the  joints  have  been  tested. 
"  Joints  in  wrought  iron  or  steel  pipe  shall  be  screw  joints. 

1  Providence,  Sec.  5. 

2  Brooklyn,  Sec.  37. 

8  Asbury  Park,  Sec.  33. 


PLUMBING.  233 

"  Joints  in  lead  pipe  shall  be  in  all  cases  wiped  or  overcast. 

11  Joints  between  lead  and  iron  pipes  shall  be  made  by  extra  heavy  cast,  or  pref- 
erably drawn,  brass  screw  nipples,  or  with  such  caulking  ferrules  of  the  full  size  of 
the  iron  pipe.  The  thickness  of  all  brass  thimbles  or  ferrules  shall  be  at  least  one- 
eight  of  an  inch."  2 

"  .  .  •.  Brass  ferrules  must  be  best  quality,  bell  shaped,  extra  heavy  cast  brass, 
not  less  than  four  inches  long  and  two  and  one-quarter  inches,  three  and  one-half 
inches,  and  four  and  one-half  inches  in  diameter,  and  not  less  than  the  following 
weights: 

Diameter.  Weight. 

'1\  inches  1  pound,     0  ounces 

'■',  .   inches  1  pound,   12  ounces 

-H  inches  2  pounds.  8  ounces 

"One  and  one-half-inch  ferrules  axe-not  permitted.  Soldering  nipples  musi  !"■ 
heavy  casl  brass,  or  of  brass  pipe,  iron  pipe  size.  When  cast  they  must  not  be  less 
than  the  folic  .winy  weights: 

Diameters.  Weights. 

li   inches  0  pounds.     8  ounces 

1     inches  0  pounds,  14  ounces 

•_'     inches  1    pound,      b'  ounces 

3  inches  2  pounds,     0  ounces 

4  inches  '■'>  pounds.     8  oun<  i 

In  Providence  joints  in  earthen  pipe  shall  be  made  with  Portland 
or  hydraulic  cement  and  sand  in  proper  proportions  and  in  Pittsburg, 
as  above,  the  proportions  of  cemenl  and  sand  arc  specified. 

In  the  joints  of  oast  iron  pipes,  Rochester  requires  not  loss  than 
twelve  mmces  of  lead  for  each  inch  of  the  diameter  of  the  pipe  so  con- 
nected. A  few  cities  permit  "rust  joints  carefully  and  properly  made." 
In  Now  Bedford  they  musi  be  one  and  one-half  inches  deep.  In  Phila- 
delphia they  may  be  of  "cemenl  made  of  iron  filings  and  solammoniac, 
so  a>  io  make  them  gas  tight." 

In  Manchester,  N.  II..  Fall  River  and  Haverhill,  joints  in  load  pipe 
arc  to  ho  wiped  joints  ••when  practicable."  Screw  joints  must  be  made 
up  with  rod  load  or  be  steam  tight.  In  Manchester,  Portsmouth,  Haver- 
hill, and  Now  Bedford  saddle  hnhs  arc  forbidden  and  in  the  District  of 
Columbia  -no  soil  or  waste  pipe  shall  be  tapped."  In  Lawrence  sad- 
dle hubs  are  allowed  when  it  is  impossible  to  connect  otherwise.  In 
Now  Bedford  double  hubs  are  prohibited  on  all  oast  iron  soil  or  waste 
pipes.  In  Hartford  rubber  vent  couplings  and  brass  vent  unions  for 
lead  and  iron  pipe  will  not  ho  allowed  under  any  circumstances.  In 
Fitchburg  "  combination  brass  ferrules  with  ground  joints  may  be  used.1 

Pitch. 

■The  inclination  of  water-closet,  kitchen  and  all  othei  drains  do!  over  sj\  in 
in  diameter,  liable  to  receive  solid  substances,  shall  not  be  less  than  one-half  an  inch 

1  I ;  i  ...  1, 1  \  n   Se<  ,  29. 
bury  Park,  s'-c.  :;::. 


234  PLUMBING. 

in  two  feet;  and  of  cellar  or  other  drains,  to  receive  water  only,  one-quarter  of  an 

inch  in  two  feet."  x 

The  same  is  found  in  Milwaukee  and  Cleveland.  In  Albany  the 
drain  inside  the  house  may  have  a  pitch  of  one-eighth  inch  per  foot  and 
outside  the  house  one-quarter  inch  per  foot.  Usually  one-quarter  inch 
per  foot  is  the  minimum  pitch  allowed.  In  the  District  of  Columbia 
the  minimum  pitch  for  a  drain  is  one-fifth  inch  per  foot  and  the  rules 
further  prescribe  that : 

"•  No  house  sewer  shall  be  laid  with  a  less  fall  than  required  by  this  table,  or 
with  a  greater  fall  at  or  within  four  (4)  feet  of  the  junction  witli  the  main  sewer 
than  two  (2)  inches  vertical  in  three  (3)  inches  horizontal. 

"  The  limits  of  grade  specified  are  intended  to  apply  only  to  extreme  and  unusual 
cases;  in  all  ordinary  cases  a  practically  uniform  grade  shall  be  preserved  from  a 
point  five  (5)  feet  exterior  to  the  building  served  or  the  building  line  thereof  to  the 
junction  with  the  main  sewer."'2 

Changes  in  Direction. 

In  Lowell  changes  in  direction  of  soil  pipes  shall  be  made  with  slow 
curves. 

"  The  arrangement  of  drain,  soil,  waste  and  vent  pipes  must  be  as  direct  as  pos- 
sible. All  changes  in  the  direction  of  drain,  soil  or  waste  pipes  shall  be  made  with 
Y  branches,  1-16,  1-6,  or  1-8  bends.  Offsets  may  be  used,  provided  the  angle  they 
present  is  not  less  than  that  represented  by  a  1-6  bend."  3 

In  Brooklyn  offsets  must  "  be  made  with  forty-five  degree  bends  or 
similar  fittings,"  and  in  that  and  some  other  cities  "  the  use  of  T-Y's 
will  be  permitted  on  upright  lines  only. 

Openings  for  Pipes. 

Jn  Boston  the  "drain  shall  not  be  subjected  to  pressure  where  it 
passes  through  a  wall." 

In  Pittsburg,  when  the  house  drain  passes  through  a  new  foundation 

wall,  a  relieving  arch  shall  be  built  over  it  with  a  two-inch  space  on 

either  side  of  the  drain.     In  Fall  River  there  must  also  be  a  two-inch 

space  on  top ;  and  in  the  District  of  Columbia  "  there  shall  be  built  into 

the  wall  during  its  construction  an  iron  pipe  not  less  than  two  inches 

in  diameter  greater  then  the  pipe  proposed  to  be  run." 

"  Wherever  pipes  pass  through  floors,  the  openings  in  both  floors  and  ceilings 
shall  be  tightly  closed  to  prevent  the  passage  of  air  currents  from  one  story  to 
another,  or  from  the  pipes  into  the  ceiling  spaces  in  a  horizontal  direction."  4 

Supports  for  Pipes. 

"  Whenever  practicable,  sewer  pipes  within  the  buildings  shall  be  supported  by 
substantial  brick  piers,  or  properly  secured  to  walls,  or  suspended  to  floor  timbers 

1  Providence,  .Sec.  10. 

2  District  of  Columbia,  Sec.  70. 

3  San  Francisco,  Sec.  2. 

4  Brooklyn,  Sec.  42. 


PLUMBING.  235 

by  strong  iron  hangers.  When  sewers  are  necessarily  laid  below  the  floor,  brick 
manholes  shall  be  built  to  give  access  to  all  handholes.'1 1 

In  Portland  "  they  may  be  laid  in  a  brick  or  cemented  trench  in  the 

cellar  bottom." 

"...  When  required  by  the  inspector  of  buildings,  drain  pipes  below  a 
cellar  floor  shall  be  laid  in  a  brick  trench  with  a  concrete  bottom,  and  shall  be 
accessible  through  sufficient  unattached  covers."'  - 

In  Boston  this  is  the  rule  in  every  instance. 

Supports. 

In  Manchester,  N.  H.,  when  any  floor  other  than  earth  is  to  be  laid 
over  a  pipe  in  a  basement  or  cellar  it   must   be   laid   in   a  trench.     In 

Philadelphia  "it  may  be  constructed  along  the  foundation  walls  above 
the  cellar  floor,  resting  on  nine  (9)  inch  brick  piers  laid  in  cement  mor- 
tar, said  piers  to  be  not  nunc  than  seven  (7)  feet  apart,  and  securely 
fastened  to  said  walls." 

"All  soil  and  waste  pipes  shall  be  properly  fastened  and  secured  with  either 
heavy  wrought  iron  straps  or  hooks.  If  hooks  are  used  they  shall  be  forged  out  of 
one  piece  of  iron,  not  welded."  ; 

"  Wrought  iron  hangers  (double  hangers),  one-half  inch  in  diameter,  will  be 
required  for  five  and  six  inch  pipe,  three-eighths  inch  for  three  and  four  inch  pipe, 
and  one-quarter  inch  for  two  inch  pipe.  Hangers,  clamps,  or  suitable  brick  piers 
must  lx'  placed  at  intervals  of  seven  and  one-half  feet."  4 

In  Now  Haven  and  Haverhill  supports  may  be  ten  feet  apart,  and 
in  Scranton  there  must  be  a  support  for  every  Length  of  pipe.  In 
Asonry  Park  the  use  of  pipe    hooks  for  supporting  pipes  is  pr<  hibited. 

■•All  connections  of  l< sad  supplies,  waste,  vent,  or  flush  pipes  shall  he  made  by 
1 1 i*-;i  ii-^  of  wiped  joints,  and  shall  be  supported  their  entire  length  by  means  of  lead 
tacks  or  clips  screwed  to  boards  provided  for  the  purpose."  •"■ 

In  Hartford  and  Rochester  vertical  soil  pipes  musl  rest  <»n  a  pier  or 
foundation. 

Exposure  of  Pipes  and  Fixtures. 

"The  drain,  soil,  and  waste  pipes,  and  the  traps  must,  it  pracl it  aide,  be  exposed 
to\iiu  for  ready  inspection  at  all  times  and  for  convenience  in  repairing.  When 
necessarily  placed  within  partition  or  in  recesses  of  walls,  soil,  waste  pipes  should 
be  covered  with  woodwork  so  fastened  with  screws  as  to  be  readilj  removed;  in  no 
hall  t  hey  be  absolutely  inaccessible.  It  is  recommended  to  place  soil  and  other 
vertical  pipes  in  a  special  shaft  between  or  adjacenl  to  the  water  closets  and  bath 
room,  and  serving  as  a  ventilating  shafl  for  them.     This  shaft  should  be  at  least  two 

1  Brooklyn,  Sec.  18. 
"  Somen  tile,  Sec.  •_'". 

San  Francisco,  Sec.  l  I. 
1  Hartford   Sec.  16. 
•  Hartford,  Sec.  88. 


236  PLUMBING. 

and  one-half  feet  square.  It  should  extend  from  the  cellar  through  the  roof,  and 
should  he  covered  by  a  "  louvered  skylight,"  it  should  be  accessible  at  every  story 
and  should  have  a  very  open  but  strong  grating  at  each  floor  to  stand  upon.  Shafts 
not  less  than  three  square  feet  in  area  are  required  in  tenement  houses  to  ventilate 
interior  water-closets."  1 

In  Reading,  when  sewers  are  below  floors,  manholes  must  be  pro- 
vided to  give  access  to  the  cleansing  branches. 

"  No  soil  pipe  shall  be  run  up  outside  of  any  building,  or  between  the  studdings 
or  between  the  walls  of  rooms. 

"Where  a  lead  waste,  or  ventilation  pipe,  passes  through  between  the  floors, 
ceiling  or  other  places  accessible  to  rats,  such  pipes  must  be  encased  with  sheet  tin, 
copper  or  galvanized  iron."  2 

111  Milwaukee  no  soil  or  waste  pipe  shall  be  placed  in  a  recess  in 
the  outside  wall.  In  the  District  of  Columbia  '.'  all  soil,  drain,  waste, 
and  vent  pipes  shall  lie  located  inside  of  buildings.  In  Brooklyn  the 
enclosing  of  water-closets  with  wooden  casing  will  not  be  permitted. 

"The  space  in  and  around  water-closets,  and  wash  bowls,  shall  not  be  enclosed 
by  woodwork,  but  shall  remain  open  and  exposed  to  view,  except  that  a  closet  may 
be  made  under  a  wash  bowl,  when  provided  with  a  suitable  door."  3 

"In  tenement  and  apartment  houses  sinks  must  be  entirely  open  and  placed  on 
iron  legs  or  brackets  without  any  enclosing  woodwork."  4 

Cleanouts. 

"  Cleanouts  shall  be  placed  in  horizontal  drain  and  waste  pipes  close  to  Y 
branches,  and  at  every  right  angle  turn  in  the  drain.  All  traps  shall  be  provided 
with  suitable  accessible  openings  for  cleaning  purposes,  and  all  such  openings  or 
cleanouts  shall  be  exposed  to  view.  Traps  with  covers  depending  on  putty  connec- 
tions to  make  them  tight  are  prohibited."  ° 

hi  Xew  Bedford  cleanouts  must  be  placed  where  the  inspector  may 
designate  and  shall  be  approved  by  him. 

"  Cleanouts  for  inspection  purposes,  corresponding  in  size  with  the  drain  or 
waste  pipe,  with  covers  to  handholes  made  gas  and  air  tight,  and  of  a  pattern  ap- 
proved by  the  board  of  health,  shall  be  provided  at  intervals  of  not  more  thaii 
twenty  feet,  and  one  such  opening  shall  be  requred  at  each  horizontal  branch  of 
fifteen  feet;  and  on  all  pipes  laid  beneath  the  ground  said  cleanouts  must  be  in 
bricked  and  cemented  pits,  and  easy  of  access."0 

In  Detroit  cleanouts  must  be  brought  up  to  floor  level  with  branches 
and  curves. 


1  Cleveland,  Rule  4. 

-  Lawrence,  Sec.  4,  Rule  5,  and  Sec.  6,  Rule  9. 

3  Worcester,  Sec.  15. 

4  Asbury  Park,  Sec.  22. 

5  Hartford,  Sec.  6. 

6  Haverhill,  Sec.  10. 


PLUMBING.  237 

■  Each  vertical  soil  pipe  shall  be   provided  near  its  lower  end  with  a  T  branch, 

suitably  located,  and  having  a  cast-iron  plug  not  less  than  four  inches  in  diameter 
leaded  in."  * 

In  Asbury  Park  cleanouts  must  not  be  more  than  twenty-five  feet 
apart  and  the  main  trap  and  cleanout  must  be  in  an  eight-inch  brick  well 

with  iron  or  stone  cover  if  in  the  cellar : 

"  Brass  screw  caps  for  cleanouts  must  be  extra  heavy,  not  less  than  one-eighth 
of  an  inch  thick,  and  must  have  a  flange  of  not  less  than  three-sixteenths  of  an  inch 
thick.  The  screw  cap  must  have  a  solid  square,  or  hexagonal  nut  not  less  than  one 
(1)  inch  high,  with  a  diameter  not  less  than  one  and  one-half  (14)  inches.  The  body 
of  the  cleanout  ferrule  must  not  be  less  in  weight  and  thickness  than  the  caulking 
ferrule  for  the  same  size  of  pipe.  Where  cleanouts  are  required  by  the  rules  and  by 
the  approved  plan  the  screw  cap  must  be  of  brass.  The  engaging  parts  must  have 
not  less  than  six  (6)  threads  of  iron  pipe  size  and  be  tapered.  Cleanouts  must  be  of 
full  size  of  the  trap  up  to  four  (4)  inches  in  diameter,  and  not  less  than  four  (4) 
Inches  for  longer  traps."'  - 

Termination  of  Pipes  at  Roof. 

"All  soil  and  waste  pipes  shall  be  carried  undiminished  in  size  to  a  height  at 
least  two  feet  above  the  roof,  except  in  the  case  of  roofs  of  tenement  houses  or  roofs 
used  for  drying  purposes,  in  which  case  they  shall  extend  seven  feet  above  the  roof 
and  be  suitably  braced.  Such  pipes  shall  terminate  at  a  point  approved  by  the  com- 
missioner of  health.  Pipes  on  extension  roofs  when  within  twenty  feet  of  any  win- 
dow, shall  be  carried  up  and  continued  above  the  main  roof,  and  where  necessarily 
carried  up  on  the  outside  of  the  main  building,  they  shall  have  a  diameter  of  not 
less  than  four  inches.  There  shall  be  no  caps,  cowls,  ventilators  or  return  bends 
put  on  the  ends  of  the  pipes  above  the  roof,  and  the  mouths  of  all  such  pipes  on  the 
roof  shall  be  kept  wide  open.  The  size  of  all  pipes  shall  be  increased  one  inch  from 
a  point  just  below  the  roof  to  the  terminal  of  the  pipe  above  t lie  roof,  but  no  pipe 
above  the  roof  shall  have  a  diameter  less  than  four  inches.  Iron,  brass  or  copper 
wire  baskets  will  be  permitted  in  the  mouths  of  pipes  to  keep  out  obstructions. 
Vent  pipes  may  be  carried  above  the  roof  in  the  same  manner  as  soil  ;ui<l  waste  pipes, 
or  they  may  be  connected  with  a  soil  or  waste  pipe  above  the  highest  floor." 

The  height  to  which  the  pipe  must  be  carried  varies  in  different 
cities.  In  Brooklyn,,  as  above,  and  Somerville  and  Portsmouth,  N.  1 1.,  it 
is  two  feet.  In  Bridgeport,  Chicago,  Cincinnati,  Cleveland,  Lawrence, 
and  New  Bedford  it  is  one  foot.  In  Denver  the  soil  pipe  must  be  car- 
ried to  a  height  six  indies  above  the  ridge  or  the  fire  wall,  if  the  i< »< » t"  is 
Mat:    in    San    Francisco,   t\\<>   feel   above   the   highest    line   <>l    roof  <>r 

Coping.      The  soil    pipe  is  to  be  increased  one  inch    in  diameter  one  fool 

below  the  roof  in  Chicago,  and  two  feel  below  in  Fall  River.  In  Cleve- 
land the  soil  pipe  is  to  be  one  size  larger  where  it  passes  through  the 
roof  and   never  less  than  tour  inches.     In  Rochester  the  soil  pipe  must 

lie    three    feet    ;il  i<  >\  e    ;i  1 1  \     WllldnW      ;ilid     live     feet      ll  <  'III     Mil  \      el  I  i  II 11  le\  .         Ill 

1  District  of  Columbia,  - 

\  ibury  Park,  Sec.  :;:;. 

i; ki\n.  Sec.  38. 


238  PLUMB  IX  a. 

Portsmouth,  N.  H.,  it  must  extend  five  feet  above  the  roof  if  fifteen 
feet  from  a  window,  and  in  Somerville  and  New  Haven  if  ten  feet  from 
a  window  ;  and  in  the  New  Jersey  cities  if  twenty  feet  from  a  window  it 
must  extend  above  the  main  roof.  In  New  Bedford  it  must  be  away 
from  all  windows.  In  Lawrence  it  must  be  two  feet  above  the  highest 
opening  in  the  building.  In  Lowell  "said  roof  opening  must  be  at  a 
point  where  it  cannot  ventilate  into  a  window  of  any  dwelling."  In 
Albany  the  soil  pipe  is  to  be  one  inch  larger  above  the  roof  and  is  only 
required  to  extend  two  feet  when  it  receives  discharges  from  fixtures  on 
two  or  more  floors.  In  Paterson  and  Hartford  if  in  flat  tenement  roofs 
the  pipe  must  extend  six  feet,  and  in  Reading  five  feet.  In  Cleveland 
if  in  an  ell  it  is  to  extend  above  the  main  roof.  In  Lowell  it  must  be 
as  high  as  the  ridge  pole.  In  Providence  it  must  be  carried  to  such  a 
height  as  the  inspector  may  direct.  In  Fall  River  "  all  branches  of  soil 
pipe  ten  feet  or  more  in  length  shall  be  continued  full  size  through  the 
roof  or  be  taken  into  the  soil  pipe  above  the  highest  fixtures  unless 
otherwise  permitted."  In  Haverhill  soil  pipes  of  ten  feet  arid  waste 
pipes  of  fifteen  feet  length  must  be  carried  separately  through  the  roof 

RaiwrWater  Leaders. 

"Rain-water  leaders  must  never  be  used  as  soil,  waste  or  vent  pipes,  nor  shall 
any  soil,  waste  or  vent  pipe  be  used  as  a  leader.  Where  the  leader  is  within  the 
house  it  must  be  of  extra  heavy  cast  iron  pipe  with  leaded  joints,  or  of  heavy 
asphalted  or  galvanized  wrought  iron  pipe  with  screw  joints.  When  outside  the 
house,  if  of  sheet  metal,  with  slip  joints,  and,  if  connected  with  the  drain,  it  must 
be  trapped  beneath  the  ground  or  just  inside  the  wall,  the  trap  being  arranged  so  as 
to  prevent  freezing.  In  every  case  where  a  leader  opens  near  a  window  or  light  shaft 
it  must  be  properly  trapped  at  its  base.  The  joint  between  inside  iron  leaders  and 
the  roof  must  be  made  tight  by  means  of  a  brass  ferrule  and  lead  or  copper  pipe, 
properly  connected  to  rain-water  inlet  head  on  root/"  ' 

In  Albany  leaders  are  to  be  trapped  only  when  they  open  within 
twenty  feet  of  a  window,  and  in  Hartford  and  San  Francisco  the  dis- 
tance is  ten  feet.  In  Hartford  "  all  leader  drains  from  two  feet  above 
the  ground  to  the  distance  of  six  feet  from  the  outside  of  the  cellar 
walls  of  buildings  shall  be  of  extra  heavy  cast-iron  pipe."  In  San  Fran- 
cisco leaders  must  be  of  cast-iron  five  feet  above  the  ground.  In  Haver- 
hill they  must  enter  the  drain  at  such  a  point  and  in  such  a  manner  as 
to  prevent  syphoning.  In  San  Francisco  "the  connection  between  cast- 
iron  and  sheet-iron  leader  pipe  is  to  be  made  with  brass  ferrules  soldered 
to  leader  and  caulked  into  cast-iron." 

"  Drains  from  rain-water  leaders  shall  connect  with  the  sewer  outside  of  house 
trap  with  a  cast-iron  L  Y '  branch  trap  and  cleanout,  and  if  properly  supplied  with 
clear  water  from  flushing  tank  to  maintain  seal  in  trap,  may  be  of  first-class  vitrified 


1  Brooklyn,  Sec.  23. 


PLUMBING.  239 

pipe,  provided  that  all  rises  to,  and  at  least  eight   inches  above  grade,  shall  lie  oi 
cast-iron.""  l 

"All  leaders  from  points  below  line  of  main  roof  must  discharge  into  open  trapped 
hoppers,  and  said  hoppers  supplied  from  snitahle  interior  fixture,  same  as  above 
provided  for  in  surface  drains.'1  - 

Main  Trap. 

■\  running  or  P  trap,  of  form  approved  by  the  Inspector  of  Plumbing,  shall  be 
placed  on  every  bouse  sewer,  except  where  there  is  no  plumbing  fixture  located 
within  the  building  under  or  through  which  the  house  sewer  is  laid.  Such  trap 
shall  be  placed  at  an  accessible  point,  if  practicable  within  the  wall  of  the  building. 
and  a  vertical  pipe  of  the  same  diameter,  and  provided  with  a  brass  trap  screw,  shall 
be  constructed  over  the  trap  to  admit  of  cleaning  the  same. 

•A  brick  manhole  provided  with  cast-iron  frame  and  air-tight  cover  maybe  used 

n  lieu  of  tlie  vertical  pipe  to  afford  easy  access  to  the  trap." 
i 

In  Pittsburgh  it  is  provided  that  the  trap  must  ho  inside  the  huilding, 

in  which  case   tin-  cleanout   must   not   be  on  the  sewer   side.      In  New 

York  City  and    other  cities  the  trap  must    he    placed  ••near  the    front  of 

the  house"  either  inside  or  outside.      In  the  large  New  Jersey  cities  the 

bleanout  is  to  he  made  tight  with  cement.     New  Bedford  provides  for 

the  co-operation  of  plumber  and  drain  layer: 

"When  the  city  drain  pipe  layer  is  ready  to  connect  the  vitrified  pipe  with  the 
iron  pipe  the  plumber  shall  have  the  iron  pipe  caulked  into  the  running  trap;  he 
shall  place  the  trap  in  position  for  the  drain  layer  to  make  the  cement  connection. 
All  cast-iron  soil  pipe  shall  he  laid  by  the  plumber.11 

In    Manchester,  N.  II.,  and  Hartford,  a  main  trap  in  the  drain  is  not 

required,  and    in  Albany   it  may   he  omitted   with   the  approval  of  the 

board  of  health.  In  Manchester  if  the  trap  is  omitted  the  fresh  air 
iidet  is  also  to  he  omitted. 

Back  Pressim    Valve. 

"All  permits  for  connecting  with  public  sewers  are  given  on  condition  that 
owners  take  all  risk  of  damages  thai  may  result  from  water  setting  hack  into 
premises  from  the  main  sewer,  ami  in  order  to  prevent  as  much  as  possible  1  he  sel- 
ling hack  of  water  the  owner  is  hereb]  required  at  his  own  cost  and  risk  to  put  in  a 
self-aci  ing  or  oth.i  valve  in  all  cases  when  a  back  tlow  from  a  sewer  is  is  to  be  appre- 
hended and  it  shall  he  the  duty  of  I  he  owner  to  keep  I  he  \al\e  in  order,  and  he  shall 

he  responsible  for  its  action  in  all  cases.  When  the  sewer  connection  is  of  iron  and 
carried  up  within  tin-  premises  as  a  closed  pipe,  without  openings  or  connections  ol 
an\  kind,  above  the  level  of  any  possible  back-flow,  the  flood-valve  mag  he  dis- 
pensed wit h."  ' 

In  Lawrence  aiea  drains  must  he  suppled  with  hack  pressure  valves. 
See  also  snh-soil  drains. 

i  Detroit,  Rule  is. 
1  San  Francisco,  s> 

I  >ist  i  i.  t   '.I   <  dluinhia.  >its.    1  I  I    •">. 

'  Dist  ret  ,,t  ( lolumbia,  Sec.  86. 


240  PLUMBING. 

Trap*  for  Fixtures. 

''Every  water-closet,  urinal,  sink,  basin  or  bath,  or  set  of  wash  trays,  must  be 
separately  and  effectively  trapped.  The  traps  must  be  placed  as  near  to  the  fixtures 
as  possible,  and  in  no  case  more  than  two  feet  from  the  fixtures.  In  no  case  shall 
the  trap  of  one  fixture  connect  with  the  trap  of  another."  1 

In  other  cities  the  words  "  other  fixtures  "  are  added  after  traps  and 
sometimes  urinal  and  hydrant  wastes  are  named  and  usually  the  trap 
must  be  set  as  "  near  as  practicable."  In  Lawrence  the  trap  must  be  a 
four-inch  bottle  trap  or  other  trap  approved  by  the  board  of  health. 

Many  cities  do  not  go  so  far  as  San  Francisco  in  forbidding  that  any 
two  fixtures  shall  have  a  common  trap,  though  it  is  often  ordered 
that : 

"In  no  case  shall  the  waste  from  a  bath  tub,  basin,  sink,  or  other  fixture  be  con- 
nected with  a  water-closet  trap."  2 

In  Portland,  Me.,  and  New  Bedford  no  bath  waste  shall  be  con- 
nected with  a  set  tub  or  sink-waste  ;  but  in  Worcester  and  Somerville, 
Mass.,  fixtures  may  have  a  common  trap  if  they  are  not  distant  from  it 
more  than  three  feet,  and  in  Somerville  the  trap  must  have  a  diameter 
of  three  and  one-half  inches. 

"Traps  and  branch  waste  pipes  shall  be  of  the  following  sizes: 

Fi  »r  basins  and  pantry  sinks 1£  inches. 

Slop  sinks 3         " 

Kitchen  sinks 1^  or  2         " 

Bath  tubs H  or  2         " 

Urinals H  or  2         " 

Laundry  tubs 1|  or  2         " 

Water-closets ±        "  3 

In  the  District  of  Columbia  "  No  trap  with  a  hand-hole  cover  shall 
be  used/' 

Traps  at  the  foot  of  vertical  soil  pipes  are  forbidden  in  many  cities. 

Area  <<n<t  Surface  Drains. 

"  No  opening  shall  be  provided  in  the  sewer  pipe  of  any  building  for  the  purpose 
of  surface  drainage  unless  said  opening  is  properly  trapped  and  supplied  with  water 
from  a  suitable  fixture.  When  said  surface  drain  is  situated  at  a  distance  greater 
than  twenty  feet,  reckoning  in  a  horizontal  line  from  said  suitable  fixture,  then  it 
may  be  supplied  by  a  hose-bibb.     Bell  traps  strictly  prohibited."  4 

In  Pittsburgh  this  connection  must  not  be  used  as  a  fresh  air  inlet. 
Masons'  traps  in  such  positions  are  prohibited  in  New  York  City,  and 
in  Chicago  no  catch  basin  will  be  allowed  in  any  building: 

1  >San  Francisco,  .Sec  •!'■',. 

2  Brooklyn,  Sec.  34. 

3  Brooklyn,  Sec.  36. 

4  San  Francisco,  Sec.  25. 


PLUMBING.  241 

•■All  pipes  that  must  be  left  open  to  drain  cellars,  areas,  yards  or  gardens,  shall 
he  connected  with  suitable  catch-basins,  the  bottoms  of  which  shall  not  he  less  than 
two  and  one-half  feet  below  the  bottom  of  the  outlet  pipe,  the  size,  form  and  con- 
struction of  which  are  to  be  prescribed  by  the  officer  named  in  section  three.  .  .  . 
When  the  end  of  thedrain  pipe  is  connected  with  a  temporary  wooden  catch-basin  for 
draining  foundations  during  the  erection  of  buildings,  the  drain-layer  shall  he  held 
risible  for  dirt,  sand  or  any  other  substance  getting  into  the  drain  or  sewer 
from  such  temporary  catch-basins."1 

••  Every  cellar  shall  have  a  trap  for  surface  drainage  provided  with  a  brass  clean- 
out  plug  caulked  into  the  inlet  of  same,  and  must  be  located  where  it  will  he  a 
sible  at  all  times. 

•■  Surface  drains  must  never  be  connected  directly  with  the  trap,  hut  shall  enter 
an  open  well  that  shall  be  built  around  the  trap."  - 

••The  superficial  area  of  every  catch-basin  hereafter  constructed  shall  not  be 
greater  than  four  hundred  and  fifty-six  square  inches,  and  except  in  cases  where  the 
catch-basin  is  to  be  placed  in  the  street,  the  same  shall  be  covered  with  a  flagging 
stone  with  movable  iron  cover;  in  cases  where  the  catch-basin  is  to  be  placed  in  the 
street  or  adjoining  the  wall  of  any  building  it  shall  he  of  iron  of  such  construction 
as  may  be  approved  by  this  Board. 

Ghreast    Trap. 

••  Waste  pipes  from  kitchen  sinks  in  any  hotel,  restaurant  or  other  public  cook- 
ing establishment,  and  in  every  dwelling  house,  shall  run  separate  to  a  grease  trap 
in  yard  when  practicable;  and  when  the  same  is  nol  practicable  to  put  in  yard,  a 
•  trap  must  be  placed  belovj  each  sink,  with  water  jacket  to  keep  the  water  in 
i  rap  chilled. 

"  Grease  traps  in  yards  shall  be  constructed  of  hydraulic  cement,  sand  and  gravel 
in  the  proportions  of  one  pari  cement  to  three  parts  of  all  other  material,  or  of 
earthen  ware  or  brick,  laid  in  hydraulic  cement,  and  in  case  of  brick  being  used, 
the  wall  shall  be  plastered  on  ail  sides  and  bottom  with  hydraulic  cement  mortar  at 
Ii-asi  one  inch  thick,  made  in  proportion  of  one  of  cemenl  t"  two  of  sand,  with  eight- 
inch  wall.  Grease  traps  to  have  stone  or  iron  covers,  the  same  to  he  not  more  than 
six  inches  he  low  grade.  '  Srease  tra  ps  for  small  building  or  ordinary  dwelling  houses 
to  be  not  less  than  twenty-four  inches  in  diameter.  Motels,  restaurants  or  other 
cooking  establishments  to  have  the  size  of  urease  traps  not  less  than  forty  inches  in 
diamett  r.  ami  according  to  tie-  directions  of  the  plumbing  Inspector."  4 

Fr<  sll  Air   I, iht. 

•■  Everj  sewer  shall  have  a  fresh  air  inlet  of  not  less  than  four  inches  internal 
diameter  entering  the  sewer  between  the  intercepting  trap  and  all  house  connec- 
tions, and  extending  to  the  external  air  al  leasl  one  foot  above  the  surface  of  the 
ground  at  a  place  shown  on  the  approved  plan.  When  it  is  nol  pracl  icable  to  extend 
the  fresh  air  inlet  above  the  ground,  it  shall  i>e  carried  to  the  curb  ami  terminate  in 
a  suitable  receptacle,  covered  by  an  iron  grating. 

In  Pittsburgh  the  inlel  musl  have  an  accessible  cleanout  and 

••  Where  ail    inlets  are  lo.ated  oft  the  stairway,  on  grass  plats,  lawns,  etc.,  they 

shall  extend  not  less  than  six  inches,  nor  more  than  fifteen  inches  above  the  surface 

1  Proi  id<  nee,  Sec.  L3. 
-  Hartford,  Sec.  9. 

\siinn  Park,  Sec.  '.i. 

1  I  )en\  ei  .  Sees.   1  I   and  5. 

Brooklyn,  Sec.  21. 
16 


242  PLUMBIXG. 

of  the  ground,  and  be  protected  by  a  cowl  securely  fastened  with  bolts.  Where  the 
fresh  air  inlet  is  placed  at  the  curb,  there  shall  be  at  least  three  feet  of  extra  heavy 
cast-iron  pipe  extended  up  even  with  pavement,  and  covered  with  strong  iron 
grating." 

In  Rochester  the  inlet  must  extend  twelve  inches  above  the  ground 
and  be  provided  with  a  suitable  cap.  In  the  District  of  Columbia  it 
must  have  a  one-quarter  bend  and  grating. 

In  Milwaukee  the  inlet  must  enter  drain  just  six  feet  inside  the 
trap. 

In  the  District  of  Columbia  the  inlet  must  be  six  inches  in  diameter, 
in  Portland,  Me.,  three  inches,  and  in  Milwaukee  two  inches. 

In  Xew  York  City  the  inlet  must  be  not  less  than  fifteen  feet  from 
the  nearest  window,  and  no  cold  air  box  from  a  furnace  shall  be  so 
placed  that  it  can  possibly  draw  air  from  it.  In  Hartford,  Lowell,  and 
San  Francisco  it  must  not  be  within  ten  feet  of  a  window.  In  Mil- 
waukee it  must  be  four  feet  from  a  window  ;  in  Detroit  and  Xew  Bed- 
ford five  feet  or  -such  distance  as  the  inspector  may  direct,  and  in  Port 
land  eight  feet  from  window  or  cold  air  box  of  furnace. 

In  Philadelphia  there  must  be  a  second  inlet  "  at  the  rear  of  the 
system  of  plumbing  when  the  vertical  line  of  soil  pipe  is  located  in  the 
central  part  of  the  building  and  is  deemed  insufficient  to  ventilate  the 
entire  system." 

Back  Air  Pipes  Required. 

Nearly  all  plumbing  rules  require  that  '•  traps  must   be  protected 

from  siphonage   by  special  air  pipes."     Such  pipes  are  not,  however, 

invariably  required : 

"...  Water-sealing  traps  of  any  pattern  may  be  used  when  separate  air 
\>\\h'  connections  from  the  top  of  the  same  are  provided:  where  separate  air-pipe 
connections  are  not  provided,  traps  which  will  not  unseal  shall  be  used;  such  traps 
to  be  first  approved  by  the  inspector  of  plumbing.'"  2 

Similar  provisions  are  found  in  Atlanta  and  Albany,  and  in  Roches- 
ter back  airing  may  be  omitted  by  special  permit  of  the  board  of  health. 
In  Detroit,  where  any  fixtures  are  not  more  than  five  feet  from  a  verti- 
cal run  of  soil  pipe,  and  no  fixture  over  the  same,  the  back  vent  may 
be  omitted.  In  Portsmouth  the  maximum  distance  is  four  feet  meas- 
ured from  the  centre  of  the  trap  to  the  hub  of  the  Y  on  the  main 
pipe : 

"  Where  a  sink,  bath  tub,  wash  bowl,  wash  tub,  urinal,  or  any  other  plumbing 
fixture  is  located  on  a  floor  not  more  than  six  feet  from  the  ground  (within  build- 
ing), and  no  fixture  or  fixtures  connected  or  to  be  connected  to  waste  pipe,  the  two- 
inch  waste  pipe  with  increaser  shall  be  run  to  and  through  the  roof;  re-vents  may 


1  Providence,  Sec.  17. 


PLTTMB1NG.  943 

be  dispensed  with,  provided,  the  trap  of  the  fixture  is  not  more  than  five  feet  from 
the  waste  pipe.1"  1 

In  Fall  River  all  traps  liable  to  be  siphoned  or  affected  by  l>ack 
pressure  shall  be  protected  therefrom  by  a  special  air-pipe.  In  the 
District  of  Columbia  and  San  Francisco  traps  shall  lie  vented  "  except- 
ing that  in  the  case  of  the  upper,  and  only  water-closet  on  a  soil  pipe 
and  having  its  centre  within  two  feet  of  the  centre  of  the  stack,  it  will 
not  he  required.*'  In  Cincinnati  a  single  fixture  discharging  into  an 
Open  drain  needs  no  vent  pipe.  In  Buffalo  "the  use  of  non-siphoning 
automatic  fixtures  of  old  buildings  only  allowed  at  the  discretion  of  the 
health  officer."  In  New  Haven  Sanitas  traps  are  allowed  without 
vents.     In  New  Jersey  cities  traps  must  be  vented  by  an  air  pipe, 

"Or  by  some  approved  automatic  vent.  Approved  mechanical  traps  may  be 
substituted  where  it  is  necessary  or  advisable,  but  only  on  special  permit  from  the 
Board  of  Health." 

The  McLellan  vent  is  often  used  in  Newark,  as  many  as  42i>  having 
been  put  in  in  1896.  It  has  been  permitted  in  Albany,  but  has  not 
been  satisfactory,  as  the  mercury  is  driven  out  when  obstructions  are 
forced.2 

■■  Ventilating  pipes  must  be  run  with  as  few  bends  as  possible,  and  the  branches 
must  be  connected  to  main  vent  at  an  angle  of  not  less  than  forty-five  degrees,  and 
in-  increased  in  size  every  thirty  feet.  When  combined  the  vent  pipes  must  be  in- 
creased in  size  according  to  the  following  table: 

••  In  ;ill  buildings  of  four  stories  or  less — 

"Branch  rents  "i  water-closets  shall  not  be  of  a  size  less  than  the  following: 

"  (The  term  '  Branch  Vent'  as  here  applied  shall  be  construed  to  mean  all  that 
vi-nt  pipe  located  between  the  fixture  and  the  point  where  the  vent  joins  into  the 
main  verl  ical  vent.) 

•  Four  water  eh, sets  may  be  vented  into  a  li.l-inch  branch  vent. 

•■  Five  to  eighl  water-closets  may  be  vented  into  a  3-inch  branch  vent. 

■•  Nine  or  more  water-closets  may  he  vented  into  a   1-inch  branch  vent. 

••  Single  water-closets  located  in  the  basement  or  firs!  floor  of  a  building,  if  the 
soil  pipe  drop  does  not  exceed  10  feet,  may  be  vented  with  a  2-inch  vent  pipe  for  a 
distance  of  30  feet;  when  the  vent  is  longer  than  30  feet,  then  1  he  entire  venl  shall 

he    J    -inch    until    the    distance    of    60    feet,   when    it    shall    be    increased    to  .".-inch  to  a 

finish,  in  all  cases  where  the  soil  pipe  has  a  drop  greater  than  10  feet,  then  the 
soil  pipe  shall  he  continued  full  bore  to  a  point  •_'  feel  above  root,  and  act  as  a  vent 
pipe. 

••  In  each  ami  every  building  to  be  used  as  a  residence  or  otherwise,  ami  where  a 
closet  or  closets  is,  or  are,  situated  either  within  the  premises,  or  within   ten 

t    the    outside    walls    "I    said    premises,  then,  in    an\    and    all    cases,   it  shall    he 

required  thai  at  hast  one  four-inch  venl  pipe  he  continued  to  above  the  root  line. 
and  this,  irrespei  tive  "I   what  distance  the  soil  pipe  may  drop. 

■  ■  Three  wash  has  ins.  baths  or  similar  fixtures  may  he  vented  bj  a  2-incli  vertical 

vent    pipe. 


'  ( Ihicago,  See.  37. 
Albany,  Repori  oi  Board  of  Health  (1898),  p.  l»». 


244  PLUMBING. 

"  Six  similar  fixtures  by  a  2i-inch  vertical  vent  pipe. 

li  Twelve  similar  fixtures  by  a  3-inch  vertical  vent  pipe. 

••  When  more  than  12  fixtures,  they  may  be  vented  by  a  4-inch  vertical  vent  pipe. 
Single  one  and  one-half  inch  traps  may  be  vented  by  a  one  and  one-half  inch  vent 
pipe  when  the  vent  does  notexceed  twenty-five  feet.  When  it  is  in  excess  of  twenty- 
five  feet,  then  the  entire  main  vent  shall  be  of  two-inch  pipe. 

"  When  one  and  one-half  inch  branch  vents  are  used  on  fixtures  the  said  branch 
vent  shall  not  exceed  five  feet.  In  the  calculation  of  the  relation  of  basins,  baths. 
and  similar  fixtures  towards  water-closets,  it  shall  be  reckoned  that  four  basins  or 
baths  or  similar  fixtures  shall  equal  two  water  closets,  and  so  on,  at  that  ratio. 

•'  When  more  than  sixteen  wash  basins,  baths  or  similar  fixtures  are  on  a  line  and 
are  situated  in  a  live-story  building  or  over,  below  the  fifth  floor,  then  the  vertical 
vent,  from  the  fifth  floor  up.  must  not  be  less  than  four-inch  pipe. 

■•  On  buildings  five  stories  or  over  not  more  than  twenty  feet  may  be  used  as  a 
branch  vent."'  1 

Li  Denver  not  more  than  thirty  feet  of  one  and  one-quarter  inch 
pipe  can  be  used  for  a  vent  for  one  fixture,  thirty  feet  of  one  and  one- 
half  fur  two  fixtures,  and  thirty  feet  of  two  inch-pipe  for  water-closetSs 
In  Somerville  vent  pipes  of  less  than  thirty  feet  must  lie  two  inches, 
and  over  thirty  feet  three  inches  in  diameter.  In  Hartford  vents  for 
three  water-closets  must  be  two-inch,  for  more  than  three  water-closets 
three-inch,  and  vents  for  four  fixtures  other  than  water-closets  must  be 
one  and  one-half-inch,  and  for  more  than  four  fixtures  two-inch.  In 
Cleveland  one  fixture  may  have  a  one  and  one-quarter-inch  vent,  ami 
two  fixtures  one  and  one-half.  In  buildings  of  over  four  stories  water 
closet  vents  must  be  three  inches  and  fixture  vents  two  inches  in  diame- 
ter. In  the  District  of  Columbia  in  three  story  buildings  with  three 
water-closets  or  three  fixtures  there  must  lie  a  vertical  vent  to  which 
all  vents  lead,  increasing  in  diameter  to  equal  the  combined  diameter  of 
the  vents  entering  it. 

Most  cities,  like  San  Francisco,  require  that  vent  pipes  shall  extend 
above  the  roof  in  the  same  manner  as  soil  pipes  and  usually  they  must 
never  be  less  than  four  inches  in  diameter:  or  they  may  combine  and 
enter  the  soil  pipe  above  the  highest  fixture:  the  distance  above  the 
fixture  is  specified  as  three  and  one-half  feet  in  San  Francisco  and 
Cleveland,  five  feet  in  Detroit,  and  six  inches  in  Bridgeport :  but  Denver 
requires  that  in  buildings  of  more  than  two  stories  the  vent  pipes 
must  run  separately  through  the  roof.  In  Hartford  if  fixtures  are  eight 
feet  from  a  line  of  vent  they  must  have  a  separate  vent  to  the  roof. 

It  is  usually  provided  that  vent  pipes  must  have  a  continuous  slope 
to  prevent  filling  with  condensation. 

New  Bedford  requires  siphon  closets  to  be  vented  from  the  lead  bend. 

The  use  of  lead  pipe  for  vents  is  usually  restricted  to  short  lengths. 


1  San  Francisco.  Sec.  28. 


PLUMBING.  245 

In  Cleveland  it  must  not  be  lighter  than  extra  light.  In  Boston,  Somer- 
ville,  and  Manchester,  X.  H.,  lead  can  be  used  only  when  exposed  to 
view.      In  New  Haven  lead  is  not  permitted. 

Safe    Wastes. 

■■  Every  safe  waste  under  a  basin,  bath,  water-closet,  tank  or  other  fixture,  must 
lie  drained  with  a  special  pipe  of  lead,  galvanized  or  dipped  iron  pipe,  of  a  diameter 
not  less  than  one  inch  bore,  and  in  no  case  directly  connected  with  any  soil,  waste, 
vent,  drain  or  sewer,  hut  made  to  discharge  outside  of  house.  Urinal  safe  waste 
may  he  connected  with  main  waste  or  soil  pipe;  provided,  suitable  traps  are  pro- 
vided to  botli  urinal  and  safe  wastes,  and  both  properly  vented  ami  both  supplied 
with  water."  ! 

■•  Wherever  safes  are  placed  under  lixtures  the  safe  wastes  shall  be  run  separately 
to  t  lie  basement  or  cellar,  and  be  closed  by  a  hinged  brass  flap  valve,  or  other  approved 
device,  to  prevent  cellar  air  from  rising  through  the  pipe.  In  tenement  houses  the 
safe  wastes  shall  be  extended  to  the  roof.  Urinal  platforms  shall  not  be  provided 
with  safe  wastes.""  - 

Iii  the  City  of  New  York  water-closets,  and  in  the  District  of  Colum- 
bia any  fixtures  cased  with  wood  must  have  a  safe  drained  as  above.  In 
Cleveland  wastes  from  stopcocks  must  not  run  into  soil  or  waste  pipes. 

//  ■ .  igerator   Wastes. 

■  No  waste  pipe  from  a  refrigerator  or  other  receptacle  where  food  is  kept  shall 
he  connected  with  a  drain,  soil  or  other  waste  pipe.  Refrigerator  wastes  must  be  of 
a  diameter  of  not  less  than  one  and  one-half  inches,  and  so  arranged  as  to  be  properly 
Bushed.  They  shall  empty  over  a  water  supplied  sink,  the  mouth  of  the  pipe  to 
have  a  brass-hinged  flap  valve.  In  tenement  houses,  vertical  lines  of  refrigerator 
Wastes  shall  have  a  diameter  of  at  least  two  inches,  and  shall  extend  through  the 
roof  for  ventilation."  3 

In    New   York   refrigerator   wastes   must    not   discharge   on    in   the 

ground. 

■•  No  waste  pipe  from  any  refrigerator,  or  other  receptacle  in  which  provisions 
are  stored  shall  discharge  into  the  soil  of  am  cellar  bottom,  or  into  the  soil  beneath 
any  floor  of  any  building;  or  into  any  wast.-,  drain  or  soil  pipe. 

In  Rochester  refrigerator  wastes  musl  be  as  Bhorl  as  possible. 
' '     'flotv   Pipes. 

14  Overflow  pipes  from  li\t  ures  must,  in  each  case,  lie  connected  on  the  inlet  side 
of  t  he  t  rap. 

"  The  overflow  pipes  from  water-closet  cisterns  may  discharge  int..  the  v.. 
closet  howl,  an  open  sink,  or  where  its  discharge  will  attract  at  tent  ion  and  indicate 
thai  waste  of  water  is  occurring,  but  not  into  the  soil  or  waste  pipe,  nor  into  the 

dram  or  sew  .•!.'" 

Francisco,  Sec.  ■'■>'<. 
Brooklj  n,  Si 

i; kiyn,  Sec.  89. 

1  Providence,  Sec.  20. 

1 1    ot    N 'eu    Y.  irk  .    s'-'  S    !■■  and  50. 


246  PLUMBING. 

In  Rochester  they  may  run  into  a  roof  gutter. 

Water-closets  to  be  Provided. 

"All  buildings  that  are  located  upon  a  street  in  which  a  public  sewer  exists  must 
be  provided  with  water-closets  either  in  the  house  or  yard.  When  there  is  no  sewer 
in  the  street,  and  no  practicable  way  of  reaching  a  sewer  in  an  adjacent  street,  water- 
closets  may  be  connected  with  a  water-tight  cesspool,  or  privy  vaults  will  be  per- 
mitted.11 J 

In  New  York  there  must  be  one  water-closet  for  every  fifteen  per- 
sons, in  Rochester  one  for  every  ten ;  in  Somerville,  Mass.,  one  for 
each  family;  in  Albany  one  for  two  families;  and  in  Fitchburg  and 
Worcester  one  for  each  family  and  every  fifteen  persons. 

Certain   Water-closets  Prohibited. 

"Privy  sinks,  pan  closets  and  all  water-closets  having  any  mechanism  in  connec- 
tion with  the  bowl,  forming  a  mechanical  seal,  are  prohibited."  2 

"  Hopper  closets  shall  not  be  allowed  inside  any  building  or  enclosed  porch. 
They  may,  however,  be  used  in  yards  or  upon  open  porches.  Provided,  they  are 
supplied  with  a  tank."  3 

New  Bedford  forbids  the  use  of  long  hoppers  and  Hartford  forbids 
iron  hoppers  and  offset  washout  closets.  The  District  of  Columbia, 
requires  every  water-closet  to  have  a  rim.  Asbury  Park  forbids  long 
hoppers  except  where  there  is  exposure  to  frost.  All  iron  traps  must 
be  porcelain  lined. 

Water-closet  Floor  Flanges. 

"  Earthern  or  iron  water-closets,  having  traps  above  the  floor,  using  lead  con«- 
nections,  must  have  a  cast  brass  flange,  not  less  than  one-eighth  inch  thick,  soldered 
to  the  lead  and  bolted  to  trap  of  closet,  the  joint  being  made  perfectly  air-tight."  4 

"  Floor  plates  shall  be  used  with  earthenware  water-closet  traps,  and  the  joints 
shall  be  secure  and  gas  tight.  Brass  bolts  and  a  brass  flange  not  less  than  one-quarter 
of  an  inch  in  thickness,  soldered  to  lead  bend  and  fitted  with  a  rubber  gasket  or 
white  lead  putty  to  insure  a  tight  joint,  shall  be  used."  5 

In  Cleveland  and  Philadelphia  the  flange  may  be  three-sixteenths  of 
an  inch  thick.  In  Buffalo  pasteboard  gaskets  may  be  used.  In  Asbury 
Park  the  use  of  rubber  washers  for  floor  connections  is  prohibited. 

Seat  Ventilation  for  Water-closet. 

"No  water-closet  shall  be  set  in  any  room  or  apartment  that  has  not  a  window 
having  an  area  of  at  least  three  square  feet  opening  directly  to  the  external  air, 
unless  there  is  a  local  vent,  with  its  opening  under  or  near  the  seat  of  the  closet, 


1  Brooklyn,  Sec.  45. 

2  Brooklyn,  Sec.  46. 

3  San  Francisco,  Sec.  41. 

4  Brooklyn,  Sec.  48. 

5  New  Bedford,  Sec.  20. 


PLUMBING.  247 

and  carried  to  and  entering  a  chimney  tine  above  all  openings  for  stoves  or  venti- 
lating registers  or  continued  up  through  the  roof,  with  heat  or  other  means  provided 
to  ensure  a  steady  current  of  air. 

"Such  pipes  shall  be  of  copper  or  galvanized  iron,  and  connections  with  crockery 
shall  be  made  with  a  brass,  lead  or  copper  sleeve,  with  the  joint  white-leaded;  they 
shall  not  be  less  than  two  inches  in  diameter  for  distances  of  less  than  thirty  feet, 
and  for  any  further  distance  their  diameter  shall  be  increased  to  three  inches. 

'■When  more  than  one  closet  connects  with  such  pipe,  its  capacity  shall  be  at 
least  equal  to  that  of  all  pipes  that  enter  it.'1  * 

ln  Fitchburg  the  diameter  of  local  vent  for  one  closet  shall  he  two 
inch.es,  for  two  to  four  closets  three  inches,  and  for  any  number  exceed- 
ing four  closets  a  proportionally  increased  diameter.  If  there  is  no 
heated  fine  the  vent  shall  enter  the  kitchen  chimney  above  the  highest 
opening.  The  connection  with  the  chimney  shall  he  made  with  cast- 
iron  or  other  suitable  material  of  a  size  not  less  than  one  size  larger 
than  the  vent.  In  Lawrence  the  connection  with  the  closet  is  to  lie 
made  tight  with  paint  and  plastic  putty  or  other  composition  acceptable 
tn  the  hoard  of  health. 

Loeation  ,i,nl  Ventilation  of  Water-closet. 

•■  Water-closets  must  never  be  placed  in  an  unventilated  room  or  compartment. 
In  every  case  the  compartment  must  lie  open  to  the  outer  air,  or  be  ventilated  by 
means  of  an  air-shaft  not  used  to  ventilate  any  living  or  sleeping  room,  and  having 
an  area  of  at  least  four  square  feet,  and  an  opening  at  the  roof  to  the  external  air  of 
an  area  equal  to  the  area  of  the  shaft.  Id  no  buildings  will  water-closets  be  allowed 
in  cellars,  except  by  special  permit  from  the  Department  of  Health.'"  - 

In  Now   York  city.  Fall  River.  Rochester,  Lawrence,  and  Worcester 

the  area  <d'  the  ventilating  shaft  may  he  three  square  feet. 

••  No  water-closet  shall  he  set  up  in  any  room  or  apartment  that  has  not  a  window 
having  an  area  of  at  least  three  square  feet  opening  directly  to  the  external  air; 
they  will,  however,  he  permitted  in  rooms  or  apartments  baving.no  windows  com- 
municating directly  with  the  external  air,  providing  that  there  is  a  duct  to  the  open 
air  through  a  heated  Hue  with  an  opening  under,  or  near  the  seat  of  the  water-closet 
for  taking  air:  and  such  air  ducts  shall  enter  the  flue  above  all  openings  for  stoves.1' 

It    is  absolutely    forbidden  t<>    place  water-closets    in  cellars  in    New 

York  City,  Buffalo,  Pittsburgh,  and  Hartford. 

•   This  ride  dues  not  apply  to  old  property  where  i t  her  place  can  he  provided; 

[n  which  case  the  walls  of  closet  rooms  must  he  lathed  ami  plastered  or  sheathed 
with  plain  matched  l>i>ar<ls.  ami  floors  of  rooms  ami  passageway  shall  he  cither  con- 
crete, cement,  or  boarded.     Entrance  to  he  sufficiently  lighted  ami  tree  Erom  any 

means  of    probable  foul  deposits.""  ' 

Iii  Bridgeporl  wooden  floors  shall  nut  he  placed  under  an\  water 
closel  below  the  firsl  or  main  floor;  all  such  plumbing  as  shall  he  placed 

■  Haverhill.  Sec.  7. 
oklj  ii.  Sec.  50. 
tall  River,  Sec.  11. 

1  Lawrence.  Sec.  7.   Rule  8. 


248  PLUMBING. 

in  cellars  or  basements  shall  rest  on  solid  masonry.     In  Cleveland  water- 
closets  must  not  be  located  in  the  sleeping  apartment  of  any  building. 

"  Each  room  or  stall  in  which  a  closet  is  set  will  be  well  lighted.  No  direct  sup- 
ply closet  shall  be  set  unless  located  outside  the  building  proper  in  places  where 
tanks  cannot  be  made  secure  from  frost,  and  no  such  location  of  closets  shall  be 
allowed  unless  the  board  lias  become  satisfied  that  it  is  impracticable  to  put  closets 
in  the  building  proper.  When  direct  supply  closets  are  allowed  they  shall  receive 
their  water  supply  directly  from  the  main  through  fixtures,  service  pipe,  and  con- 
nections approved  by  the  board  of  health."  : 

'•  Water-closets,  when  placed  in  the  yard,  shall  be  so  arranged  as  to  be  conven- 
iently and  adequately  flushed,  and  their  water  supply  pipes  and  traps  shall  be  pro- 
tected from  freezing  by  placing  them  in  a  hopper-pit,  at  least  three  and  one-half 
(:•>! )  feet  below  the  surface  of  the  ground,  the  walls  of  which  shall  be  of  brick  or 
stone  laid  in  cement  mortar.  The  waste  water  from  the  hopper  stop-cock  shall  be 
conveyed  to  the  drain  through  a  three-eighths  (■§)  inch  pipe,  properly  connected. 

"  The  enclosure  of  the  yard  water-closet  shall  be  ventilated  by  slatted  openings, 
and  there  shall  be  a  trap  door  in  the  floor  of  sufficient  size  for  access  to  the  hopper- 
pit."  2 

'.'All  vaults  condemned  as  nuisances  must  have  hopper  closets  substituted,  prop- 
erly trapped  and  connected  to  sewer  with  proper  ventilation,  and  shall  not  be  built 
over  main  house  sewer,  but  should  be  placed  on  a  branch,  suitably  trapped  and  sup- 
plied with  water  for  flushing  and  connected  with  main  sewer  from  house.'1  3 

Water-closet  Supply. 

"  Every  water-closet  within  or  adjoining  the  house  must  be  supplied  with  water 
from  a  separate  tank  or  cistern  containing  at  least  ten  gallons  below  the  overflow, 
and  shall  have  a  flushing  pipe  not  less  than  one  and  one-quarter  inches  in  diameter. 
Cistern  valves  shall  be  so  fitted  and  adjusted  as  to  prevent  waste  of  water.  When 
the  tank  or  cistern  is  located  outside  the  water-closet  compartment,  the  stand  pipe 
shall  be  covered  by  a  float  valve  to  prevent  circulation  of  air  from  the  water-closet 
to  the  adjoining  room."  4 

Many  cities  permit  a  group  of  closets  on  one  floor  to  be  flushed 
from  one  tank,  but  this  is  not  permitted  in  tenement  houses  in  New 
York  City.  In  Worcester  water-closet  tanks  can  be  used  for  no  other 
purpose  except  with  the  permission  of  the  board  of  health.  But  usually 
there  is  no  exception  to  the  rule  that  they  shall  not  be  so  used. 

In  the  District  of  Columbia  and  Rochester,  when  the  pressure  is  not 
sufficient  to  supply  these  tanks,  adequate  pumps  must  be  provided.  In 
New  York : 

"  Where  the  pressure  of  Croton  water  is  insufficient  to  supply  water-closets  or 
other  fixtures  in  tenement  and  lodging  houses,  factories  or  workshops,  water  must 
be  supplied  for  such  fixtures  from  a  house  tank  of  such  size  as  to  afford  an  adequate 
supply  at  all  times."  5 


1  Portsmouth,  Sec.  11. 

2  Philadelphia,  Rules  41-2. 

3  Detroit,  Pvule  33. 

4  Brooklyn,  Sec.  47. 

5  City  of  Xew  York,  Sec.  51. 


PLUMBING.  24!  > 

The  size  of  the  discharge  pipe  must  be  one  inch  in  Boston,  and  one 
and  one-eighth  inch  in  Cincinnati.  In  Philadelphia  the  tank  must  hold 
eight  gallons  when  full  up  to  the  level  of  the  overflow  pipe,  except  that 
automatic  or  siphon  closets  shall  hold  live  gallons.  The  same  rule  is 
found  in.  Reading,  hut  in  Cleveland  and  Scranton  the  automatic  tanks 
must  hold  six  gallons.  Tanks  supplied  under  street  pressure  must 
have  a  one-inch  overflow  in  Somerville,  and  in  Albany  tin-  overflow  may 
•Miter  inside  the  inlet  of  the  tiap. 

Many  cities  allow  outside  closets  to  be  flushed  direct: 

•■  Water-closets  which  are  Located  away  from  the  building  may  he  arranged  so  as 
td  receive  their  water  supply  directly  from  the  main,  but  they  must  he  so  arranged 
as  to  be  conveniently  and  adequately" flushed  and  efficiently  protected  from  freez- 
ing." > 

A  new  device  for  flushing  closets,  called  the  "  flushometer,"  has 
been  introduced  and  is  permitted  by  a  recent  Philadelphia  rule. 

Strainers. 

•■All  waste  pipes,  from  fixtures  other  than  water-closets,  must  he  provided  at  the 
outlet  of  such  fixtures  with  strong  metallic  strainers,  to  exclude  from  such  waste 
pipes  all  substances  likely  to  obstruct  them."  : 

Wooden  Tubs  and  Sinks  Prohibited. 

In  Brooklyn  "wooden  laundry  tubs  are  prohibited;  all  such  fixtures 
shall  eoiisist  of  non-absorbent  materials."  A  similar  rule  is  found  in 
the  District  of  Columbia,  Chicago,  Lawrence.  Lowell,  Pittsburgh,  and 
Other  cities.  In  Worcester  wooden  tubs  and  sinks  are  prohibited,  unless 
rendered  impervious  to  water.  In  Asbury  Park  cement  as  well  as  wood 
is  forbidden,  but  wooden  sinks  may,  with  the  approval  of  the  hoard  ol 

health,  he  allowed   for  washing  dishes. 

Bath-Tubs  Required. 

In  Baltimore  a  recent  ordinance  requires  a  hath  tub  in  every  new 
hou 

Hot    Water  Boilers. 

•■All  hoi  water  boilers  sel  hereafter  shall  be  provided  with  a  steam  exhaust  or 
expansion  pipe  Leading  up  to  and  above  the  tank  which  supplies  the  water  to  the 
boiler.  This  lank  shall  he  Located  s<>  n-  to  prevent  danger  from  freezing.  When 
pressure  boilers  are  used  they  shall  be  provided  with  vacuum  valves  or  some  other 
suitable  appliance  to  prevent  the  collapse  or  bursting  <>(  the  boiler." 

In  Pittsburgh  ••  the  sediment  pipe  of  kitchen  boilers  must  not  be 
connected  on  the  nutlet  side  of  the  sink  trap. 

1  Bridgeport,  Sec.  51. 
A  Ibanj .  Sec.  37. 
Fitchbure,  Sec.  31. 


250  PLUMBING. 

Sub-soil  Drains. 

"  Sub-soil  drainage  pipes  shall  be  provided  with  back  water  valves  and  connected 
with  drains  from  rain  leaders,  or  else  provided  with  trap  and  valve  and  connected 
with  the  main  drain  outside  of  house  trap.11  1 

Back  pressure  valves  are  also  required  on  subsoil  drains  in  other 
cities. 

No  Steam  to  be  Allowed  to  Enter  Sewers. 

"  No  steam  exhaust,  blow-off,  or  drip  pipe  shall  connect  directly  with  the  sewer, 
house  drain,  soil,  waste  or  vent  pipe,  or  with  any  rain-water  conductor.  Steam 
shall  be  discharged  into  a  blow-off  or  condensing  tank,  the  waste  or  overflow  of 
which  shall  be  connected  with  the  house  sewer  outside  of  the  house  trap.  Joints 
of  the  blow-off  pipe  shall  be  screw  joints,  or  in  case  of  cast-iron  pipe  they  shall  be 
rust  joints.11  2 

The  condenser  must  be  for  low  pressure  of  not  less  than  twenty 
gallons  and  for  high  pressure  of  not  less  than  forty  gallons,  with  a  vent 
leading  from  the  dome  of  a  diameter  not  less  than  that  of  the  discharge 
pipe.  In  Providence  the  size  of  the  condenser  is  to  be  determined  by 
the  inspector. 

"No  steam  exhaust,  hot  water,  or  hot  blow-off  pipes  from  any  steam  boiler, 
acids,  chemicals,  refuse,  manufacturers1  waste,  noxious  gas,  or  vapors  shall  be  con- 
nected with  or  be  discharged  into  any  soil  or  waste  pipe  or  its  connection  with  the 
main  or  street  sewer.  All  steam  or  hot  water  pipes  from  any  steam  boiler  or  heat- 
ing apparatus  if  to  be  discharged  into  a  sewer  through  the  house  drain,  must  be 
trapped  and  be  connected  on  the  sewer  side  of  the  running  trap. 

"The  waste  from  the  condenser  to  sewer  side  of  running  trap  shall  be  galvanized 
pipe  with  screw  joints.3 

Public  Urinals. 

In  Denver  all  public  urinals  must  be  supplied  with  a  flush  tank,  the 
flush  to  be  connected  with  urinal  and  head  of  trap. 

Water  Service. 

Rules  governing  the  construction  of  water  supply  pipes  are  usually 
prepared  and  enforced  by  the  water  commissioners  or  water  company. 
As  defects  in  this  department  of  plumbing  produce  uneconomic  rather 
than  unsanitary  consequences  their  prevention  may  safely  be  left  to  the 
officers  most  interested  in  preventing  waste.  Nevertheless  there  is  a 
manifest  convenience  in  having  all  the  plumbing  inspected  and  con- 
trolled by  one  inspector.  Hence  a  number  of  cities  do  regulate  this 
work  partially  if  not  entirely  by  their  plumbing  codes  : 

"Tanks  for  drinking  water  are  objectionable,  but  if  indispensable,  they  must 
never  be  lined  with  lead,  galvanized  iron  or  zinc.  They  should  be  constructed  of 
iron,  or  of  wood  lined  with  tinned  and  planished  copper,  or  of  wood  alone.11  4 

1  Detroit,  Rule  19. 

2  Brooklyn,  Sec.  54. 

3  Cleveland,  Sec.  21. 

4  City  of  New  York,  Sec.  52. 


PLUMBING.  251 

"All  supply  pipes  situated  in  exposed  places  shall  be  protected  from  the  frost, 
and  wherever  practicable  water  pipes  shall  be  kept  away  from  any  exterior  wall. 
Horizontal  lines  of  lead  supply-pipe  shall  be  properly  supported  throughout  their 
entire  length,  and  so  arranged  as  to  be  easily  and  quickly  drained.  Vertical  lines  of 
supply-pipe  shall  be  supported  by  tacks  soldered  to  the  pipe  and  placed  not  more 
than  two  feet  apart.     All  joints  in  lead  supply-pipes  shall  be  wiped  joints. 

•Lead  supply-pipes   under  pressure  from   the  street  mains  shall  be  of  standard 
lead  pipe  known  as  'A  A.'  having  not  less  than  the  foil, .winy  weights: 
f  inch  pipe,   Ik  lbs.  per  foot. 


i     " 

•_' 

I     •■ 

••       2| 

I     " 

■  ;_ 

1 

■i\ 

1±     " 

•■       5| 

u    ••      ;i     7     "     "     4tl 

As  an  example  of  the  more  extended  regulations  governing  this 
class  of  work,  such  as  are  adopted  by  water  boards,  reference  may  be 
had  to  the  plumbing  regulations  of  the  District  of  Columbia,  Sees.  34-66. 

Application  of  Rules  to  Old  Plumbing. 

Unless  otherwise  specified,  plumbing  rules  do  not  apply  to  work 
constructed  before  their  adoption:  but  BOmetimes  under  the  authority 
of  statute  law  the  board  of  health  or  other  body  which  adopts  these 
rules  makes  them  applicable  in  a  greater  or  less  degree  to  old  plumbing 
as  well  as  new.  Usually  the  new  rides  are  to  be  applied  when  changes 
arc  made.  In  some  cities  the  rules  are  to  apply  only  when  old  plumb- 
ing has  been  condemned  by  the  board  of  health  : 

••  When  the  drainage  of  buildings  erected  prior  to  1886  lias  been  inspected  and 
condemned,  plans  must  be  hied,  and  the  new  work  of  alterations  shall  be  executed 
in  accordance  with  these  rules  and  regulations."  - 

In  Philadelphia  a  very  large  amount  of  old  plumbing  has  been 
renewed,  and  it  is  said  to  be  difficult  to  let  a  house  without  good 
modem  plumbing.  The  extent  of  these  renovations  is  well  shown  by 
the  fact  that  in  1896  there   were   filed   in    Philadelphia   6,648  plumbing 

plans  for  now  buildings  and  9,078  for  old  buildings. 

••  When  a  building  has  been  inspected  and  the  plumbing  work  condemned  by  the 
building  inspector  as  being  in  an  unsanitary  condition,  notice  shall  i>e  given  in  writ- 
ing to  that  •  ffect,  informing  the  agent  or  owner  of  the  said  building  what  character 
of  repairs  or  improvements  are  to  be  made,  and  if  there  are  any  objections  to  the 
repairs  or  improvements  ordered,  they  must  lie  filed  in  the  health  office,  within  a 
period  of  three  (3)  days,  and  if  objections  are  qoI  so  filed  the  alterations  or  improve- 
ments liiusi  be  made  ;i>  directed. 

'•It'  objections  are  bo  made,  the  agent  or  owner  shall  be  heard  by  the  health 
officer,  and  fiis  decision  shall  be  final  and  conclusive  as  to  the  repairs  or  alterations 
to  be  made;  provided,  if  anj   questions  are  involved,  which  require  consideration 


1  Brooklj  n.  Bees.  W  l. 
-  Philadelphia,  Rule  7. 


252  PLUMBING, 

and  action  of  the  board  of  health  in  the  judgment  of  the  health  officer,  the  same  shall 
he  submitted  to  the  board  of  health  for  determination.'"  : 

"It  shall  be  his  (inspector  of  plumbing)  duty  at  any  time  during  reasonable 
hours,  under  like  direction,  on  application  of  the  owner  or  occupant,  or  the  com- 
plaint under  oath  of  any  reputable  citizen,  to  inspect  or  cause  to  be  inspected  any 
house  in  said  district,  and  to  examine  the  plumbing,  drainage,  and  ventilation  of 
seAvers  thereof. 

"And  he  shall,  after  inspection  and  upon  approval  by  his  immediate  superior, 
serve  a  notice  on  the  owner,  or  agent,  of  the  premises,  directing  such  changes  as  are 
necessary  to  make  the  plumbing  conform  to  the  plumbing  regulations,  to  be  com- 
menced within  ten  days  from  the  date  of  the  service  of  the  notice  and  completed 
within  a  reasonable  time  thereafter.'1 2 

But  it  is  provided  in  addition  that  there  may  be  an  appeal  by  the 
owner  (who  shall  deposit  twenty  dollars)  to  the  engineer  commis- 
sioner who  shall  order  a  re-examination  by  three  inspectors.  If  this 
report  confirms  the  first  the  changes  must  be  begun  in  five  days,  and 
failure  is  to  be  followed  by  prosecution. 

Administration  of    Plumbing  Codes. 

As  has  been  said,  the  execution  of  plumbing  laws  is  usually  in  the 
hands  of  the  board  of  health.  This  is  true  of  nearly  one  hundred 
cities  and  towns  of  which  inquiry  was  made.  The  following  is  a  list 
of  cities  in  which  the  plumbing  is  otherwise  controlled: 

New  York Department  of  Buildings. 

Boston Building  Department. 

Milwaukee City  Engineer's  Department. 

Cambridge Supt.  of  Buildings. 

Cincinnati Inspector  of  Buildings. 

St.   Loins Board  of  Public  Improvement. 

Somerville,  Mass Inspector  of  Buildings. 

Butte,  Mont Inspector  of  Buildings. 

Newton,  Mass Inspector  of    Buildings. 

New  London,  Conn Board  of  Sewer  Commissioners. 

Erie,   Penn Water  Department. 

Providence Independent  Department. 

Omaha Independent  Department. 

Pawtucket Independent  Department. 

Memphis Independent  Department. 

Columbus Department  of  Public  Improvements. 

Minneapolis Building  Department. 

Licensing  of  Plumbers. 

It  has  of  late  come  to  be  generally  considered  that  the  first  step  in 
securing  good  plumbing  is  to  secure  good  plumbers.  To  bring  this 
about  examining  boards  are  established  to  examine  and  license  plumbers. 

1  San  Francisco,  Sec.  47. 

2  District  of  Columbia,  Sec.  3. 


PLUMBING.  253 

Most  of  the  examinations  are  made  under  state  law.  Such  laws  are 
found  in  the  District  of  Columbia,1  Illinois.'2  Maryland  for  Baltimore,3 
Massachusetts,4  Minnesota."  New  Hampshire,6  New  York,"  Ohio,8  Penn- 
sylvania, for  cities  of  the  second  class."  Texas.1"  Washington.11  and  Wis- 
consin,12 and  in  all  of  them  provision  is  made  for  the  examination  of 
fche  plumbers  by  a  properly  constituted  board. 

Of  the  above  states,  in  Maryland  and  Minnesota  the  examining 
hoard  is  a  state  board  and  is  appointed  by  the  Governor.  In  both  states 
the  term  of  service  is  two  years.  In  Maryland  the  hoard  consists  of 
three  practical  plumbers,  the  commissioner  of  health  of  Baltimore  and 
a  member  of  the  state  hoard  of  health.  In  Minnesota  the  hoard  con- 
sists of  two  master  plumbers,  two  journeymen  and  one  plumbing  inspec- 
tor of  ,-niy  city  of  the  first  class. 

In  the  other  states  the  law  provides  for  a  local  examining  hoard  as 
follows : 

Massachusetts.  In  cities  of  5,000  inhabitants,  or  those  with  a  water 
and  sewerage  system  there  must  he  an  examining  board  to  consist  of 
the  chairman  of  the  hoard  of  health,  the  inspector  of  buildings,  and  a 
plumber  appointed  by  the  hoard  of  health.  If  there  is  no  inspector  of 
buildings  there  must  he  two  plumbers. 

New  York.  In  all  cities  except  the  City  of  New  York  and  Albany 
the-  examining  hoard  appointed  by  the  mayor  is  to  consist  of  two  master 
plumbers,  one  journeyman,  each  of  ten  years'  experience,  the  chief 
engineer  of  sewers,  and  the  chief  inspector  of  plumbing. 

Illinois.  In  cities  and  villages  of  over  10,000  inhabitants,  the  hoard 
consists  of  the  chairman  of  the  hoard  of  health,  one  master  plumber  and 
one  journeyman. 

Washington.  In  cities  of  the  first  class  the  examining  board  con- 
sists of  the  president  of  the  board  of  health,  the  inspector  of  plumbing, 
one  master  plumber  ami  two  journeymen.  If  there  is  no  inspector 
another  master  plumber  is  added. 

1  District  of  Columbia,  A<t  of  23  April.  1892. 
-'  [llinois,  A.(  of   10  .Imp-.  1897. 

Maryland,  Chapter  139  of  1896. 
1  Massachusetts,  Chapter  477  of.  1893,  155  ol    1894,  and  153  of   18 

Minnesota,  Chapter  319  of  1897. 

\c  u  Hampshire,  Chapter  55  of  1899. 

■  New  Fork,  Revised  Statutes  (1895),  p.  137. 
Ohio,  Annotated  Statutes  (1900),  Sec.  12381   10). 

■  I'.nn  \  i>.  ania,  *  hapter  l  J6  i  if  1895. 
"'  Texas,  Chapter  163  oi  1897. 

11  Washington,  Code  1 1-  1248  '■'. 

'-  Wisconsin,  Statutes  (1898     -     .959 


254  PL  UMBixa. 

New  Hampshire.  In  cities  and  towns  which  accept  the  act,  the 
mayor  in  cities,  and  the  selectmen  in  towns  appoint  the  board. 

Texas.  In  cities  with  sewers  or  cesspools  the  hoard  consists  of  a 
member  of  the  board  of  health,  the  city  engineer,  the  plumbing  inspec- 
tor, one  master  plumber,  and  one  journeyman,  each  of  five  years"  ex- 
perience. 

Ohio.  The  Ohio  law  is  like  that  of  Massachusetts,  except  that  two 
master  plumbers  and  one  journeyman  are  on  the  board.  Physicians 
may  be  appointed  in  the  place  of  plumbers  if  the  latter  are  not  avail- 
able. 

Wisconsin.  In  cities  of  the  first,  second,  and  third  class,  the  board 
consists  of  the  commissioner  of  public  works,  or  the  chairman  of  the  board 
of  health,  the  inspector  of  plumbing,  and  a  plum  Iter  appointed  by  the 
mayor.  If  there  is  no  inspector  of  plumbing,  there  shall  be  two 
plumbers  appointed  by  the  mayor. 

In  all  of  these  boards  the  members  are  to  serve  without  pay,  except 
in  Massachusetts,  where  the  plumber  is  to  receive  five  dollars  per  day 
for  actual  service. 

These  laws  are  all  mandatory  and  require  the  establishment  of  the 
licensing  board  and  forbid  any  one  acting  as  master  or  journeyman 
plumber  without  a  certificate,  which  shall  be  given  only  when  the  can- 
didate has  passed  a  practical  and  satisfactory  examination.  Usually  it 
is  sufficient  for  one  member  of  a  firm  to  have  a  license.  In  Massachu- 
setts the  board  examines,  but  the  board  of  health  or  inspector  of  build- 
ings issues  the  license.  The  New  York  law  differs  from  the  other 
laws  in  requiring  an  examination  of  master  plumbers  only :  but  all 
licensed  plumbers  may  register  with  the  board  of  health  in  New  York. 

<  hitside  of  the  states  which  have  by  statute  provided  for  the  ex- 
amination of  plumbers  several  cities  have  adopted  this  plan,  sometimes 
With  and  sometimes  without  special  legislative  sanction.  Among  these 
are  Atlanta,  Chicago,  Detroit,  Hartford,  New  Haven,  Pennsylvania 
cities  of  the  second  class,  Portland,  Me.,  San  Francisco,  St.  Louis,  and 
Savannah.  In  Atlanta  the  examining  board  consists  of  a  master  and 
journeyman  plumber,  chief  sanitary  inspector,  the  city  engineer,  and 
secretary  of  board  of  health.  In  Portland,  Hartford,  and  San  Fran- 
cisco, it  is  the  board  of  health  ;  in  Detroit  it  is  a  special  board  appointed 
by  the  board  of  health. 

In  Chicago  the  commissioner  of  health  appoints  a  competent 
plumber  to  be  examiner.  In  that  city  only  masters  are  examined;  in 
Hartford  only  journeymen,  but  in  other  cities  both  classes.  In  the 
District  of  Columbia  masters  and  journeymen  are  to  be  examined  by  a 
board  appointed  by  the  commissioners  of  the  district.     In  Denver,  while 


PLUMBING.  2-35 

there  is  no  examination,  the  license  has  to  be  approved  by  a  board  con- 
sisting of  a  member  of  the  master  plumbers'  association,  a  member  of 
the  journeymen  plumbers'  union  and  the  plumbing  inspector:  the  asso- 
ciation members  are  to  be  elected  by  their  respective  associations.  In 
St.  Louis  plumbers  are  examined  by  the  supervisor  of  plumbing  (chief 
inspector). 

The  rules  governing  the  examinations  in  Detroit  are  given  below.1 

Somewhat  more  elaborate  rules  are  found  in  the  District  of  Colum- 
bia (  sections  A  to  -I ). 

The  states  and  cities  which  provide  for  the  examination  of  plumbers 
usually  provide  also  for  the  issuing  of  a  license  or  certificate,  and  the 
registration  of  the  name  and  address  of  the  plumber  with  the  board  of 
health  or  other  department  having  charge  of  the  plumbing. 

As  the  licensing  of  plumbers  is  of  value  to  the  plumber  as  well  as  to 


1  Detroit  Rules  for  Plumbing  and  Drainage: 

"Rule  6.  Application  for  examination  of  master  plumbers  will  be  received  by 
tin-  clerk  of  the  board  and  ailed  upon  at  the  next  regular  meeting,  and  shall  be 
properly  tilled  out  and  acknowledged  and  tiled  with  the  clerk  before  being  received 
by  the  Hoard  of  Kxaininers.  The  applicant  shall  state  on  oath,  and  in  his  own  hand- 
Writing,  that  he  is  a  citizen  of  the  United  States;  that  he  is  a  party  directly  inter- 
ested in  tin-  license,  giving  his  fidl  name,  residence,  street  and  number,  his  term  of 
residence  in  the  city,  ami  the  names  of  the  parties,  firms  or  corporations  in  whose 
service  he  has  been.  He  shall  also  state  his  business  or  employment  during  the  live 
years  immediately  preceding  the  date  of  application,  as  well  as  the  number  of  years 
during  which  he  has  been  engaged  in  the  business,  trade  or  calling  of  plumbing. 
The  application  must  be  accompanied  by  a  certificate  signed  b\  not  less  than  two 
reputable  citizens  of  Detroit,  stating  that  they  are  personally  acquainted  with  the 
applicant  and  believe  him  to  he  of  good  moral  character  ami  temperate  babits.  The 
examination  will  he  of  such  character  as  to  fcesl  the  litncss  and  qualifications  "f  the 
applicant  for  the  trade,  business  or  calling  of  plumbing,  who  must  have  a  standing 
of  at  least  sixty  per  cent,  in  his  examination  to  he  entitled  to  a  certificate  of  com- 
petency. Falsehood  or  fraud  in  the  examination  shall  be  a  sufficient  cause  for  a 
refusal"!'  his  certificate,  together  with  the  dismissal  of  his  application.  When  the 
applicant  fails  to  pass  the  examination  he  shall  not  be  entitled  to  another  examina- 
tion before  the  next  regular  meeting  of  the  board. 

•■  hi  it  7.  There  will  be  two  grades  of  examinations  for  journeymen  plumbers, 
viz. :  « Ordinary  and  honorary.  The  applicant  can  select  the  grade,  and  if  successful 
he  will  be  furnished  with  a  certificate  "t  competency  in  cither  grade  ns  the  case  may 
be.  bui  he  cannot  take  the  honorary  grade  until  he  has  passed  a  successful  examina- 
tion in  the  ordinary  grade.  If  the  candidate  fails  to  pass  the  examination  in  either 
he  shall  uot  be  entitled  to  another  examination  before  the  expiration  of  one 
month  from  date  of  failure.  The  applicant  who  applies  foj  a  certificate  of  compe- 
ther  ordinary  or  honorary  journeyman  plumber,  must  give  his  full  name. 

residence,   street    number,    term   Of   residence   in  t  he  city,    if  a  citizen  ;    the  names  i d  the 

parties,  firms  or  corporations   in  whose  services  he  has  been;  where  be  served   his 
apprenticeship;  how  long  he  has  been  engaged  as  a  journeyman   plumber.     If  the 

said   journeyman    plumber  wishes  to  engage    in  business  for    himself   at  any  time,   he 

must  comply  with  section  -±  <>f  the  rules  relating  t^  master  plumbers,  before  engag 

ing  i  herein.*' 


256  PLUMBING. 

the  public  it   is  deemed   wise  in   many  cities   to  charge  a  fee  for  the 
license  or  for  the  examination. 

The  following  are  some  of  the  fees  : 

City  or  State.  Master.         Journeyman.    Annual  Renewal. 

Massachusetts 82  00  -     50  $     50 

Xew  York 5  00 

Ohio 5  00  1  00 

Pennsylvania  cities  of  the  second  class. .  5  00  50 

Maryland 3  00  3  00  1  00 

Illinois 5  00  1  00 

Minnesota 3  00  3  00  1  00 

Wisconsin 2  00  50           '          50 

Washington 5  00  1  00  1  00 

Chicago :)0  00  30  00 

Denver 10  00  10  00 

New  Haven 1  00  1  00  1  00 

Reading 100  loo  i  00 

■San  Francisco 1  00  1  00  1  00 

Texas 3  00  2  00 

In  a  number  of  cities,  as  Philadelphia  and  Providence,  no  fee  is 
charged. 

As  has  been  seen  an  annual  license  only  is  granted  in  most  in- 
stances, but  in  the  District  of  Columbia  the  license  is  for  live  years,  and 
in  Philadelphia  and  other  Pennsylvania  cities  and  in  Xew  Vork  the 
duration  of  license  is  indeterminate. 

The  special  act  tor  Philadelphia  and  also  the  general  act  for  Penn- 
sylvania cities  and  boroughs  and  the  Xew  Jersey  law  provide  simply 
for  the  registration  of  plumbers,  they  do  not  refer  to  a  license  :  but  in 
certain  cities  at  least,  as  Philadelphia,  Scranton  and  Reading,  "  certifi- 
cates of  registration  "'  are  issued  which  are  practically  licenses,  and  in 
Reading  a  fee  is  charged  for  this.  This  practice  of  registration  is  fol- 
lowed in  certain  other  cities,  as  Pawtucket,  Manchester,  and  Ports- 
mouth. X.  H.  In  Pawtucket  the  plumber  must  notify  the  inspector  of 
any  change  in  his  place  of  business. 

In  Buffalo  a  list  of  licensed  plumbers  must  lie  published  once  a 
year  in  the  paper  receiving  the  city  advertising.  In  Hartford  the  list 
must  be  published  in  the  city  year  book. 

Bonds, 

In  a  number  of  cities  plumbers  are  required  to  give  bond.1 

The  usual  amount  of  the  bond  is  $5 1,000.     In  the  District  of  Coluni- 


1  Chicago  Plumbing  Code,  Sec.  2: 
"...    Every  such  person  shall,  with  such  application,  trie  with  the  city  clerk  a 
bond,  signed  by  two  or  more  sureties,  to  be  approved  by  the  city  clerk,  in  the  sum 
of  three  thousand   (3.000)   dollars,   conditioned  that  the    applicant  shall  indemnify 


PLUMBING.  257 

bia  and   Baltimore  it   is  $2,000;  in  Chicago   and    Denver,   #3,000;  in 
Cincinnati  and  San  Francisco.  $500. 

Inspectors. 

The  next  step  after  the  adoption  of  plumbing  rules  and  the  licens- 
ing of  plumbers  is  the  appointment  of  inspectors.  This  has  in  many 
cases  been  done  without  special  legislation  under  the  grant  of  general 
sanitary  powers,  as  in  Baltimore,  or  under  a  special  statute  authorizing 
the  ••  regulation  of  plumbing  and  drainage,"  as  in  New  Jersey.  But 
several  states  have  enacted  general  laws  authorizing  the  appointment  of 
plumbing  inspectors  and  the  same  power  has  been  given  to  individual 
cities  by  special  acts.  Massachusetts,  New  Hampshire,  New  York. 
Ohio,  and  Pennsylvania  for  cities  of  the  second  class  have  not  only 
authorized  but  directed  the  appointment  of  plumbing  inspectors,  also 
Washington  for  the  cities  of  the  first  class  with  water  and  sewers, 
Wisconsin  for  cities  of  first  to  third  class,  and  Texas  for  cities  with 
sewers. 

Several  cities  have  rules  for  the  government  of  their  inspectors. 
The  San  Francisco  rules  are  given  below.1 


and  save  harmless  the  City  of  Chicago  from  all  accidents  and  damages  which  may 
be  caused  by  any  negligence,  unskilfulness  or  inadequacy  in  the  execution  or  pro- 
tection <>f  any  work  be  may  do  under  and  by  virtue  of  his  license,  if  issued,  and  that 
he  will  conform  to  all  lawful  requirements  and  regulations  of  the  city  pertaining  to 
the  business  of  plumbing  in  accordance  with  the  ordinances  of  the  city,  and  with 
the  rules  and  regulations  of  the  department  of  public  works,  and  the  department  of 
health.  The  city  clerk  shall  notify  the  commissioner  of  health  of  the  filing  of  all 
such  applh  at  ions  and  bonds." 

1  San  Francisco.  Plumbing  Code: 

''Section  61.  Fntsr —  The  Plumbing  Inspector  shall  be  in  attendance  at  the 
Health  Office  between  the  hours  of  8  and  9.30  \.  «.  and  4  to  5  p.  \i..  to  receive  plans 
oi  proposed  plumbing  and  drainage,  and  to  make  appointments  for  the   inspection 

of  the  work  in  the  course  of  construction. 

'Second      Be  shall  number  and  file  all  plans  and  specifications  accepted,  and 

record  in  the  Hoard  of  Health  the  names  of  the  owner  and  architect,  and  plumber, 
and  local  ion  of  work. 

•  Thikd  He  shall,  upon  being  notified,  examine  all  plumbing  work  before  the 
same  is  covered  up  and  concealed,  and.  if  found  to  be  iii  accordance  with  the  rules 
of  the  Board  of  Health,  upon  presentation  of  an  accurate   plan  ami  specification  of 

same  by  the  plumber,  shall  issue  a  certificate  to   that    effect.      It.  on   examination   of 

said  work,  he  finds  any  violation  of  the  rules  oi  t  he  Board  of  Health,  he  shall  report 
the  same  to  the  Health  Officer  with  a  note  explaining  the  necessary  corrections,  and 
have  if  altered  accordingly.  Upon  completion  of  any  plumbing  work  he  shall  ex- 
amine the  same,  ami  if  found  to  he  in  accordance  with  the  rules  of  the  Board  of 
Health,  and  the  plans  ami  specifications  filed,  he  shall  issue  a  final  certificate. 

i"i  kiii  He  must  make  a  monthly  report  to  the  Board  oi  Health  of  the  num- 
ber of  plans  ami  specifications  received;  the  number  approved  and  rejected;  also 
stating  the  number  of  first  and  final  examinations   made,  and   where  and  by  whom 

17 


Allegheny. 


Minneapolis. 


258  PLUMBING. 

The  following  is  a  list  of  cities  having  inspectors  of  plumbing  and 
also  the  salaries  of  the  inspectors  : 

Number  of  Annual 

City.  Inspectors.  Salaries. 

(  1  $1,200 

!  1  864 

Baltimore 1  1,200 

R     .                                                                              (  1  2,500 

B°St0n 1  10  1,400-1,800 

Brockton I1 1,2002 

Cambridge 1  1,000 

Chicago 14  1,000 

Cincinnati 2  ._ 1,100 

Columbus 1  •" 900 

Dayton 1  1,000     . 

Denver 2  1,200 

Fitchburg 1  1,000 

Hartford 1  1,200    . 

Haverhill 1  1,000 

Holyoke 1  1,000 

Lawrence 2  1,200 

Lynn 1  per  inspection            5 

„.,         ,                                                                       \  1  1,500s 

Milwaukee >  g  12003 

<  1  1,000 

'  I  1  900 

Newark 1  1,200 

New  Bedford 1  1,400 

New  Haven 1 1,200 

Newton 1  1,250 

New  York,  (Manhattan  and  Bronx) J  Vino  i'-nn 

(  So  1,1UU— l,oOU 

Paterson 1  1,375 

Philadelphia 13  1,200 

,  1  1,800 

Pittsburgh ]  2  1,500 

'  2  1,200 

„       .,                                                                          <  1  1,500-' 

Providence j  g  1Q^ 

Reading 1  1,000 

,  1  1,500 

San  Francisco ]  3  1,200 

'  1  900 

Somerville 1  1,200 

Springfield,  Mass 1  1,100 

Syracuse 2  1,200 

the  rules  have  been  violated,  and  such  other  matter  as  may  be  required  by  the  Board 
of  Health. 

"Fifth  —  The  Assistant  Inspector  of  Plumbing  and  Drainage  will  act  under  the 
orders  of  the  Inspector  of  Plumbing  and  Drainage,  and  assist  him  in  discharge  of 
his  duties.'1 

1  Also  disinfects. 

2  Has  horse  and  buggy  in  addition. 

3  Furnish  own  horse  and  buggy. 


PLUMBING.  .  259 

Notification  of  Inspection. 

"  The  department  of  health  must  be  notified  when  the  work  is  begun,  and  when 
any  work  is  ready  for  inspection.  All  work  must  be  left  uncovered  and  convenient 
for  examination  until  inspected  and  approved.  No  notice  shall  be  sent  for  any 
inspection  until  the  work  is  entirely  ready  for  thorough  inspection.  In  case  of  any 
violation  of  this  regulation,  the  approval  of  said  plans  may  be  at  once  revoked  by 
the  commissioner  of  health,  and  upon  notice  of  such  revocation  being  given,  all 
work  under  said  plans  must  cease.'1 

In  Milwaukee  the  notification  must  be  in  writing  and  specify  the 
plan  number.  In  Lowell  the  notification  must  be  at  least  eight  hours 
before  the  work  is  sufficiently  advanced  for  such  inspection.  Failure  to 
be  ready  for  inspection  at  the  time  set  requires  some  penalty.  In  San 
Francisco  it  is  deemed  sufficient  cause  for  suspension  of  license  for  such 
time  as  the  hoard  of  health  may  deem  proper.  In  Reading  if  the  work 
is  not  ready  another  notice  must  be  sent  and  if  the  work  is  not  then 
ready  one  dollar  will  be  charged  for  receiving  a  third  notice.  In  Provi- 
dence : 

"  .  .  .  In  case  it  shall  be  necessary  for  said  inspector  to  inspect  said  work 
more  than  once,  by  reason  of  the  same  not  being  ready  for  final  inspection,  after 
notice  has  been  given  the  inspector  of  the  completion  of  said  work,  then  said  inspec- 
tor shall  charge  and  collect  from  said  plumber  the  sum  of  fifty  rents  for  each  visit 
of  inspection  required  to  be  made  as  aforesaid."2 

Inspection  of  Work. 

In  Pittsburgh  the  inspector  must  examine  the  work  within  three 
days  alter  receiving  notice  that  it  is  ready  for  inspection:  in  Ports- 
mouth and  Manchester,  N.  II.,  within  twenty-tour  hours.  In  Albany 
the  sewer  connection  must  be  inspected  in  twenty-four  hours,  and  the 
Other  work  in  three  days  after  notice.  If  it  is  not  inspected  in  that 
time  the  plumber  may  cover  in  the  work  and  complete  the  job. 

"All  soil,  waste  and  vent  pipe  must  be  tested  i>\  the  plumber  in  charge  with  a 
water  test,  as  directed  by  the  inspector,  and  in  the  presence  of  the  inspector.  All 
openings  having  been  closed  by  the  plumber  in  charge  of  the  work,  pipe-joints,  fit- 
tings, or  fixtures  thus  shown  to  be  defective  or  wronglj  placed  must  be  replaced 
within  three  days  and  again  tested  if  required  by  the  inspector.  None  of  the  said 
pipes  shall  be  covered  from  sight  till  they  have  been  shown  to  stand  the  test  pre- 
scribed to  the  satisfai  tion  of  the  inspector.  After  the  plumbing  work  of  the  build- 
ing has  been  tested  as  directed,  no  alteration  will  be  permitted  except  upon  written 
application  of  the  plumber  in  charge  of  the  work.  Permits  must  l>e  taken  out 
before  work  will  be  inspected.  Notice  must  be  sent  to  the  said  inspector  when 
work  is  sufficiently  advanced  for  inspection.  No  inspection  will  be  made  on  legal 
bolidaj  s."  a 

"  Tin-  plumber  shall  test  all  soil,  waste,  drain,  and  venl  pipes  in  the  presence  of 
the  plumbing   inspector,  by  the  water  test,  or  by  such  other  methods  as  may   he 

Brooklj  n,  Sec.  10, 
Proi  idence,  Sec.  4. 
Cleveland,  Sec.  20. 


260  PLUMBING. 

approved  by  the  board  of  health,  the  pressure  to  be  applied  as  directed  by  the 
inspector,  the  test  to  be  made  as  follows:  All  connections  must  be  made  with  the 
exception  of  the  main  trap  clean-out  for  the  testing-  plug.  Place  traps  in  their 
proper  places.  Connect  all  back  vent  pipes  to  traps,  caulk  all  ferrules  in  soil  and 
waste  pipes,  place  all  iron  hangers  and  other  supports  in  their  position."1 

"The  entire  system  of  plumbing,  including  lead,  connections,  and  drains  within 
the  building,  must  be  tested  by  filling  the  whole  system  with  water,  and  having  it 
remain  filled  for  at  least  twenty-four  hours.'"2 

Iii  Rochester  stop-cocks  shall  be  placed  at  the  foot  of  vertical  soil  or 
waste  pipes  for  the  convenience  of  the  plumbing  inspector  of  the  board 
of  health.  Other  cities  than  New  Bedford  permit  or  require  other  tests 
than  the  water  test.  Thus  in  Providence  the  test  is  the  water  test  "  or  if 
that  is  not  practicable,  the  air-pressure,  peppermint,  or  other  reliable 
test."  In  Pittsburgh  the  peppermint  test  is  permitted,  and  in  Scranton 
the  smoke  or  peppermint  test,  and  in  many  New  Jersey  cities  the  pepper- 
mint, ether,  or  smoke  test.  In  Asbury  Park,  Montclair,  and  Newark 
the  smoke  test  is  usually  employed.  In  New  Haven  and  Asbury  Park 
a  five-pound  air-pressure,  and  in  the  District  of  Columbia  a  two-pound 
air-pressure  test  is  allowed.  In  Manchester  the  smoke  test  may  be 
used  if  no  water  is  to  be  had. 

After  this  preliminary  test  a  certificate  is  usually  given  approving 
the  work  already  done.  After  the  work  is  entirely  completed  a  final 
inspection  is  usually  required  for  which  another  application  must  be 
made. 

The  peppermint  or  other  practical  test  is  allowed  for  the  final  test 
in  several  cities.  In  Providence  the  final  test  is  simply  an  inspection 
and  no  mechanical  test  is  employed  other  than  the  first  water  test. 

After  the  completion  of  the  final  test  a  certificate  is  in  many  cities 
given  to  the  plumber  to  show  that  the  work  has  been  properly  done. 
The  form  used  in  Denver  is  shown  in  Appendix  41,  a  similar  form 
being  kept  as  a  stub. 

In  several  cities  drain  layers  are  a  distinct  class  from  plumbers  and 
have  separate  licenses.  In  such  cases  separate  plans,  inspections,  and 
approvals  are  required  for  the  drain  layers'  work.  These  usually  follow 
the  same  form  and  procedure  as  provided  for  plumbers. 

In  many  cities  also  it  is  provided  that  "  plumbing  work  shall  not  be 
used  unless  the  same  has  first  been  tested  and  approved  in  writing  "  by 
the  inspector: 

"  Plumbing  work  shall  not  be  used  unless  the  same  has  been  first  tested  at  the 
expense  of  the  plumber,  in  the  presence  of  the  authorized  inspector  with  the  water 


1  New  Bedford,  Sec.  XXIII  (3). 

2  Hartford,  Sec.  44. 


PLUMBING.  261 

test,  or  if  that  is  not  practicable,  with  the  air  pressure,  peppermint,  or  other  reliable 
test,  and  by  hirn  approved  in  •writing."  1 

111   Hartford : 
••  Until  such  certificate  is  issued,  it  shall  not  be  lawful  for  the  owner,  manager, 
or  agent  of  said  property  to  allow  the  same  to  be  occupied  for  human  habitation."  2 

Penalty  for  Defective   Work. 

Violations  of  plumbing  rules,  like  any  other  municipal  regulations, 

are  punished  by  fine  or  imprisonment,  but,  as  is  usual  in  such  minor  police 

regulations,  the  penalties  are  not  severe.     Another  and  more  effectual 

penalty  is  the  revocation  of  the  license  of  the  plumber.     In  New  York 

this  is  provided  for  by  statute  : 

"  But  such  registration  may  be  canceled  by  such  board  of  health  or  superintend- 
ent of  the  department  of  buildings  in  the  city  of  Xew  York  for  a  violation  of  the 
rules  and  regulations  for  the  plumbing  and  drainage  of  such  city,  duly  adopted  and 
in  force  therein,  after  a  hearing  had  before  said  board  of  health,  or  superintendent 
of  the  department  of  buildings  in  the  city  of  New  York,  as  the  case  may  be,  and 
upon  a  prior  notice  of  not  less  than  ten  days,  stating  the  grounds  of  complaint,  and 
serve  upon  the  person  charged  with  the  violation  of  the  aforesaid  rules  and  regula- 
tions: but  such  revocation  shall  not  be  operative,  unless  concurred  in  by  a  majority 
of  the  local  board  of  examiners.*'  3 

Another  penalty  still  is  to  remove  defective  work  : 

••The  inspector  of  plumbing  shall  promptly  condemn  and  order  the  removal  of 
any  defective  material,  bad  workmanship,  or  of  any  work  done  otherwise  than  in 
accordance  with  the  provisions  of  these  regulations."  4 


1  Providence,  Sec.  22. 

-  Hartford,  Ordinance  of  1  March,  1887. 

■  New  York,  Revised  Statutes  (1895),  p.  437,  Sec.  6. 

4  District  of  Columbia,  Sec.  38. 


CHAPTER  VI. 

AVATER,  ICE,  AND    SEWERS. 

A  PLENTIFUL  supply  of  pure  water  is  one  of  the  prime  requisites 
of  municipal  sanitation.  Such  a  supply  can  only  be.  furnished 
through  a  system  of  mains  operated  by  a  public  or  quasi-public  corpora- 
tion. The  demand  for  municipal  water  works  in  the  United  States  has 
been  very  great.  According  to  the  "  Manual  of  American  Water 
Works  "  for  1897,1  there  were  at  the  opening  of  this  century  seventeen 
such  water  works  in  operation.  In  1896  there  were  3,196.  Of  these 
water  works  1,690,  or  more  than  one-half  were  owned  by  municipalities. 
The  tendency  for  the  city  to  own  and  operate  its  works  seems  to  be  a 
growing  one,  and  the  manual  referred  to  gives  a  list  covering  two 
closely  printed  pages,  of  cities  in  which  the  water  works  have  changed 
from  private  to  public  ownership.  This  list  includes  some  of  the  most 
important  cities  of  the  country.  The  list  of  cities  which  have  changed 
from  public  to  private  ownership  is  small,  and  the  cities  are  small.  As 
regards  the  quantity  of  water  furnished,  the  cities  and  companies  in  the 
United  States  seem  to  have  done  all  that  could  be  desired.  In  fact 
they  have  done  more  than  is  necessary.  There  is  little  doubt  that  more 
than  half  the  water  furnished  in  the  United  States  is  wasted.  The  per 
capita  comsumption  in  American  cities  is  twice  as  great  as  in  European 
cities,  and  in  the  comparatively  few  American  cities  which  are  metered 
the  per  capita  consumption  is  not  half  what  it  is  in  the  average  unmet- 
ered  city.2  It  has  been  argued  that  the  use  of  meters  tends  to  reduce 
the  consumption  of  water  to  too  low  a  minimum,  but  such  is  decidedly 
not  the  experience  in  the  city  of  the  writer.  Meters  diminish  waste, 
not  the  legitimate  use  of  water. 

The  sources  of  the  water  supplies  of  the  United  States  are  veiy 
varied  ;  lakes  and  ponds,  storage  reservoirs,  rivers  and  deep  wells  being 
the  most  important.  The  character  of  the  water  of  course  varies  from 
that  which  is  desirable  in  every  respect,  to  that  which  is  barely  endur- 
able. There  are  many  conditions  of  water  which  must  be  taken  into 
consideration  when  estimating  its  desirability  or  permissibility  as  a 
municipal  supply. 


1  Published  by  the  Engineering  News  Publishing  Company,  New  York. 

2  Water  supplies.     William  P.  Mason,  1896,  p.  438  et  seq. 


WATER,   ICE,   AXD    SEWERS.  263 

Ch  em  ical  Compositio  n . 

Water  which  contains  too  much  mineral  substance  in  solution  is 
not  desirable,  as  it  renders  the  water  unsuitable  for  boiler  or  laundry 
use. 

Suspended  Mutter. 

The  chief  form  in  which  suspended  matter  is  found  in  potable  waters 
is  in  the  form  of  tine  silt,  which  is  carried  along  by  the  current  of  a  very 
large  proportion  of  the  rivers  of  the  United  States.  More  rarely  organic 
matter  of  vegetable  origin  may  be  held  in  suspension  in  sufficient  quan- 
tity to  be  an  offence. 

Color. 

The  more  coloring  matter  the  less  pleasant  is  the  appearance  of  the 
water  to  the  consumer. 

Taste  and  Odor. 

A  slight  vegetable,  swampy,  or  peaty  taste  is  not  very  objectionable, 
but  is  certainly  far  from  desirable.  Unfortunately  this  is  not  the  only 
tasi<-  which  is  found  in  water,  for  under  certain  conditions  the  growth 
and  decay  of  algae  give  rise  to  most  disagreeable  "  fishy  "  tastes,  and 
also  to  bad  odors.  Sometimes  these  are  sufficient  to  render  the  water 
positively  nauseous. 

Pathogenic  Organisms. 

The  most  serious  contamination  of  drinking  water  is  disease  germs. 
Of  these  the  typhoid  bacillus  is  by  far  the  most  important.  It  is  pos- 
sible thai  certain  diarrhceal  affections  may  be  carried  in  drinking  water. 
but  the  evidence  is  not  clear.  Cholera  is  known  to  be  disseminated 
through  the  medium  of  public  supplies,  but  has  not  gained  a  foothold 
here  for  a  quarter  of  a  century,  and  meanwhile  typhoid  has  claimed 
hundreds  of  thousands  of  victims  and  a  very  Large  number  of  the  discs 
were  undoubtedly  caused  by  drinking  the  water  of  contaminated  muni- 
cipal supplies. 

The  health  officer  is,  of  course,  most  directly  interested  in  the  last 
form  of  contamination.  It  is  his  business  to  labor  for  the  suppression 
of  the  infectious  diseases  of  which  typhoid  is  one  of  the  most  important. 
His  chic!'  concern  is  to  see  to  it  that  water  is  tree  from  dangerous 
organisms;  but  he  should  not  neglect  the  other  factors  which  go  to 
make  a  -ood  water  supply.  It  is  of  great  importance  thai  a  water  sup- 
ply be  attractive  to  the  eye  and  taste,  or  a  pleasant,  but  dangerous  well 
may  be  preferred  in  its  stead.  It  is  also  very  desirable  thai  the  water 
should  be  soft,  so  that  it  will  be  sought  for  in  ever}  house  and  every 
manufactory;  and   il   is  furthermore  desirable  that  the  price  be  reason- 


264  WATER,   ICE,   AND   SEWERS. 

able,  that  its  use  may  not  be  restricted  by  the  poor  or  by  parsimonious 
landlords  and  corporations.  The  health  officer  should  remember  that 
he  is  doing  much  to  promote  health  when  he  gives  his  influence  to 
secure  any  of  these  desirable  conditions  of  municipal  water  supply. 

Usually,  the  health  officer,  particularly  the  local  health  officer,  does 
not  have  very  much  to  do  directly  with  the  control  of  the  water  supply. 
The  actual  labor  of  introducing  and  caring  for  a  water  supply  is  gen- 
erally in  the  hands  of  the  engineering  or  public  works  department,  or 
special  commissions,  or  private  companies.  Yet  it  is  true  that  in  cer- 
tain states  and  cities  health  officials  have  done  very  much  for  the  im- 
provement of  the  water  supplies  within  their  jurisdictions. 

The  duties  of  the  state  boards  of  health  in  Massachusetts,  Minnesota, 
and  New  York  in  regard  to  the  prevention  and  abatement  of  nuisances 
causing  pollution  of  potable  waters  will  be  referred  to  on  another  page. 
Further  than  this,  local  governments  in  these  states  and  in  North  Caro- 
lina are  required  to  consult  with  and  receive  advice  from  the  state  board 
of  health  in  regard  to  introducing  or  extending  their  water  supply.  In 
Ohio  the  law  goes  further  than  this  and  requires  the  towns  and  cities  to 
heed  the  advice  of  the  state  board.1 

Besides  thus  specifically  advising  and  controlling  the  local  supplies, 
the  state  board  of  health  may  do  very  much  by  a  systematic  study  and 
investigation  of  the  existing  and  available  supplies  of  drinking  water  for 
cities  and  towns,  and  by  a  careful  investigation  of  the  various  scientific 
problems  connected  with  the  furnishing  of  a  pure  municipal  water. 
The  state  of  Massachusetts  has  set  an  example  in  this  work  which  it 
will  be  difficult  for  others  to  equal  and  which  none  have  yet  attempted 
to  do.  The  now  well  known  results  of  the  Lawrence  filter  experiments 
are  classics  in  this  line  of  work,  and  the  Massachusetts  board  of 
health,  and  the  men  that  have  been  associated  with  it,  have  done  more 
than  all  others  to  awaken  an  interest  in  pure  water,  and,  what  is  more, 
they  have  shown  how  it  is  possible  to  secure  it.  The  board  has  also 
since  1887  conducted  a  systematic  investigation  of  the  water  supplies 
of  the  state,  and  has  published  its  results  in  a  voluminous  special  report 
in  1890,  and  in  its  annual  reports  since  that  date.  Connecticut,  New  Jer- 
sey, New  York,  and  Ohio  have  also  investigated  local  supplies,  the  lat- 
ter state  having  recently  (1898)  issued  a  special  report.  The  control 
which  is  exercised  or  the  influence  which  is  exerted  by  some  of  the 


1  Ohio,  Annotated  Statutes  (1900),  Sees.  409-25: 

"  And  no  city,  village,  corporation  or  person  shall  introduce  a  public  water  sup- 
ply or  system  of  sewerage,  or  change  or  extend  any  public  water  supply  or  outlet 
of  any  system  of  sewerage  now  in  use,  unless  the  proposed  source  of  such  water 
supply  or  outlet  for  such  sewerage  system  shall  have  been  submitted  to  and  received 
the  approval  of  the  state  board  of  health.     (O.  L.  Vol.  90,  p.  94.) 


WATER,   ICE.   AND    SEWERS.  265 

state  boards  above  mentioned  in  regard  to  sewage  disposal  is  of  great 
importance  in  connection  with  the  maintenance  of  the  purity  of  water- 
supplies. 

Such  general  investigations  as  are  above  referred  to  should,  in  the 
opinion  of  the  writer,  be  undertaken  by  the  state  as  they  have  been  in 
Connecticut,  Massachusetts,  and  Ohio ;  but  in  default  of  this  the  cities 
have,  outside  of  these  states,  been  very  largely  obliged  to  do  work  of 
this  kind  themselves.  Local  boards  of  health  have  thus  very  generally 
felt  it  their  duty  to  advise  concerning  the  adoption  or  improvement  of 
the  water  supply  of  their  city,  and  have  been  obliged  to  undertake 
inspections  and  investigations  in  regard  to  its  purity.  It  will  generally 
be  found  that  local  boards  of  health  are  in  advance  of  the  public,  and 
in  advance  of  the  other  municipal  officers  in  demanding  the  introduc- 
tion of  sanitary  purification  of  water.  A  perusal  of  the  reports  from 
year  to  year  of  Baltimore,  Chicago,  Cincinnati,  Denver,  District  of  Col- 
umbia, Minneapolis,  Philadelphia,  Pittsburgh,  Providence,  Reading, 
Rochester,  St.  Louis,  Scranton,  and  Syracuse  will  show  that  local 
boards  of  health  have  been  alive  to  the  needs  of  their  cities  and  have 
often  for  years  called  in  vain  for  purer  water.  They  have  made  inves- 
tigations and  have  shown  conclusively  that  the  water  was  dangerously 
contaminated,  and  they  have  also  shown  the  remedy.  Local  boards  of 
health  may,  outside  of  their  advisory  capacity,  exert  an  actual  control 
Over  their  water  by  patrol  and  enforcing  pollution  laws  and  by  carrying 
on  systematic  analysis  of  the  water.  This  will  be  referred  to  on  a  suc- 
ceeding page.  The  legislation  concerning  the  pollution  of  potable 
waters  will  now    be  considered. 

Prevention  of  Pollution  by  Legislation. 

There  is  considerable  statutory  legislation  intended  to  prevent  the 
pollution  of  public  water  supplies.3  Much  of  this  is  of  a  very  general 
nature  and  dates  back  to  the  time  when  the  exael  danger  to  be  appre- 
hended in  water  pollution  was  not  as  well  understood  as  it  is  at  the  pres- 
ent time.  .Much  of  this  legislation  is  evidently  based  on  the  Massa- 
chusetts statute  of   L843.2     Some  of  the   laws  specify  more  I'nIK  than 

'Such  laws  are  found  in  California,  Connecticut,  Delaware,  Illinois,  Indiana, 
K;ihn;in.  Kentucky,  Maine,  Maryland,  Massachusetts,  Michigan,  Minnesota,  Ne^i 
Hampshire,  Sevt  Jersey,  Ne\i  Fork,  North  Carolina,  Ohio,  Oregon,  Tennessee, 
Virginia,  Wesl  Virginia,  and  Wisconsin. 

Massachusetts,  Public  Statutes  (1882),  Chapter  208,  s''.-.  7: 

••  Whoever  w  ilfully  or  maliciously  defiles,  corrupts,  or  makes  impure  any  spring, 
or  other  source  of  water,  or  reservoir,  or  destroys  or  injures  any  pipe,  conductor  of 
water,  or  other  property  pertaining  to  an  aqueduct,  or  ;ii<ls  or  abets  in  any  such 
trespass,  shall  be  punished  by  line  no!  exceeding  one  thousand  dollars,  or  by  impris- 
onment in  the  j;iil  nol  exceeding  one  year 


266  WATER,   ICE,   AND    8 E WEES. 

that  of  Massachuaetts  the  waters  that  shall  not  be  corrupted,  as  water 
courses,  streams  of  running-  water,  pond,  well,  fountain,  cistern,  other 
place  from  which  water  is  procured  for  drinking  purposes,  streams 
from  which  towns  are  supplied,  brook,  canal,  river,  water  used  for  do- 
mestic purposes,  or  used  for  man  or  beast. 

The  act  of  pollution  is  sometimes  more  specifically  defined.  Thus 
among  the  things  that  must  not  be  put  into  the  water  are  mentioned, 
carcasses  of  dead  animals,  slaughter-house  refuse,  contents  of  privy 
vaults,  cesspools  and  drains,  human  animal  excrement ;  slops,  filth,  dye- 
stuffs,  drugs,  chemicals,  putrid,  noisome,  nauseous  and  offensive  sub- 
stances ;  decaying  animal  or  vegetable  matter  and  sewage  ;  and  nothing 
must  be  done  to  befoul  or  pollute  the  water  or  injure  health.  Usually 
in  these  laws  the  words  "  wilfully  *'  and  "  maliciously  "  are  omitted,  but 
sometimes  they  are  retained.  In  Kentucky  it  is  forbidden  to  place  such 
materials  within  twenty-five  feet  of  the  bank,  and  a  later  Massachusetts 
statute  places  the  limit  at  five  rods.  A  statute  more  explicit  than  the 
Massachusetts  type  has  been  enacted  in  New  Hampshire  and  is  given 
below.1  A  later  law,  and  one  making  better  application  of  our  present 
knowledge,  is  that  of  Virginia,  but  it  is  not  applicable  to  water  sheds 
having  an  area  of  over  fifty  square  miles.2 


1  New  Hampshire,  Public  Statutes  (1891),  108,  Sec.  13: 

"  If  a  person  shall  place,  leave,  or  cause  to  be  placed  or  left,  in  or  near  a  lake, 
pond,  reservoir,  or  stream  tributary  thereto,  from  which  the  water  supply  for  domestic 
purposes  of  a  city,  town,  or  village  is  taken,  in  whole  or  in  part,  any  substance  or 
fluid  that  may  cause  the  water  thereof  to  become  impure  or  unfit  for  such  purposes, 
he  shall  be  fined  not  exceeding  twenty  dollars,  or  be  imprisoned  not  exceeding  thirty 
days,  or  both.'1 

2  Virginia,  Chapter  460  of  1892 : 

''Section  1.  Be  it  enacted  by  the  general  assembly  of  Virginia,  That  it  shall 
be  unlawful,  except  as  hereinafter  provided,  for  any  person  to  defile  or  render  im- 
pure, turbid  or  offensive  the  water  used  for  the  supply  of  any  city  or  town  of  this 
state,  or  the  sources  or  streams  used  for  furnishing  such  supply,  or  to  endanger  the 
parity  thereof  by  the  following  means,  or  any  of  them,  to  wit:  by  washing  or  bath- 
ing therein,  or  by  casting  into  any  spring,  well,  pond,  lake  or  reservoir  from  which 
supply  is  drawn,  or  into  any  stream  so  used,  or  the  tributary  thereof,  above  the 
point  where  such  supply  is  taken  out  of  such  stream,  or  is  impounded  for  the  pur- 
poses of  such  supply,  or  into  any  canal,  acqueduct  or  other  channel  or  receptacle  for 
water  connected  with  any  works  for  furnishing  a  public  water  supply,  any  offal, 
dead  fish,  or  carcass  of  any  animal,  or  any  human  or  animal  filth,  or  other  foul  or 
waste  animal  matter,  —  or  any  waste  vegetable  or  mineral  substance,  or  the  refuse 
of  any  mine,  manufactory  or  manufacturing  process,  or  by  discharging  or  permitting 
to  flow  into  any  such  source,  spring,  well,  reservoir,  pond,  stream,  or  the  tributary 
thereof,  canal,  acqueduct  or  other  receptacle  for  water,  the  contents  of  any  sewer, 
privy,  stable  or  barn  yard,  or  the  impure  drainage  of  any  mine,  any  crude  or  refined 
petroleum,  chemicals,  or  any  foul,  noxious,  or  offensive  drainage  whatsoever,  or  by 
constructing  or  maintaining  any  privy  vault  or  cesspool,  or  by  storing  manure  or 
other  stable  fertilizer  of  any  offensive  character,  or  by  disposing  of  the  carcass  of 


WATER,    KE.   AXU    sEWERs.  267 

The  bathing  in  waters  used  for  domestic  supply  is  prohibited  in 
Massachusetts,  Connecticut,  and  New  Hampshire  within  one  quarter 
mile  of  intake.  In  Maine,  Minnesota  and  North  Dakota  it  is  forbidden 
to  place  upon  the  ice  any  substances  which  would  pollute  the  water, 
and  in  Massachusetts  horses  must  not  be  driven  upon  such  ice.1  In 
North  Carolina  it  is  forbidden  to  "  empty  on  the  water  shed  of  any  pond 
or  stream  furnishing  the  source  of  water  supply  of  any  public  institu- 
tion, city  or  town,  the  undisinfected  discharges  of  a  person  sick  with 
cholera  or  typhoid  fever."  The  cutting  of  ice  on  waters  used  for  a 
public  supply  is  regulated  in  New  Hampshire.2 

The  injurious  effects  of  cemeteries  bordering  upon  a  public  water 
supply  have  been  considerably  discussed,  and  a  careful  consideration  of 
the  subject  may  be  found  in  the  reports  of  the  Pennsylvania  state  board 
of  health.3  While  it  was  felt  that  it  would  be  dangerous  for  the  un- 
altered drainage  of  cemeteries  to  flow  into  a  river  used  as  a  source  of 
public  supply,  yet  the  danger  of  locating  near  such  a  river  is  not  very 
great.  A  law  was  enacted  in  Pennsylvania4  that  was  declared  uncon- 
stitutional and  another  was  enacted  in  1895.s     This  law  forbids  the  use 


any  animal,  or  any  foul,  noxious  or  putrescible  substance,  whether  solid  or  fluid 
and  whether  the  same  be  buried  or  not,  -within  two  hundred  feet  of  any  water 
course,  canal,  pond,  or  lake  aforesaid,  which  is  liable  to  contamination  by  the  wash- 
ing thereof  or  percolation  therefrom:  provided  that  nothing  in  this  act  contained 
shall  be  construed  to  authorize  the  pollution  of  any  of  the  waters  in  this  state  in  any 
manner  now  contrary  to  law:  and  provided  further,  that  this  act  shall  not  apply  to 
streams,  the  draining  area  of  which,  above  the  point  where  the  water  thereof  is 
withdraw  n  for  the  supply  of  any  city  or  town,  or  is  impounded  for  the  purposes  of 
such  supply,  shall  exceed  fifty  square  miles." 

Massachusetts.  Public  Statutes  (1882),  Chapter  80: 
"Sec.  101.     Whoever  drives  a  horse  on  the  ice  on  a  pond,  the  water  of  which  is 
used  for  the  purpose  of  domestic  water  supply  for  a  city  or  town,  shall  be  punished 
lis  line  not  exceeding  fifty  dollars,  or  imprisonment  not  exceeding  thirty  days. 

1'Se<  .   102.     The  preceding  section  shall  nol  apply  to  persons  engaged  in  cutting 
or  harvesting  ice  from  such  ponds,  or  in  bauling  logs,  \\ 1.  or  lumber." 

\ew  Hampshire,   Vt  of 28  March.  1895: 

Si  ■  .  -.  No  person  shall  cut  or  take  ice  Erom  any  lake,  pond,  or  reservoir  used 
as  the  source  of  a  public  water  or  ice  supply  for  domestic  purposes  for  man.  un- 
less he  lirst  shall  comply  in  all  respects  with  sii.h  reasonable  rules  and  regulations 
in  regard  t"  the  manner  and  place  of  cutting  and  taking  such  ice  on  said  lake,  pond, 
or  reservoir,  as  may  be  prescribed  by  the  local  board  of  control  or  officers  of  a  water 
company,  wl ay  have  charge  of  the  works  of  anj  city  or  town  supplying  its  in- 
habitants with  water  from  said  lake,  pond,  or  reservoir.  The  supreme  court  shall 
have  power  to  issue  injunctions  restraining  any  person  from  cutting  or  taking  ice 
from  such  lakes,  ponds,  or  reservoirs  until  thej  have  complied  with  the  reasonable 
regulations  made  as  aforesaid." 

Pennsylvania,  Mate  Hoard  of  Health  Report,  1894,  p.  99,  etseq. 
'  Pennsylvania,  Brightly's,  Purdon's  Digest  (1895),  ;  .6. 

Pennsylvania,  Act  of  24  June,  1895. 


268  WATER,   ICE,   AND    HEWERS. 

for  a  burial  ground  of  any  land  the  drainage  of  which  reaches  a  water 
supply  within  one  mile  of  the  city  using  the  supply,  but  it  does  not 
apply  to  grounds  in  use  at  the  time  of  its  passage.  The  Connecticut 
law  is  given  below.1 

Besides  the  general  legislation  for  the  protection  of  water  supplies 
that  has  been  referred  to,  there  has  been  a  good  deal  of  a  special  char- 
acter to  meet  the  requirements  of  individual  towns  and  cities.  Some 
of  this  is  found  in  the  form  of  special  acts.  One  of  the  earliest  of 
these  was  that  for  Philadelphia.2  Among  recent  acts  may  be  mentioned 
those  of  Paterson3  and  Manchester,  N.  H.4 

In  New  York,  where  power  to  legislate  in  regard  to  the  protection 
of  water  supplies  has  been  delegated  to  the  state  board  of  health,  that 
board  has  made  rules,  often  elaborate  ones,  to  meet  the  exigencies  of 
individual  cities,  as  Brooklyn,5  Rochester,5  Sing  Sing,5  New  York,6  New- 
burgh,0  Elmira,"  Syracuse,7  Utica,7  Mount  Vernon,8  Peekskill,8  Sara- 
toga,8 and  many  others.  The  Massachusetts  state  board  of  health  is 
authorized9  to  make  similar  rules  and  has  done  so  for  the  Metropolitan 
Water  Board  (Boston),  and  for  Cambridge.  These  rules  are  very  com- 
plete and  specific.10  The  North  Dakota  state  board  of  health  also  has 
made  regulations  for  the  protection  of  potable  waters. 

These  regulations  cover  a  great  variety  of  detail  concerning  the 
location  and  construction  of  privy  vaults,  cesspools  and  the  care  and 
disposal  of  house  slops,  sewage,  wash  water,  garbage,  manure,  dead  ani- 
mals, manufacturers'  wastes,  etc.     The  rules  for  Brooklyn  (Ridgewood 

1  Connecticut,  General  Statutes  (1888): 

"  Skc.  2655.  No  cemetery  or  place  of  sepulture  shall  hereafter  be  located  or 
established  within  one-half  mile  of  any  reservor  from  which  the  inhabitants  of  any 
town,  city,  or  borough  are  supplied  with  water,  nor  shall  such  reservor  be  located 
or  established  within  one-half  mile  of  any  cemetery  or  place  of  sepulture,  unless  the 
Superior  Court  of  the  county  wherein  such  cemetery  or  place  of  sepulture  or  reser- 
voir is  located  shall,  upon  application  and  such  notice  as  it  may  deem  proper,  find 
that  such  cemetery  or  place  of  sepulture  or  such  reservoir  so  proposed  to  be  located 
is  of  public  convenience  and  necessity,  and  will  not  be  detrimental  to  the  public 
health.'" 

2  Pennsylvania,  Act  of  12  April,  1828. 
New  Jersey,  Act  of  28  March,  1895. 

4  New  Hampshire,  1891. 

5  New  York,  State  Board  of  Health  Report,  Vol.  XV.,  p.  309  et  seq. 

6  New  York,  State  Board  of  Health  Report,  Vol.  XIV.,  p.  565  et  seq. 

7  New  York,  State  Board  of  Health  Report,  Vol.  XVII.,  p.  402  et  seq. 

8  New  York,  State  Board  of  Health  Report,  Vol.  XVIII.,  343  et  seq. 

9  Massachusetts,  Chapter  488  of  1895,  Sec.  24. 

10  Massachusetts,  Senate  Doc.  No.  4,  1900,  Water  Supply  and  Sewage,  10  January, 
p.  118  et  seq. 


WATER,    ICE,    A XI)    SEWERS.  269 

water),  cover  seven  pages.  Other  legislation  forbidding  the  pollution  of 
public  supplies  is  to  be  found  in  the  charters  of  water  companies  and 
in  the  special   acts  authorizing  municipalities  to  construct  water  works. 

As  may  be  seen  from  the  examples  given,  and  would  he  seen  from 
a  study  of  the  other  laws,  the  penalties  are  as  they  should  be,  rather 
severe;  but  besides  criminal  action  for  the  violation  of  the  statutes 
other  courses  may  be  open  for  the  cities  that  are  injured  by  the  pollu- 
tion. Action  may  be  taken  to  get  rid  of  the  nuisance  by  calling  in  the 
aid  of  the  state  board  of  health.  In  one  state  at  least,  Xew  Hamp- 
shire, the  statute  directs  the  local  government  to  abate  the  nuisance, 
and  in  Connecticut  the  statute  directs  that  appeal  be  had  tothe  cou 

While  most  state  boards  of  health  are  authorized  in  a  general  way 
in  their  advisory  capacity  to  assist  cities,  towns,  and  villages  in  select- 
ing or  improving  their  water  supplies,  it  is  only  in  a  few  states  that 
these  boards  have  any  real  power  to  enforce  their  decision  or  to  aid 
the  towns  in  bringing  to  justice  the  offenders  against  the  laws  relative 
to  the  pollution  of  streams.  Massachusetts,  Minnesota,  Xew  York,  and 
Ohio  have  however  given  their  state  board  of  health  considerable  power 
in  such  matters.  The  action  of  the  state  board  of  health  may  relate  to 
the  abatement  of  nuisances  on  the  banks  of  streams,  or  it  may  have  to 
do  with  the  more  important  subject  of  the  approval  of  new  work,  and 
in  this  respect  the  state  board  of  health  holds  a  position  somewhat  like 
that  of  the  local  government  board  in  England  which  exercises  a  con- 
trol  over  all   the  municipal    public  works  in  the   kingdom.     The   state 

'Xew  Hampshire,  Public  Statutes  (1891),  Chapter  108: 

Si  c.  14.  The  board  of  health  of  the  town,  or  the  water  commissioners  having 
charge  of  the  water  supply,  or  the  proprietors  thereof,  may  remove  such  substance 
or  fluid;  and  they  may  recover  the  expense  of  removal  from  the  person  who  placed 
the  same  or  caused  it  to  be  placed  in  or  near  the  water  as  aforesaid,  in  an  action  on 
the  case." 

The  section  preceding  the  above  is  given  on  p.  266. 

Connecticut,  Chapter  203  of  1895: 

L4Sec.  l.  Section  2656  of  the  General  Statutes  is  herebj  amended  to  read  a^ 
follows:  Whenever  any  land  or  building  is  so  used,  occupied,  or  suffered  to  re  ma  in, 
that  it  is  a  source  of  injury  to  the  water  stored  in  anj  reservoir  used  for  supplying 
an\  town.  city,  or  borough  with  water,  or  to  any  source  ot'  supply  to  any  such  reser- 
voir, or  when  any  such  water  is  liable  to  pollution  in  consequence  of  the  use  ol  the 
same,  either  the  authoriti  ^  of  such  town.  city,  or  borough,  or  the  company  having 
charge  ol  said  water,  may  bring  their  petition  to  the  superior  court  in  and  for  the 

county  in  which  said  town,  city,  borough    Or  COmpanj    is  located  tor  relief;   and  said 

court.uiK.ii  such  petition,  shall  have  full  power  as  a  couri  of  equity  to  order  the 
removal  "i  any  building,  to  enjoin  any  use  or  occupation  "i  anj  land  or  building,  ■■> 

■  a  said  water,  which  i^  detrimental  t"  said  water,  oi-  i,,  make  any  other  order  tem- 
porary or  permanent  which  in  its  judgmenl  may  be  oecessarj  i"  preserve  the  purity 
of  said  water. 


270  WATER,   ICE,   AND    SEWERS. 

board  of  health,  unlike  the  English  board,  only  takes  cognizance  of  the 
sanitary  works  of  sewerage  and  water  works. 

In  Massachusetts1  the  state  board  of  health  on  application  of  the 
mayor  of  a  city,  the  selectmen  of  a  town,  or  the  president  of  a  water  or 
ice  company  complaining  that  the  water  or  ice  supply  of  the  city  or 
town  is  polluted,  shall  give  a  hearing,  after  due  notice  to  all  parties 
interested.  If  after  the  hearing,  the  state  board  of  health  so  deter- 
mines, they 

•  shall  prohibit  the  deposit,  keeping,  or  discharge  of  any  such  material  or  other 
cause  of  pollution  as  aforesaid,  and  shall  order  any  person  to  desist  therefrom  and 
to  remove  any  such  material  theretofore  deposited,  or  other  cause  of-pollution;  but 
said  board  shall  not  prohibit  the  cultivation  and  use  of  the  soil  in  the  ordinary 
methods  of  agriculture,  provided  that  no  human  excrement  is  used  thereon.  But 
said  board  shall  not  prohibit  the  use  of  any  structure  which  was  in  existence  at  the 
time  of  the  passage  of  this  act,  in  case  the  complaint  referring  to  or  including  said 
structure  is  made  by  the  board  of  water  commissioners  of  any  city  or  town,  or  by 
any  water  or  ice  company,  unless  the  board  of  water  commissioners  or  the  water  or 
ice  company  making  the  complaint,  shall  file  with  said  state  board  of  health  an 
order  or  vote  of  its  city  council,  selectmen,  or  water  or  ice  company  respectively,  to 
the  effect  that  such  city,  town,  or  water  or  ice  company  will  at  its  own  expense  make 
such  changes  in  said  structure  or  its  location  as  said  board  shall  deem  expedient. 
Such  order  or  yote  shall  be  binding  on  such  city,  town,  or  water  or  ice  company; 
and,  when  such  changes  shall  have  been  made,  all  damages  occasioned  thereby  shall 
be  paid  by  such  city,  town,  or-  water  or  ice  company;  and  if  the  parties  cannot  agree 
thereon  such  damages  shall  be  determined  by  a  jury  on  petition  of  either  party, 
filed  in  the  clerk's  office  of  the  superior  court  in  the  county  where  the  premises  are 
located,  in  the  manner  provided  by  law  in  relation  to  determining  the  damages 
occasioned  by  taking  land  for  highways  in  such  city  or  town,  or  in  the  case  of  a 
water  or  ice  company,  in  the  city  or  town  in  which  said  structure  is  located." 

The  succeeding  sections  of  the  law  relate  to  appeals  and  to  the 
power  of  the  courts  to  enforce  the  orders  of  the  board.  The  Minne- 
sota law  is  quite  similar. 

In  Xew  York2  the  state  board  of  health  may  make  rules  and  regu- 
lations in  regard  to  the  protection  of  water  supply,  and  such  regu- 
lations may  even  go  so  far  as  to  require  the  construction  of  municipal 
systems  of  sewerage,  the  removal  of  buildings  and  interference  with 
industries  ;  but  in  all  cases  the  water  company  or  municipality  benefited 
must  bear  the  cost.  If  a  regulation  of  the  state  board  is  violated  the 
state  board  may  investigate  and  direct  the  local  board  of  health  to 
enforce  the  regulation.  By  the  act  of  18923  a  town  may  bring  action 
against  parties  who  pollute  its  water  supply,  provided  the  fact  of  pollu- 
tion is  attested  by  the  state  board  of  health  and  also  provided  that  the 
town  does  not  itself  pollute  a  stream. 


1  Massachusetts,  Chapter  510  of  1897,  Sec.  3. 

2  Xew  York,  Revised  Statutes  (1895),  p.  2437,  Sees.  70-2. 

3  Xew  York,  Revised  Statutes  (1895),  p.  2439,  Sec.  72a-d. 


WATER,   ICE,   AX1>    SEWEBS.  271 

Of  course,  statutory  legislation  in  regard  to  water  protection  is 
much  more  important  and  useful  than  any  local  regulation  can  be,  for 
it  is  only  in  rare  instances  that  the  source  of  a  municipal  supply  is 
entirely  within  the  city's  jurisdiction.  A  part  of  the  supply,  however, 
often  is  within  the  city  limits,  and  sometimes  as  in  Chicago,  the  whole  of 
the  pollution  comes  from  the  city  itself.  A  considerable  number  of 
cities  have  therefore  made  rule^  for  the  protection  of  their  water  sup- 
plies. Usually  these  rules  have  no  special  legislative  sanction,  though 
in  Illinois1,  and  New  Jersey2  local  governments  are  authorized  to  make 
such  regulations.  In  Xew  Jersey  the  hoard  of  health  is  given  this 
[lower.  The  provisions  given  below  were  found  in  Brooklyn1  and  regu- 
lations of  a  similar  general  character  have  been  adopted  in  Augusta, 
Gra.,  Chicago,  Cincinnati.  Denver,  Memphis,  Omaha,  Yonkers,  and  other 
cities. 

It  makes  very  little  difference  what  legislation  there  may  he  con- 
cerning water  pollution,  unless  active  measures  are  taken  to  maintain  a 
constant  supervision  over  the  water  and  the  hanks  of  the  rivers  or  lakes 
from  which  it  is  obtained.  There  are  two  means  which  may  be  combined 
in  securing  this  supervision.  <  >ne  is  the  inspection  or  patrol  of  the  water 
shed,  and  the  other  is  the  laboratory  study  of  specimens  of  the  water. 
Patrol  of  the  banks  of  lakes  or  streams  which  are  likely  to  yield  con- 
taminated water  is  of  the  utmost  value.  Even  when  not  backed  by 
sufficient   legislative   power,  the  inspector,  if  diligent,  alert,  and  tactful, 

•Illinois,  Annotated  Statutes  (1896),  Chapter  24,  Sec.  126. 

-  New  Jersey,  General  Statutes  (1895),  p.  1647,  Sec,  19  |  XII). 
Brooklj  M.  Sanitary  ( lode: 

"Sec.  46.  That  no  person  shall  throw  or  allow  to  run  or  pass  in  any  public 
reservoir,  water  pipe  or  aqueduct,  or  into  or  upon  any  border  or  margin  thereof,  or 
excavation  or  stream  therewith  connected,  any  animal,  vegetable  or  mineral  sub- 
Btanc<  whatever;  nor  shall  any  person  allow  the  same  to  be  done  (having  power  or 
right  to  prevent  the  same),  nor  shall  any  person  do  or  permit  to  in-  done  (having 
right  or  power  to  prevent  the  same),  any  ad  or  thing  that  will  impair  or  imperil  t  he 
purity  or  wholesomeness  of  any  water  or  other  fluid  used  or  designed  as  a  drink  in 
any  part  of  said  citj  ;  nor  shall  any  person  bathe  nor  (except  in  the  dischai 
public  dutj  i  put  anj  pari  of  his  person  into  such  water,  nor  shall  any  unauthorized 
person  open  anj  erection  or  unscrew  anj  hydrant  holding  such  water. 

"Sec.  IT.  That  it  shall  hi'  the  duty  of  every  person,  officer,  department  ami 
board,  having  any  authority  ami  control  in  regard  to  anj  water  designed  Cor  human 
consumption  (and  within  t  he  proper  sphere  of  the  duty  of  each  thereof),  to  take  all 
usual  ami  also  all  reasonable  measures  and  precautions  to  secure  and  preserve  the 
purity  ami  wholesomeness  of  such  water. 

"Sec.  is.  Thai  no  person  shall  destroy  nor  in  anywise  injure  or  impair  any  drink- 
ing hydrant,  or  pan  thereof,  in  the  said  city;  nor  shall  anj  person  interfere  with 
the  use  of  or  enjoyment  of  the  water  therein,  or  therefrom,  or  interrupt  the  flow 
thereof,  or  as  a  drink;  nor  shall  anj  person  put  any  dirty,  poisonous,  medicinal  or 
any  noxious  substance  into  or  near  said  water  or  hydrant,  whereby  such  water  i> 
made  or  maj  hi'  regarded  as  dangerous  or  unwholesome  as  a  drink.11 


272  WATER,   ICE,   AND    SEWER8. 

can  accomplish  no  mean  results.     If  the  laws  are  capable  of  enforce- 
ment he  can  of  course  do  much  more. 

When  the  water  supply  of  a  city  comes  from  a  very  large  water 
shed,  particularly  if  it  is  situated  partly  outside  of  the  state  in  which 
the  city  is  located,  it  is  hardly  practicable  to  accomplish  much  by  patrol. 
So,  too,  when  the  chief  source  of  pollution  is  municipal  sewage,  patrol 
can  be  of  little  avail.  There  are,  however,  many  cities  which  take  their 
water  from  a  small  area  where  the  pollution  is  mostly  from  isolated 
houses,  barns  or  mills,  where  patrol  may  give  a  very  great  degree  of 
security,  particularly  if  there  is  good  statutory  law  against  pollution. 
Many  cities  have  adopted  this  method  of  protecting  their  supplies. 
Most  communities  having  a  doubtful  supply  have  probably  made  occa- 
sional efforts  to  improve  it  by  the  personal  visits  of  an  inspector,  but 
some  have  gone  farther  than  this  and  maintain  a  permanent  supervision. 
Providence  began  in  1875  with  a  thorough  investigation  of  the  sources 
of  pollution  of  its  public  supply.  During  the  next  ten  years  the  board 
of  water  commissioners  attempted,  under  a  very  defective  law,  to  get 
rid  of  most  of  the  contamination.  The  health  department  then  made 
several  inspections  of  the  water  shed,  and  the  presence  of  typhoid  fever 
called  attention  to  the  subject,  and  a  man  was  employed  a  considerable 
part  of  the  time  to  look  after  the  nuisances  along  the  banks.  Since 
1889  an  inspector  employed  by  the  commissioner  of  public  works  at  a 
salary  of  -f  1,200  has  devoted  all  his  time  to  the  work,  and  recently 
another  inspector  has  been  employed  at  a  salary  of  $1,000,  and  though 
there  has  been  a  great  increase  of  population,  there  is  far  less  pollution 
than  at  any  time  since  the  supply  was  made  use  of.  In  Baltimore1 
since  1896  an  inspector,  a  physician,  under  the  health  department,  has 
made  daily  inspections  of  the  water  shed  and  has  secured  many  volun- 
tary abatements  of  dangerous  nuisances ;  but  all  offenders  have  not 
willingly  complied  with  his  requirements,  for  in  1897,2  of  ninety-five 
orders,  fifteen  were  followed  by  suit.  About  the  same  time  the  Brook- 
lyn health  department3  established  a  laboratory  at  a  convenient  location 
on  the  water  shed  of  its  supply,  and  together  with  a  daily  collection 
and  examination  of  specimens,  made  note  of  all  possible  sources  of  con- 
tamination. Interesting  photographs  of  some  of  these  offenses  are  shown 
in  the  report  for  1895,  page  272.  In  Manchester,  N.  H.,4  where  the 
water  supply  is  taken  from  a  lake,  the  shores  of  which  are  occupied  by 


1  Baltimore,  Report  of  Health  Department  (1896),  p.  11. 

2  Baltimore,  Report  of  Health  Department  (1897),  p.  16. 

3  Brooklyn,  Report  of  Department  of  Health  (1895),  p.  272;  (1896),  pp.  123  and 
216. 

4  Manchester,  Report  of  Board  of  Health  (1897),  p.  25. 


WATER,   ICK   AND    SEWERS.  273 

summer  cottages  and  are  used  for  picnics,  the  board  of  health  maintains 
a  daily  inspection  during  the  summer  season,  and  on  Sundays  and  holi- 
days the  inspector  is  on  hand  all  day.  Bathing  and  washing  are  pre- 
vented, also  the  flow  of  sewage,  and  the  throwing  of  rubbish  in  the 
water.  The  Newark 2  and  Scranton 2  boards  of  health  make  annual 
inspections. 

Another  method  of  supervising  the  water  supply  is  by  frequent 
examinations  of  the  water  itself.  There  are  three  general  laboratory 
methods  of  testing  water.  One  of  these,  the  oldest  method,  is  the 
chemical  examination,  which  consists  chiefly  in  estimating  the  amount 
of  the  different  forms  of  nitrogen  "  albuminoid  ammonia,"  "free  ammo- 
nia," nitrites  and  nitrates,  and  also  the  amount  of  chlorine  present. 
Contrary  to  the  popular  notion,  the  interpretation  of  the  results  of  the 
chemical  examination  of  the  water  is  by  no  means  easy.  A  chemist 
must  have  a  full  knowledge  of  the  history  of  the  water  in  order  to  form 
even  an  approximate  estimate  of  its  sanitary  condition.  Nevertheless, 
the  chemical  examination  of  drinking  water  is  of  very  great  importance, 
and  much  information  can  be  derived  from  it  which  is  of  value  in 
determining  whether  or  not  a  given  water  may  safely  be  used  for  drink- 
ing. Of  late  years  the  biological  examination  of  water  has  come  to  be 
considered  important,  and  here  again  two  methods  are  made  use  of  for 
the  study  of  two  classes  of  organisms.  The  algce  are  plants  of  con- 
siderable microscopic  size  and  they  can  be  isolated  and  studied  by  filter- 
ing a  sample  through  a  coarse  filter  and  washing  the  filter  in  a  small 
volume  of  water  which  may  be  examined  at  once  under  the  microscope. 
The  role  played  by  these  organisms  in  producing  disagreeable  odors  and 
tasns  iii  certain  waters  has  made  such  microscopical  examination  of 
water  very  useful  in  the  care  of  waters  that  are  likely  to  be  so  affected. 
Lastly  the  bacteriological  method  of  water  examination  has  been  made  use 
of  to  study  those  minute  organisms  which  can  only  be  isolated  and  studied 
by  growing  them  in  artificial  culture  media.  The  number  of  bacteria 
present  iii  waters  is  often  an  excellent  index  of  their  contamination,  and 
the  presence  of  certain  species  is  of  still  greater  value.  The  presence 
pf  tyhoid  or  cholera  organisms  would  of  course  condemn  a  water,  and 
the  presence  of  any  form  of  bacteria  characteristic  of  fecal  matter  should 
do  the  same.  The  proper  study  of  municipal  water  supplies  requires 
then  the  inspection  of  the  source  of  the  supply,  the  chemical  and  bacte- 
riological examination  of  samples,  and  often  the  microscopical  examina- 
tion also.  Cities  which  wish  to  secure  or  maintain  as  good  a  water 
supply  as  possible  cannot   afford   to  iie-led   an\  of  this  work,  though 

1  Newark,  Report  oi  Board  <>i  Health  (1897),  \>.  24. 
Scranton,  Report  ol  Board  ol  Bealth  (1894). 


274  WATER,   ICE,   AND   SEWERS. 

the  completeness  with  which  it  is  necessary  to  follow  it  out  will  vary  in 
individual  cases. 

In  a  number  of  cities  the  examination  of  water  samples  is  in  the 
hands  of  the  board  of  health,  partly  because  the  health  department 
appreciates  more  fully  than  any  other  department  the  necessity  for 
vigilance  in  such  matters,  and  partly  because  other  laboratory  work  is 
done  by  that  department,  rendering  the  employment  of  chemists  and 
bacteriologists  a  necessity.  Among  the  cities  in  which  the  health 
department  carries  on  regular  chemical  examinations  of  the  public  water 
supply  may  be  mentioned  Baltimore,  Brooklyn,  Buffalo,  Chicago,  Den- 
ver, Hartford,  Lawrence,  Newark,  and  New  York  City. 

Bacteriological  tests  are  made  in  Albany,  Buffalo,  Denver,  Hartford, 
Lawrence,  Newark,  and  New  York  City. 

Miscroscopical  tests  are  carried  on  very  extensively  in  Brooklyn 
under  the  direction  of  George  C.  Whipple,  and  at  Albany,  Boston, 
Lynn,  Pittsburgh,  and  to  some  extent  at  Buffalo,  and  also  by  the  water 
company  at  Wilkesbarre,  Penn.  Sometimes  water  tests  are  made 
monthly  as  in  Rochester,  bi-monthly  as  in  Providence,  bi-weekly  as  in 
Hartford,  weekly  as  in  New  York,  or  daily  as  in  Buffalo. 

A  law  was  passed  in  Michigan1  in  1897,  by  which,  on  resolution  of 
any  municipal  council,  water  may  be  sent  to  the  state  university  for 
analysis,  the  municipality  to  pay  only  the  cost  of  materials  used  in 
making  the  analysis. 

Purification  of  Public  Water  Sulplies. 

It  not  infrequently  happens  that  it  is  practically  impossible  for  a 
community  to  secure  a  water  supply  which  is  free  from  dangerous  pol- 
lution. It  is  of  course  wise  to  keep  in  mind  the  maxim  of  Dr.  Kedzie, 
that  what  is  needed  in  water  supplies  is  "innocence  not  repentance," 
nevertheless  an  "  innocent "  supply  cannot  in  some  cases  be  obtained 
for  a  sum  of  money  that  can  be  appropriated.  The  community  must 
drink  contaminated  water  or  else  purify  it.  The  most  essential  thing 
to  get  rid  of  is,  of  course,  the  pathogenic  bacteria,  of  which  at  present, 
so  far  as  we  know,  the  typhoid  bacillus  is  the  one  constant  menace. 
But,  as  has  been  previously  alluded  to,  it  is  also  important  to  get  rid  of 
color,  suspended  matter,  taste  and  odor.  Fortunately,  both  taste  and  odor 
can  usually  be  prevented,  and  bacteria,  suspended  matter  and  color  can 
be  removed  by  one  and  the  same  process.  The  seriously  disagreeable 
tastes  and  odors  in  water  are  usually  due  to  the  growth  of  algas  and 
this  can  largely  be  prevented.     The  principal  means  of  prevention  are 


1  Michigan,  Compiled  Laws  (1897),  See.  4484. 


WATER,   KK.    AND    SEWERS.  275 

the  proper  construction  and  cleansing  of  reservoirs.  Reservoirs  with 
hard,  clean  bottoms,  particularly  if  they  are  deep,  are  unfavorable  to 
the  growth  of  alga',  but  certain  waters  will  grow  algae  even  in  deep 
reservoirs  or  tanks.  This  is  particularly  true  of  ground  waters,  and  in 
such  cases  the  reservoirs  may  be  covered,  as  the  algae  will  not  grow  with- 
out the  sunlight.  In  Boston  where  the  supply  was  drawn  from  several 
sources,  it  was  found  that  the  alga'  rarely  grew  in  more  than  one  reser- 
voir at  a  time,  and  by  care  that  could  be  shut  off  before  harm  was  done. 
There  are  three  practical  methods  of  purification  in  use,  aeration, 
sedimentation  and  filtration. 

Aeration. 

At  one  time  it  was  believed  by  many  that  this  would  do  much 
towards  purifying  water,  even  if  dangerously  polluted.  It  is  now  known 
that  this  was  a  false  hope  and  the  field  for  aeration  is  much  restricted. 
It  is  now  rarely  employed  and  only  to  get  rid  of  odors  and  tastes. 
Among  the  cities  which  make  use  of  aeration  are  Rochester  and  Albany. 

Storage  and  Sedimentation. 

This  method  of  purifying  water  by  allowing  time  for  the  suspended 
matter  to  settle  to  the  bottom,  has  long  been  employed  to  clarify  muddy 
waters.  It  has  only  within  very  recent  years  been  learned  that  this  is 
also  a  most  excellent  method  of  getting  rid  of  disease  germs,  and  indeed 
of  all  kinds  of  bacteria.  The  pathogenic  bacteria  which  are  feared  in 
drinking  water,  do  not  thrive  in  that  medium,  but  rapidly  die  out. 
These  as  well  as  the  other  non-pathogenic  forms  are  largely  carried  to 
the  bottom  by  their  own  weight,  or  by  the  precipitation  of  other  ma- 
terials. River  waters  stored  in  large  reservoirs  often  lose  in  a  few 
weeks  ninety  to  ninety-five  per  cent,  of  their  bacterial  contents.  While 
reservoirs  are  frequently  constructed  for  the  purpose  of  removing  silt 
from  water,  they  have  probably  never  been  constructed  for  the  express 
purpose  of  freeing  water  from  pathogenic  organisms,  and  they  are  not 
likely  to  be;  but  in  any  consideration  of  water  works  construction  or 
extension,  it  is  well  to  keep  iii  mind  this  useful  result  of  the  Btorage  of 
water.  Unfortunately  the  storage  of  water  has.  as  has  been  shown,  its 
disadvantages  as  well  as  its  advantages,  for  the  storage  of  certain  waters 
yen  greatl)  favors  the  growth  of  alga'. 

filtration. 

The  first  extensive  successful  filters  were  those  constructed  by  the 
London  water  companies.  These  niters  have  nov  been  in  use  about  fiftj 
years.  They  are  in  most  instances  great^  assisted  to  their  success  by 
the  large  storage  reservoirs  in  which   the  water  remains  .1  considerable 


276  WATER,   ICE,   AND   SEWERS. 

time  before  it  is  allowed  to  pass  on  to  the  filter  beds.  The  excellent 
results  obtained  by  these  filters  and  their  storage  reservoirs,  was  largely 
due  to  a  happy  chance,  for  at  the  time  they  were  built  and  for  many 
years  afterwards,  the  true  nature  of  the  dangerous  constituents  of  river 
water  was  not  known.  It  was  only  with  the  development  of  bac- 
teriology that  the  action  of  filters  could  be  studied  in  a  satisfactory  and 
scientific  manner,  and  rational  deductions  made  for  their  improvement. 
Though  for  many  years  and  to  a  very  recent  date  the  London  filters 
served  as  the  best  models,  yet  it  was  not  from  their  management  that  a 
correct  knowledge  was  derived  of  the  way  in  which  filters  should  be 
constructed  and  operated.  It  was  the  engineer  of  the  Berlin  water 
works  and  the  officers  of  the  Massachusetts  state  board  of  health  who 
first  placed  the  art  of  filtration  on  a  scientific  basis. 

While  filters  are  exceedingly  common  on  the  continent  of  Europe 
they  have  not  been  used  at  all  in  the  United  States  until  a  quite  recent 
period,  and  then  usually  in  a  very  unscientific  manner.  The  European 
filters  are  almost  without  exception  patterned  on  the  London  model. 
They  consist  of  beds  of  sand  through  which  the  water  slowly  percolates 
downwards.  In  the  United  States  nearly  all  the  filters  until  within  the 
last  two  or  three  years  have  been  of  a  very  different  type.  In  them  the 
water  is  passed  rapidly  through  the  sand,  and  before  its  passage  there 
is  added  to  it  a  small  amount  of  some  coagulant  such  as  sulphate  of 
alumina.  The  bed  of  the  filter  is  frequently  agitated  to  clean  it.  The 
European  method  is  in  the  United  States  usually  spoken  of  as  "  natural 
filtration "  and  the  latter  method  as  "  mechanical  filtration,"  though 
neither  of  these  terms  is  desirable  or  descriptive  of  the  process. 

Natural  Filtration. 

Most  natural  filter  beds  are  provided  with  sedimentation  basins  of 
varying  capacity  in  which  the  water  may  deposit  a  part  of  its  impurities 
before  it  passes  on  to  the  filters.  In  the  case  of  very  muddy  waters 
such  a  basin  or  reservoir  is  a  necessity.  A  filter  consists  of  a  bed  of 
sand  of  about  an  acre  in  area  and  enclosed  by  masonry  or  other  embank- 
ment. Some  beds  are  much  larger  than  that,  and  some  smaller,  but  an 
acre  is  a  convenient  size.  The  sand  bed  consists  of  several  layers, 
coarse  materials  being  placed  at  the  bottom  and  about  two  feet  of  a 
moderately  fine  sand  at  the  top.  It  is  this  layer  that  is  the  essential 
part  of  the  filter  and  it  is  quite  necessary  to  secure  sand  of  the  right 
quality ;  it  should  be  sharp  but  even.  The  total  thickness  of  the  filter 
is  from  four  to  six  feet,  and  it  has  a  system  of  under  drains  at  the 
bottom  which  carry  off  the  filtered  water  to  the  reservoir  or  pump  well 
as  the  case  may  be.  The  filter  is  filled  beneath  to  drive  the  air  out  and 
the  water  is  allowed  to  stand  at  a  depth  of  three  to  six  feet  above  the 


WATER.    K'K   AND    SEWERS. 


277 


Z     c 


Zi 


WATER,   ICE,   AND    &EWEBS. 


surface  of  the  sand.  Often  the  water  is  allowed  to  rest  for  twenty-four 
hours  before  the  filter  is  started,  and  the  first  water  which  passes  through 
runs  to  waste.  The  efficiency  of  the  filter  depends  upon  the  layer  of 
dirt  and  slime  which  is  precipitated  upon  the  surface  of  the  sand  from 
the  water  standing  upon  it  and  from  that  which  first  passes  through. 
The  efficiency  of  the  filter  is  also  in  a  general  way  the  converse  of  the 
rate  of  filtration,  the  higher  the  rate  the  less  is  the  water  improved  by 
its  passage.  The  rates  now  deemed  most  advantageous  range  from 
2,000,000  to  4,000,000  gallons  per  acre  each  twenty-four  hours.  With 
the  increasing  deposit  of  sediment  on  the  surface  of  the  filter,  less  and 
less  water  will  pass  through  under  a  given  head.  The  head  of  water 
on  these  filters  does  not  usually  exceed  four  feet.  Various  contrivances 
are  employed  to  regulate  the  head  of  water  on  the  filter  but  in  all  cases 
constant  supervision  is  necessary.  When  through  the  clogging  of  the 
filter  the  rate  becomes  too  slow  to  furnish  the  needed  water,  the  filter 
has  to  be  cleaned  by  drawing  off  the  water  and  scraping  about  a  half  an 
inch  from  the  surface  of  the  sand. 

In  cold  climates  much  difficulty  is  experienced  in  cleaning  the  filter  in 
the  winter  time.  It  is  necessary  to  wait  for  a  thaw  when  the  ice  is  melted 
or  else  to  cut  it  and  remove  it.  Care  must  also  be  taken  that  the  sand 
does  not  freeze  when  the  water  is  drawn.  If  a  very  large  area  of  filter- 
ing surface  is  provided  so  that  the  rate  may  be  slow,  the  time  between 
scrapings  may  be  lengthened  so  as  to  lessen  the  difficulties  of  winter 


Plan  and  Section  of  Water  Filtration  Bed,  Lawrence,  Mass.,  Hiram  F.  Mills,  Designing  Engineer. 


WATER,    ICE,    AND    SEWERS. 


279 


280  WATER,   ICE,   AND    SEWERS. 

cleaning ;  but  the  best  method  in  regions  where  the  temperature  falls 
below  30°  F.,  is  to  cover  the  filters. 

The  earliest  natural  sand  filter  constructed  in  this  country  was  at 
Poughkeepsie.  It  has  never  been  carefully  operated  for  the  purpose  of 
removing  bacteria,  and  comparatively  few  bacterial  counts  have  been 
made  of  the  water.  The  cost  of  cleaning  is  said  to  be  $2.99  per  million 
gallons,  but  little  can  be  inferred  from  these  figures  as  to  the  cost  of 
operating  filters  for  bacterial  efficiency.  Small  sand  filters  have  also 
been  constructed  at  Greenwich,  Conn.,  Ilion,  N.  Y.,  Nantucket,  Mass., 
Mt.  Vernon,  N.  Y. 

In  1893  a  sand  filter  was  built  at  Lawrence,  Mass.,  for  the  purpose 
of  removing  the  dangerous  bacteria  from  the  Merrimac  River  water. 
This  filter  lias  apparently  done  its  work  well,  for  Lawrence  has  since 
been  free  from  the  outbreaks  of  typhoid  which  were  formerly  so  common. 
The  filter  has  an  area  of  two  and  one-half  acres  and  was  intended  to 
yield  a  flow  of  5,000,000  gallons.  See  Figs.  5  and  6  from  plates  loaned 
by  the  superintendent  of  the  Lawrence  Water  Works.  This  filter  is 
not  constructed  according  to  the  best  design,  and  in  a  climate  as  cold  as 
Lawrence  should  be  covered.  Hence  the  cost  of  cleaning  is  high. 
This  should  not,  however,  be  taken  as  an  indication  of  what  the  cost  of 
operating  the  best  form  of  modern  filter  would  be. 

A  filter  was  put  in  operation  in  Albany  in  1899  which  ma}T  be  con- 
sidered representative  of  the  best  ideas  in  regard  to  sand  filtration. 
This  filter1  consists  of  a  series  of  eight  basins  having  an  area  each  of 
about  0.7  of  an  acre.  The  normal  rate  of  filtration  is  3,000,000  gallons 
per  acre  daily,  and  with  one  basin  out  of  use  for  cleaning,  the  capacity 
of  the  whole  filter  would  be  14,700,000  gallons  per  day.  The  cost  of 
the  filters  was  about  -$255,000  exclusive  of  land  and  engineering.  ' 

In  order  to  protect  them  from  freezing  the  filters  are  arched  over 
with  brickwork  supported  on  brick  piers.  The  whole  is  covered  with 
two  feet  of  earth  and  grassed  over.  Access  is  gained  through  numer- 
ous manholes  which  are  protected  by  double  steel  covers.  The  tops  of 
the  manholes  are  carried  up  six  inches  above  the  grass.  The  water  is 
collected  underneath  the  filter  by  six-inch  vitrified  drains  laid  with  open 
joints.  The  pipes  are  of  this  large  size  in  order  to  prevent  the  slightest 
friction  and  consequent  irregular  action  of  the  filter.  The  collectors 
are  thirty-inch  pipes. 

The  gravel  surrounding  the  under  drains  is  of  three  grades.  The 
first  immediately  surrounding  the  drain  consists  of  stones,  one  to  two 


1  This  account  of  the  Albany  filter  is  taken  from  the  Proceedings  of  the  Ameri- 
can Society  of  Civil  Engineers,  November,  1899,  and  the  electrotypes  for  the  accom- 
panying illustrations  were  loaned  by  the  society. 


WATER,   ICE,   AND    SEWERS. 


281 


. 

1 

i 

5JL 

Fig.  8. 
Interior  view  of  the  Albany  Filter.  Bbowiog  drains  before  they  were  covered  with  gravel. 


i  "i   \  1 1 i:i 1 1 >  Filter,  showing  sand  in  place  before  watei  Is  turned, 


282  WATER,   ICE,   AND    SEWERS. 

inches  in  diameter.  This  is  covered  with  gravel  between  one  inch  and 
three-eighths  of  an  inch  in  diameter.  The  finest  gravel  is  intermediate, 
between  three-eighths  and  three-sixteenths  of  an  inch  in  diameter.  The 
thickness  of  the  latter  layer  is  about  two  inches.  Above  the  gravel  is 
four  feet  of  sand.  The  specifications  for  this  sand  require  that  it  shall 
be  clean,  river,  beach,  or  bank  sand  with  either  sharp  or  rounded  grains, 
that  it  shall  be  free  from  clay,  dust  or  organic  impurities.  The  sand 
has  effective  sizes  averaging  0.31  millimeter. 

The  dirty  sand  which  is  removed  from  time  to  time  is  thoroughly 
washed  and  again  replaced  in  the  filters.  Two  ejector  sand-washing 
machines  are  provided  at  convenient  places  between  the  filters.  In 
them  the  dirty  sand  is  mixed  with  water  and  is  thrown  up  lyy  an  ejector, 
after  which  it  runs  through  a  chute  into  a  receptacle  from  which  it  is 
again  lifted  by  another  ejector.  It  passes  altogether  through  five 
ejectors,  a  part  of  the  dirty  water  being  wasted  each  time.  The  sand 
is  finally  collected  from  the  last  ejector  where  it  is  allowed  to  deposit 
from  the  water. 

The  report  of  the  board  of  water  commissioners  for  1899  states  that 
the  filters  were  put  in  operation  in  August,  1899,  and  by  the  end  of  the 
year  they  had  reached  a  bacterial  efficiency  of  over  ninety-nine  per  cent. 
The  cost  of  operating  the  filters  was  $1.67  per  million  gallons.  This 
included  laboratory  supervision. 
Mechanical  Filters. 

These  filters  consist  usually  of  cylindrical  wooden  or  metal  tanks. 
One  type  of  the  filter,  the  pressure  filter,  is  a  horizontal,  or  sometimes  a 
vertical,  closed  tank  in  which  is  a  bed  of  sand  or  crushed  quartz.  When 
it  is  necessary  to  clean  the  filter  the  current  of  water  is  reversed  through 
the  effluent  pipes  and  the  sand  is  cleaned  by  the  action  of  the  water. 
Various  types  of  pressure  filters  are  made  by  the  New  York  Filter 
Manufacturing  Company.  Such  filters  are  in  use  at  Oakland,  Cal., 
Atlanta,  Long  Branch,  Kingston,  N.  Y.,  Asheville,  N.  C,  Raleigh,  Nash- 
ville, Davenport,  la.,  Little  Rock,  Ark.     This  filter  is  shown  hi  Fig.  11. 

A  style  of  filter  similar  to  the  above  has  recently  been  put  on  the 
market  by  the  Continental  Filter  Company,  in  which  the  agitation  of 
the  sand  during  washing  is  accomplished  by  the  use  of  compressed  air. 
This  filter  is  in  use  at  Asbury  Park,  N.  J.,  and  Vincennes,  Ind. 

The  gravity  type  of  mechanical  filter  is  represented  by  the  Morrison- 
Jewell  filter,  made  by  the  New  York  Filter  Manufacturing  Company. 
This  filter  consists  af  an  open  perpendicular  tank  of  wood  or  steel  with 
about  two  feet  of  crushed  quartz  in  the  bottom.  In  this  quartz  are  a  series 
of  rakes  which  can  be  rotated  by  machinery.  When  it  is  necessary  to 
clean  the  filter  the  current  of  water  is  reversed  and  sent  up  through  the 


WATER,    KK   AND    SEWERS. 


283 


284 


WATER,   ICE,   AND    SEWERS. 


Fig.  11. 
Pressure  Filter  made  by  New  York  Filter  Manufacturing  Co. 


outlet  pipes  and  is  greatly  aided  in  scouring  the  sand  by  the  agitation 
of  the  rotating  rakes.  These  tanks  are  from  fifteen  to  twenty-four  feet 
inside  diameter.  They  are  now  constructed  with  a  sediment  compart- 
ment occupying  the  lower  portion,  in  which  a  part  of  the  coagulated 
material  may  be  precipitated  before  the  water  flows  on  the  surface  of 
the  sand.  These  gravity  filters  of  different  forms  are  in  use  at  Augusta, 
Ga.,  Quincy,  111.,  Burlington,  Cedar  Rapids,  Keokuk,  Ottumwa,  Dubuque, 
la.,  Lexington,  Ky.,  St.  Joseph,  Mo.,  Elmira,  Niagara  Falls,  N.  Y., 
Lorain,  O.,  York,  Penn.,  East  Providence,  R.  I.,  Columbia,  S.  C,  Knox- 
ville,  and  Norfolk.  Some  of  these  plants  furnish  as  high  as  9,000,000 
or  10,000,000  gallons  per  day. 

The  rate  of  filtration  in  these  mechanical  filters  is  very  high,  so  that 
only  a  small  area  of  tank  is  needed  to  supply  a  large  amount  of  water. 
With  a  rate  of  124,000,000  gallons  per  acre  per  day,  a  tank  fifteen  feet 
in  diameter  will  give  a  practical  daily  yield  of  500,000  gallons  of  fil- 
tered water. 

The  mechanical  filters  can  only  be  operated  by  the  addition  to  the 
applied  water  of  some  coagulant.  The  salts  of  aluminum  or  iron  are 
usually  employed,  and  the  commercial  sulphate  of  alumina  is  preferred. 
This  substance  tends  to  coagulate  some  of  the  dissolved  organic  matter 


I J  rA  TER,    ri  7'.    .  1  XJ>    SE  ^  1 7:7,'  S. 


285 


in  the  water,  but  it  acts  chiefly  through  the  flocculent  precipitate  of 
hydrate  of  alumina  which  is  formed  by  the  decomposition  of  the  sulphate 
bv  the  carbonates  naturally  in  solution  in  the  water.  The  amount  of 
sulphate  of  alumina  which  it  is  necessary  to  add  varies  from  0.6  to  3 
trains  per  gallon.  The  precipitated  hydrate  falling  on  the  surface  of 
the  sand  serves  the  purpose  of  the  layer  of  slime  in  the  natural  filter  to 
catch  the  bacteria  and  other  suspended  particles.  If  the  sulphate  of 
alumina  is  properly  used,  none  of  the  undecomposed  sulphate  or  of  the 
precipitated  hydrates  passes  into  the  effluent. 

Very  few  tests  have  been  made  of  the  bacterial  efficiency  of  this  type 
of  filter  except  on  experimental  work  at  Providence,  Louisville,  Cin- 
cinnati, and  Pittsburgh :  but  as  in  some  of  these  experiments,  filters  of 
ordinary  size,  operated  in  the  ordinal}'  way.  were  used,  there  is  no  rea- 
son why  the  experimental  results  should  not  be  considered  fairly  satisfac- 
tory. In  the  Cincinnati  experiments,  according  to  Fuller's  report,  over 
ninety-nine  per  cent,  of  the  bacteria  were  removed.1  A  six  weeks'  test 
made  during  the  ordinary  runs  of  the  East  Providence  filter  showed  a 
bacterial  efficiency  of  99.20  per  cent.  At  Lorain,  0..  the  filters  were 
tested  under  the  direction  of  the  state  board  of  health  and  showed  a 
high  degree  of  efficiency.     While  several  of  the  mechanical  filters,  so 


'-■.■-■.■  ' — lain — :  -  -■»>  -V  :■-'-:'■'.  '  -v  ■*-"-  -r-1 : ~r       "    : """ ' 

Fig.  12. 

Mechanical  Filter.    Section  ol  East  Providence  Filter  House       From  plate  loam 
American  Bocietj  ol  Civil  Engine* 

Report  <.f  the  investigations  on  the  Purification  ..f  tin-  Ohio  River  Water, by  the 
Board  of  Trustees,  Cincinnati,  1899( 


2  86 


WATER,   ICE,   AND    SEWERS. 


Fig.  IS. 

Seventeen  Foot  Jewel  Subsidence  Gravity  Filter. 


called,  were  installed  largely  for  the  purpose  of  freeing  the  water  from 
pathogenic  organisms,  none  of  them  are  operated  under  bacteriological 
control. 

That  the  removal  of  ninety-seven  to  ninety-nine  per  cent,  of  the  bac- 
teria from  polluted  water  is  sufficient  to  remove  the  danger  due  to  the 
presence  of  disease  germs  is  amply  proved  by  many  well  known  examples. 
The  history  of  Altona  and  Hamburgh  in  the  cholera  epidemic  of  1886 
is  known  to  almost  every  one.     The  freedom  of  London  from  typhoid 


WATER,   K'E.   AND    SEWERS.  287 

and  the  history  of  typhus  in  Zurich,  Buda-Pesth  and  Berlin,  as  well  as 
the  good  results  obtained  in  our  own  country  at  Lawrence,  show  that 
filters  may  be  relied  on  to  remove  pathogenic  bacteria  from  water. 
There  has  yet  been  no  opportunity  to  show  similar  brilliant  practical 
results  from  the  use  of  mechanical  filters,  but  as  they  do  the  same  bac- 
teriological work  they  will  doubtless  when  the  opportunity  presents, 
prove  as  useful  as  the  natural  filters. 

The  cost  of  constructing  natural  filters  is  considerably  more  than  for 
mechanical  filters,  particularly  if  the  former  have  to  be  covered.  The 
cost  of  operating  appears  to  be  not  very  different.  Every  individual 
city  must  make  a  special  study  of  its  own  conditions  and  only  after 
seeking  the  best  expert  advice  decide  upon  that  method  of  improving 
its  water  supply  which  best  suits  its  needs. 

Wells. 

It  is  an  unquestioned  fact  that  wells  are  sometimes  contaminated  in 
such  a  manner  as  to  cause  disease  in  those  who  drink  their  waters. 
There  are  many  notable  instances  of  such  on  record  and  most  health 
officers  of  extended  experience  have  had  personal  knowledge  of  epi- 
demics caused  in  this  way.  Cholera  and  typhoid  are  the  two  diseases 
which  without  question  may  be  spread  through  the  agency  of  well 
water.  While  the  danger  from  contaminated  well  water  must  be 
admitted,  the  degree  of  danger  is  not  so  apparent,  though  it  is  believed 
by  those  who  have  given  it  most  attention  to  be  very  considerable.  It 
is  usually  stated  that  the  introduction  of  a  reasonably  pure  public  supply 
in  cities  almost  always  results  in  a  diminution  of  the  death  rate  from 
typhoid  fever,  and  many  statistics  are  presented  to  support  this  view. 
There  are  several  classes  of  wells,  the  dug  wells,  or  the  shallow  driven 
wells  which  penetrate  less  than  a  hundred  feet,  and  the  deep  or  artesian 
wells  which  nia\  extend  one  or  two  thousand  feet  into  the  earth.  As  a 
rule  the  more  shallow  the  well,  the  more  liable  it  is  to  contamination. 
but  quite  deep  driven  wells  are  sometimes  contaminated.  The  danger 
in  the  use  of  wells  depends  in  the  main,  probablj  on  their  contamination 
with   human  excreta  contained   in  the  seepage  from   privy  vaults  and 

Cesspools,    or    the    Leakage    from    drains.      Well    water    is    usually    more 

palatable  than  the  softer  waters  which  are  generall)  furnished  in  public 

supplies,  and  in  summer  are  desired    on  account  of   their  coolness.       I   n- 

I'ortunateh  a  small  ai int   of  contamination,  entirely  too  small   to  be 

delected     h\    t  a>l  e  or  sn  le  1 1,   is  a  li  I  pi  V   sil  I'licieli  t     to  cause  disease.        Ileiice 

it  often   requires  considerable  pressure  either  through  persuasion  or  at 

the  hand  of  the  law,  to  prevent  persons  from  drinking  dangerous  water. 
Fortunately    there   are    factors    which    tend     tO  discourage   the    use  of    Well 


288  WATER,   ICE,   AND    XEWEI1S. 

water.  City  water  is  generally  introduced  into  dwellings  for  convenience 
in  washing,  cleaning,  and  bathing.  Once  in,  it  is  more  convenient  to 
use  it  for  drinking  than  it  is  to  use  well  water,  and,  moreover,  as  long- 
as  the  cost  of  the  city  water  has  to  be  borne,  it  is  considered  a  waste  to 
spend  money  to  keep  pumps  and  buckets  in  order,  or  to  clean  the  well. 
Hence  in  most  towns  with  a  public  water  supply,  the  wells  fall  rapidly 
into  disuse  without  any  compulsion.  Thus  in  the  city  of  the  writer, 
fourteen  years  after  water  was  introduced,  there  were  only  1,424  wrells 
in  use,  though  no  effort  had  been  made  by  the  city  to  close  them.  The 
use  of  many  thousands  had  voluntarily  been  given  up.  At  that  time 
the  population  of  the  city  was  about  118,000  living  in  over  15,000 
dwellings,  and  there  were  towards  13,000  connections  with  the  water 
mains.  Compulsion  is,  however,  at  times  necessary  to  secure  the 
abandonment  of  a  dangerous  well,  and  this  is  particularly  necessary 
where  the  water  rates  are  unreasonably  high. 

There  are  various  ways  of  gaining  information  as  to  the  dangerous 
character  of  a  well.  One  of  the  most  useful  is  an  inspection  of  the  sur- 
roundings. If  there  are  cesspools,  privy  vaults,  or  drains,  especially 
such  drains  as  are  liable  to  be  defective,  near  a  well,  it  is  likely  to  be 
contaminated.  As  a  rule  the  nearer  the  source  of  contamination,  the 
greater  the  danger ;  but  much  depends  on  the  character  of  the  soil.  A 
sandy  soil  is  the  least  dangerous,  a  seamy  rock  the  most.  A  well  on 
the  premises  where  the  writer  formerly  lived  was  contaminated  by  a 
privy  vault  300  feet  up  the  hill,  but  only  after  there  had  been  a  large 
amount  of  blasting  in  the  neighborhood,  which  probably  opened  up  new 
seams  in  the  rock.  No  hard  and  fast  rules  can  be  given  as  to  the 
desirable  distance  of  a  well  from  a  cesspool,  but  the  inspector  must 
bring  to  bear  an  experienced  judgment  and  must  take  into  account  the 
character  of  soil,  depth  of  well,  and  direction  of  flow  of  ground  and 
surface   waters. 

Secondly,  chemical  examination  is  of  very  great  assistance.  It 
furnishes  a  pretty  safe  indication  of  the  amount  of  organic  and  excre- 
mental  pollution,  but  here,  too,  the  analysis  must  be  interpreted  with 
care  and  intelligence. 

Lastly,  a  biological  examination  may  be  made.  If  typhoid  or  even 
suspiciously  fecal  bacteria  are  found,  the  question  is  settled,  but  on  the 
other  hand  their  absence  gives  no  surety  for  the  safety  of  the  water. 
Bacteriological  tests  are  difficult  to  apply,  and  of  comparatively  little 
value. 

It  is  often  necessary  for  the  person  on  whom  the  responsibility  rests 
to  carefully  consider  every  point,  but  when  the  alternative  is  a  reason- 
ably pure  municipal  supply,  the  well  ought  never  to  be  given  the  benefit 
of  the  doubt. 


WATER.   ICE,   AND    SEWERS.  289 

There  is  very  little  statutory  legislation  in  regard  to  wells.  The 
general  provisions  concerning  the  pollution  of  potable  waters  some- 
times mention  wells,  but  not  usually.  In  two  states  at  least  there  is 
some  provision  made  for  the  closing  of  wells.  Thus  in  New  Hamp- 
shire : l 

"  Whenever  any  well,  spring,  or  [other]  water  supply  is  suspected  of  being 
polluted  by  sewage  or  other  matters  dangerous  to  health,  the  health  officer  or  offi- 
cers in  any  town  or  city  where  such  water  supply  exists  may  cause  an  analysis  of 
the  suspected  water  to  be  made  by  a  competent  chemist,  without  expense  to  the 
owner,  and  if  the  analysis  shows  the  water  to  be  unfit  for  drinking  purposes,  said 
liealth  officer  or  officers,  upon  obtaining  the  indorsement  of  the  state  board  of  health 
may  prohibit  its  use,  and,  if  it  be  from  a  well,  may  cause  the  same  to  be  closed  if  in 
the  judgment  of  said  state  board  of  health  such  action  is  necessary.  The  state 
board  of  health  shall  authorize  such  investigations  whenever  deemed  necessary  for 
the  public  good.1' 

In  New  Jersey2  the  local  hoard  of  health  may  "order  not  to  he  used 
or  close  any  well,  the  water  of  which  is  polluted  or  detrimental  to  the 
public  health.''  In  the  absence  of  such  statutory  authority,  the  local 
government  may  make  regulations  or  issue  orders  under  a  general  grant 
of  sanitary  power,  and  many  cities  or  hoards  of  health  have  done  so. 
Among  cities  that  have  done  so  are  Bridgeport,  Denver,  Fitehburg, 
Haverhill,  Indianapolis,  .Memphis,  New  Orleans,  New  York  City, 
Omaha,  Rochester.  Scrantoii.  Spokane.  St.  Louis,  and  Yonkers. 

One  of  the  provisions  sometimes  adopted  is  that  vaults,  cesspools, 
and  drains  must  be  located  a  certain  distance  away  from  the  well. 
Some  of  these  rules  were  referred  to  on  page  176.  A  rule  somewhat 
different  from  those  which  specify  the  distance  of  possible  sources  of 
pollution  is  found   in  Fitehburg.8 

Instead  of  attempting  to  protect  wells,  most  cities,  tow  us,  and  villages, 
with  a  good  piil. lie  water  supply,  consider  it  the  besl  policy  to  discon- 
tinue the  nse  of  all  wells,  or  at  least  of  all  wells  that  are  considered 
likely  t<>  he  dangerous.     There  are  few  cities  which   have  absolutely 

ordained  thai  all  wells  shall  he  abandoned,  but  in  Erie4  well  water  must 
not  l.c  used  when  it  is  possible  to  make  connection  with  the  «  it\  water, 
nor  if  the  well  is  within  1 00  feet  of  a  vault  or  cesspool.  Sometimes 
the  use  of   wells   is  forbidden   unless  a   permit    is  granted.6     A  similar 

•   Bampshire,  Public  Statutes  (1891),  Chapter  108,  Se< ,  it. 
-  \.u  Jersey,  General  Statutes  (1896),  p.  1644,  Sec.  19  (XII). 
:(  Fitehburg,  Rules  and   Regulations  ol  the  Board  of  Health  1 1897),  p.  II,  Rule  2: 
•  .  cesspool  or  privy,  or  privy  vault  shall  be  established  en  land  where  there 
is  anj  well,  spring,  or  other  source  of  water  supply  used  for  culinary  or  domestic 
purposes,  ezcepl   by   special   permil   in   writing  first   obtained  from   (he  board  of 
health.11 

•Erie,  Rules  and  Regulations  of  Board  <>f  Health  (1898),  p.  19. 
Rochester,  Ordinances  of  Board  "I  Health,  Number  20: 

11  Water  from  wells  in  the  city  of  Rochester  shall  ii case  he  used  for  drink  or 

in  the  preparation  of  food  for  human  beings,  except  under  and  pursuant  to  the  con- 


290  WATER,   ICE,   AND   SEWERS. 

rule  is  found  in  the  sanitary  code  of  the  City  of  New  York,  but  it 
only  applies  to  tenement  and  lodging  houses,  and  hotels  and  office 
buildings.1 

In  New  Orleans2  no  one  may  use  water  from  any  well,  canal,  sewer, 
ditch,  or  other  excavation  in  the  ground  "for  the  purpose  of  making 
bread  or  any  other  article  intended  for  human  consumption  or  subsist- 
ence," or  for  washing  utensils  used  for  preparing  food  or  drink. 

Most  of  the  municipal  regulations  have  reference  to  the  abandon- 
ment or  closing  of  wells.  In  southern  cities  as  Memphis  where  cisterns 
are  often  used  to  furnish  domestic  supply  the  board  of  health  may  close 
them  also.  Sometimes  the  rule  or  ordinance  requires  the  health  officer 
or  board  of  health  to  close  the  well  when  he  "  is  satisfied  "  that  it  is 
dangerous  or  polluted,  or  when  he  "  finds  it "  so,  or  when  it  "  appears 
on  examination  "  or  "  on  satisfactory  evidence  "  to  be  so.  In  St.  Louis3 
whenever  a  chemical  analysis  shows  a  well  to  be  impure  or  unwhole- 
some, it  shall  be  deemed  a  nuisance.  In  Omaha  the  well  is  to  be  con- 
demned by  a  chemical  or  other  test,  and  in  Denver  if  a  chemical  test  or 
its  location  shows  it  to  be  probably  unwholesome.  As  was  stated  above, 
chemical  analyses  have  to  be  interpreted  with  some  caution  and  with 
reference  to  the  location  of  the  well,  hence  arbitrary  standards  of  purity 
are  not  usually  established ;  but  in  St.  Louis4  such  a  standard  was 
adopted  upon  the  advice  of  a  committee  of  expert  chemists.  The  stand- 
ard is  as  follows  :  All  wells  are  to  be  condemned  as  impure  and  unwhole- 
some which  contain : 

"  First,  more  than  0.05  parts  of  nitrogen  in  t^he  form  of  nitrates  per  million  parts 
of  water;  or,  second,  more  than  0.01  parts  of  nitrogen  in  the  form  of  nitrates  per 
million  parts  of  water,  in  conjunction  with  0.15  parts  of  nitrogen  in  the  form  of 
"free"  ammonia  per  million  parts  of  water,  and  100  parts  of  chlorine  per  million 
parts  of  water;  or,  third,  nitrogen  in  the  form  of  "  albuminoid  "  ammonia  to  the 
extent  of  0.2  parts  per  million  parts  of  water;  or,  fourth,  phosphoric  acid  or  phos- 
phates as  acertained  by  the  characteristic  turbidity  produced  upon  the  addition  of 
ammonia  molybdate.1' 

After  it  has  been  determined  that  a  well  is  to  be  abandoned,  a  notice 
is  issued  to  the  responsible  parties  to  fill  it  with  earth,  and  if  this  is  not 
done,  the  board  of  health  is  to  do  it.5 


ditions  of  a  permit  in  writing  from  the  health  department.  The  said  permit  shall 
be  granted  only  upon  a  certificate  from  the  health  office  declaring  the  water  of  the 
well  in  question  to  be  free  from  noxious  substances  or  influences  and  that  it  is  suit- 
able for  human  food  and  drink." 

1  New  York,  Sanitary  Code  (1899),  Sec.  62. 

2  New  Orleans,  Ordinance  No.  127,  Council  Series,  13  February,  1883,  Sec.  4. 

3  St.  Louis,  Ordinances  (1893),  Chapter  14,  Sec.  453. 

4  St.  Louis,  Report  of  Health  Commissioner  (1895-G),  p.  112. 

5  Bridgeport,  Ordinances  (1892),  Chapter  14: 

;'  Sec.  32.     That  whenever  the  board  of  health  shall  have  satisfactory  evidence 
that  any  well,  the  water  of  which  is  used  for  domestic  purposes,  has  become  pol- 


WATER,    TCM,   AND    SEWERS.  291 

That  city  wells  ought  to  be  abolished,  may  certainly  he  affirmed  if 
the  teaching's  of  the  chemist  are  to  be  followed.  Thus  in  Brooklyn  in 
1884,1  of  296  wells  analyzed,  230  were  by  the  chemical  analysis  con- 
demned. In  Newark2  of  462  wells,  57.17  per  cent,  were  considered  to 
be  contaminated,  27.30  per  cent,  suspicious,  and  15.53  per  cent,  pass- 
able. In  Minneapolis"  of  376  wells  from  which  samples  were  analyzed, 
two-thirds  were  more  or  less  polluted  with  sewage,  and  of  seventeen 
wells  supplying  bakeries,  thirteen  were  reported  as  utterly  unfit  for  use. 
The  department  closed  some  of  the  worst  wells  but  was  loath  to  close 
others  as  the  city  water  was  considered  little  better,  and  while  improve- 
ments were  being  made  in  the  city  supply,  the  citizens  were  left  tree  to 
make  their  choice.  In  St.  Louis4  of  101  wells  examined,  thirty-eight 
wen-  condemned.  The  health  officer  of  Syracuse5  says  that  chemical 
examination  shows  that  nearly  all  wells  are  unfit  for  use.  The  reports 
for  Brooklyn  and  Newark  above  referred  to,  give  the  details  of  the 
analysis  for  each  well  and  also  other  data  concerning  the  well,  and  simi- 
lar data  may  be  found  in  the  reports  of  Baltimore,'5  Milwaukee,7  Phila- 
delphia.s  Charleston,9  and  Maine.10  In  Charleston  bacteriological  exam- 
ination was  made  of  171  samples  from  wells  and  in  one  of  these  typhoid 
bacilli  were  found  and  in  one  colon  bacilli.  In  Memphis  the  board  of 
health  frequently  inspects  the  wells  and  cisterns  used  for  domestic 
supply  and  frequently  condemns  the  shallow  surface  wells. 

Springs. 

There  is  no  essential  difference  between  wells  and  springs,  for  both 
have  their  origin  in  the  great  body  of  ground  water.  Springs  are  less 
likely  to  be  contaminated  than  wells  for  the\  are  less  likely  to  be  found 

Luted  ami  rendered  unsafe  for  potable  use.  notice  to  discontinue  the  use  of  said  pol- 
luted water  shall  be  senl  to  the  owner,  agent,  lessee,  or  party  in  charge  of  said  well, 
and  at  the  discretion  of  the  board  the  owner,  lessee,  agent,  or  party  in  charge  of 
said  well  may  be  ordered  in  writing  to  close  or  fill   up  said  well.     It  the  said  order 

is  not  complied    with  within  the  time  therein  specified,  this  section  skill    be  deemed 

violated,  and  the  board  may  proceed  to  cause  the  said  well  to  be  closed  or  filled  up. 
the  owner,  a^ent.  lesser.  ..i'  party  in  charge  paying  all  expenses  therefor.'1 
1  Brooklyn,  Special  Report  of  Commissioner  of  Health,  on  Pump  Wells. 
Newark,  Reporl  of  Health  Department  (1894),  pp.  70,  92,  and  120. 

•  Minneapolis,  Reporl  of  Department  of  Health  (1897),  p.  28. 
•St.  Louis,  Reporl  of  Health  Commissioner  (1895  6),  p.  L12. 
'Syracuse,  Reporl  of  Board  of  Health  (1894),  p.  24. 

•  Baltimore,  Report  of  Board  of  Health  (1898),  pp.  80-88. 

Milwaukee,  Report  of  Commissioner  of  Heaith  for  year  ending  \  iuii    1899,  p.  98. 
Philadelphia,  Report  of  Bureau  of  Health.  (1898),  p.  L45. 
i  lharleston,  Reporl  of  Department  of   Health  (1898), 
Maine.  Reporl  ot  state  Board  of  Health  (1896  7),  p.  IT. 


292  WATER,   ICE,   AND    SEWERS. 

in  thickly  settled  regions,  for  when  the  land  is  well  occupied,  as  in  cities 
the  ground  water  is  carried  away  by  drains,  or  used  up  in  wells  so  that 
the  natural  springs  are  dried  up  and  do  not  furnish  a  sanitary  problem 
in  many  cities.  Occasion  ally,  however,  springs  do  exist  in  cities  and 
sometimes  are  found  to  be  polluted.  Thus  in  Reading1  a  local  outbreak 
of  typhoid  in  the  suburbs  threw  suspicion  on  certain  springs,  and  chem- 
ical analysis  indicated  that  they  were  decidedly  polluted.  In  Nashville 
in  18982  four  springs  and  a  well  which  were  suspected  of  contamination 
were  subjected  to  chemical  analysis  and  condemned,  and  in  one  of  the 
springs  colon  bacilli  were  afterwards  found. 

Since  the  attention  of  the  public  has  been  drawn  to  the  danger  in 
the  use  of  contaminated  municipal  supplies,  there  has  developed  quite 
a  trade  in  spring  waters  in  a  number  of  cities  which  have  the  misfor- 
tune to  be  supplied  with  dangerous,  dirt}r,  or  offensive  water.  Spring 
waters  are  colorless  and  hard  enough  to  be  agreeable,  and  hence  are  pre- 
ferred by  consumers,  as  well  as  purchased  for  prudential  reasons.  It  is 
quite  possible,  however,  that  the  consumers  in  purchasing  spring  waters 
may  be  .leaning  upon  a  broken  reed,  for  springs  may  be  impure  as  are 
wells  and  rivers  ;  also  "  spring  water  "  may,  by  an  unscrupulous  dealer 
be  drawn  from  a  neighboring  sewage  polluted  well,  and  even  if  pure  in 
the  spring,  it  may  by  handling,  be  grossly  contaminated.  Hence  some 
cities  have  given  this  subject  attention.  In  Providence3  in  1893  nearly 
2,000  gallons  of  spring  water  were  sold  daily  at  an  average  price  of  six 
cents  per  gallon.  This  water  was  taken  from  nineteen  springs.  All  of 
these  were  carefully  examined  and  a  bacteriological  analysis  was  made 
of  their  waters.  The  results  of  the  examinations  and  also  of  the  chem- 
ical analyses  which  had  been  made  by  reliable  chemists,  was  favorable 
in  all  but  four  springs.  The  position  of  these  four  showed  that  they 
were  liable  to  contamination,  and  one  of  them  came  to  the  surface 
immediately  beneath  one  of  the  trunk  sewers  recently  constructed. 
The  publication  of  the  results  of.  the  investigation  effectually  stopped 
the  sale  of  water  from  the  suspicious  springs.  A  similar  investigation 
of  springs  in  Massachusetts  was  made  by  the  state  board  of  health  in 
1891.4 

Ice. 

It  was  at  one  time  supposed  that  the  freezing  of  water  purified  it,  and 
so  it  does  to  a  slight  extent  under  certain  conditions  ;  but  the  researches 
of  Prudden  Sedgwick  Park  5  have  shown  that  it  will  not  kill  pathogenic 

1  Reading,  Report  of  Board  of  Health  (1890),  pp.  9-13. 
Nashville,  Report  of  Board  of  Health  (1898),  p.  6. 

3  Providence,  Report  of  Superintendent  of  Health  (1893),  p.  :'.T. 

4  Massachusetts,  Report  of  State  Board  of  Health  (1891),  p.  353. 

5  Boston  Journal  of  Medical  Sciences,  Vol.  8,  p.  213. 


WATER,    ICE,   AND    SEWERS.  293 

bacteria  even  if  they  be  exposed  to  severe  cold  for  a  long  period. 
These  investigations  have  caused  health  officials  to  give  increased  atten- 
tion to  ice  supplies,  and  at  present  quite  a  number  of  states  and  cities 
inspect  ice,  or  the  sources  from  which  it  is  obtained,  or  control  its  cut- 
ting and  sale.  While  it  cannot  be  denied  that  it  is  possible  for  disease 
to  be  caused  by  the  ingestion  of  ice  containing  typhoid  germs  or  other 
pathogenic  organisms,  or  perhaps  even  when  it  contains  unorganized 
poisonous  substances,  it  is  nevertheless  true  that  very  few,  if  any.  out- 
breaks of  disease  have  ever  been  traced  to  the  use  of  ice. 

Statutory  legislation  looking  to  the  prevention  of  the  sale  of  impure 
ice  has  been  enacted  in  several  states.  In  Massachusetts  cities  may 
make  regulations  in  regard  to  ice.1 

In  New  Jersey,  cities  of  the  first  class  are  given  authority  to  make 
ordinances  in  regard  to  ice.  The  Wisconsin  law  forbids  the  sale  for 
domestic,  culinary  or  drinking  purposes,  of  ice  containing  mud,  decayed 
vegetation  or  animal  matter,  foreign  matter  or  malarial  substance. 
Dealers  shall  have  a  sign  upon  their  wagons  showing  where  the  ice  is 
cut  or  made,  and  if  it  is  sold  for  cooking  purposes  only,  that  fact  must 
be  stated  on  the  sign.  In  Cleveland  a  similar  provision  is  found  in  the 
ordinance,  and  it  is  required  that  the  letters  shall  be  six  inches  high. 
Massachusetts  also  has  a  law  which  authorizes  the  state  board  of  health 
on  petition  of  twenty-five  consumers  of  ice  to  investigate  the  supply  and 
make  orders  concerning  the  same.  In  New  Hampshire  local  boards  of 
health  may  inspeel  the  sources  of  their  ice  supplies,  and  it'  they  deem 
the  ice  impure  may  order  the  sale  stopped.  In  New  Jersey  no  ice  can 
be  cut  within  a  city  or  town  for  use  in  such  city,  borough  or  township 
without  a  permit  from  the  local  board  of  health,  and  no  ice  can  be  sold 
without  such  a  permit.  The  board  of  health  may  revoke  permits  and 
forbid  the  sale  of  ice  when  in  their  judgment  its  use  would  be  detri- 
mental to  the  public  health.  The  penalty  for  disobedience  of  the  orders 
pf  the  board  of  health  or  of  the  statute  is  punishable  by  a  fine  of  $500 
Or  six  months'  imprisonment  or  both.  The  Illinois  act  of  L899  forbids 
the  sale   of  ice  made  from  water  below  the  standard  prescribed  by  the 

slate  board   of  health. 

The  New  Jersey  law  forbids  the  malicious  pollution  of  ice,  and  in 
New  Hampshire  the  acl  of  1895  concerning  the  pollution  of  water  sup- 
plies applies  to  water  from  which  ice  is  cut. 

Although,  as  is   thus  shown,  only  a  tew  states  have  authorized  any 


1  Massachusetts,  <  liapterS38of  18 

ities  may  make  ordinances  to  secure  the  inspection  of  ice  sold  within  their 
limits  and  !■>  prevenl  the  sale  "t  impure  ice.  and  thej  may  establish  penalties  for  the 
violation  of  such  ordinances,  nol  exceeding  twenty  dollars  for  each  offen 


294  WATER,    ICE,    AND  SEWEJts. 

action  concerning  ice,  on  the  part  of  cities  or  boards  of  health,  }Tet  a 
number  of  cities  outside  of  those  states  have  thus  acted.  Among  cities 
which  have  made  rules  in  regard  to  their  ice  supplies  may  be  mentioned 
Albany,  Baltimore,  Bridgeport,  Brooldine,  Mass.,  Buffalo,  Cambridge, 
Chicago,  Cleveland,  Denver,  Detroit,  Elmira,  N.  Y.,  Meadville,  Pa., 
Milwaukee,  Minneapolis,  North  Adams,  Mass.,  Paterson,  Rochester, 
Salt  Lake  City,  St.  Louis,  and  Syracuse.  In  some  of  the  cities,  as 
Albany,  the  only  rule  is  one  which  simply  prohibits  the  sale  of  impure 
ice.  Other  cities  forbid  the  harvesting  and  importation  of  ice  as  well  as 
its  sale : 

"  No  person  shall  bring,  store,  sell,  deliver  or  distribute,  or  cause  to  be  brought, 
stored,  sold,  delivered  or  distributed,  within  the  limits  of  the  City  of  Minneapolis, 
any  ice  for  domestic  use  or  cooling  purposes  within  said  city  which  shall  have  been 
formed  or  produced  by  the  freezing  of  unwholesome,  impure  or  contaminated  water, 
or  water  the  use  of  which  would  be  deleterious  to  health.  And  no  person  shall,  within 
or  without  the  limits  of  the  City  of  Minneapolis,  cut,  harvest,  or  in  any  way  obtain 
any  ice  intended  for  domestic  use  or  cooling  purposes  within  said  city,  in  or  from  any 
river,  stream,  lake  or  other  body  of  water,  the  waters  of  which  are  unwholesome, 
impure  or  contaminated,  or  the  use  of  which  would  be  deleterious  to  health.'11  l 

Still  more  elaborate  rules  are  those  of   Chicago 2  and  Cleveland,3 

though    in    the    latter    city    little    attempt    is    made   to   enforce  them. 

The  Chicago  ordinance  provides  for  the  issuing  of  licenses,  defines  what 

is  meant  by  domestic  use  and  what  is  meant  by  impure  ice,  forbids  the 

taking  of  ice  from  certain  localities,  requires  the  inspection  of  vehicles 

and   the   places  where  ice  is  stored,  and  authorizes  the  commissioner  of 

health  to  make  rules  for  storing,  delivery  and  inspection.     Cleveland 

also  attempts  to  define  what  is  meant  by  impure  ice.     The  following  is 

from  Cleveland,  where  ice  may  be  condemned  and  seized  if  it 

"Be  found  to  contain  any  nitrogen  as  nitrites,  or  any  pathogenic  bacteria,  or 
more  than  five-tenths  (0.5)  parts  nitrogen  as  nitrates  in  one  million,  or  more  than 
two  parts  of  chlorine  in  one  million,  or  more  than  five- tenths  parts  albuminoid  am- 
monia in  one  million,  or  over  one  hundred  colonies  bacteria  in  one  cubic  centimeter, 
or  any  colonies  of  bacteria  of  the  gas  producing  kind;  and  the  loss  on  ignition  at  a 
red  heat  must  be  less  than  one-half  the  total  solids.  In  ice  which  has  been  stored 
or  packed  no  account  shall  be  taken  of  the  ammonia  or  nitrates.11 

Usually  it  is  only  attempted  to  control  the  sale  of  ice  when  it  is  to 
be  used  in  such  a  manner  as  to  enter  into  the  food  or  drink  of  man. 
Thus  we  find  in  the  Albany  rule  the  limiting  terms  "  in  connection  with 
drinking  water,  liquids  or  foods."  Other  regulations  forbid  its  use  for 
"  drinking  water  or  beverages,"  "  for  drinking  or  eating,"  "  or  in  any 
way  for  human  consumption."     In  Chicago  impure  ice  must  not  be  sold 


Minneapolis,  Ordinance  of  20  December,  1897,  •'Sec  53a: 
-  Chicago,  Ordinance  of  25  May,  1896. 
3  Cleveland,  Ordinances  (1802),  Chapter  MO,  .Sees.  555-501. 


WATER,    ICE,    AND    SEWERS.  295 

"  from  house  to  house  or  to  hotels,  restaurants,  saloons  or  other  places 
where  such  iee  may  be  used  in  contact  with  food  or  drink,"  but  such  ice 
may  be  sold  for  certain  purposes  as  shown  below.1 

Another  useful  method  of  dealing-  with  the  Bale  of  ice  is  to  require 
permits  as  in  Xew  Jersey,  or  the  registration  of  the  dealers  as  in  some 
Massachusetts  cities.  Other  cities  outside  of  these  states,  as  Baltimore, 
Chicago,  Cleveland,  Denver,  St.  Louis,  Minneapolis,  and  Salt  Lake  City, 
require  dealers  to  take  out  permits  and  refuse  to  grant  them  if  the  source 
from  which  the  ice  is  obtained  is  not  satisfactory:  but  in  Cleveland, 
Denver,  and  St.  Louis  a  permit  is  only  required  for  the  cutting  or  sale 
of  impure  ice  for  cooling  purposes  or  of  ice  from  certain  localities.  In 
Si.  Loins  and  Denver  the  licensee  is  obliged  to  give  a  bond,  in  the 
former  city  in  the  sum  of  S'2,000. 

The  method  employed  in  Cambridge,  Mass.,  is  shown  by  the  rules 
given   below.2     Whether  or  not    there  are  regulations  governing  the  ice 


1  Chicago,  Ordinance 25  May  1896: 

•  Sec.  5.  This  ordinance  shall  not  be  construed  to  prohibit  the  selling  or  deliver- 
ing of  impure  ice  to  be  used  only  for  packing  or  cooling  purposes,  that  is  to  say.  tor 
use  in  refrigerators,  refrigerator  cars,  freezing  machines,  rooms  and  other  places 
where  it  will  not  come  in  contact  with  articles  of  food  or  drink;  provided,  that  a 
permit  be  first  obtained  from  the  commissioner  of  health  to  sell,  deliver,  or  use 
impure  ice  for  the  purposes  aforesaid  and  for  no  other  purpose. 

•■  Whenever  any  impure  ice  for  packing  or  cooling  purposes  shall  be  sold  or  de- 
livered from  any  wagon  or  other  vehicle  the  driver  or  other  person  in  charge  thereof 
shall  carry  a  supply  of  printed  cards,  on  which  shall  be  printed  in  large  legible  let- 
ters the  words;  "Ice  for  Packing  and  Cooling  Purposes  Only.  Not  for  Domestic 
I'se."  and  he  shall  hand  with  each  delivery  of  such  ice  one  such  card  to  each  cus- 
tomer thereof,  or  to  the  person  who  receives  the  same,  and  shall  take  at  the  same 
time  a  receipt,  which  shall  be  given  him  by  such  purchaser  or  recipient,  on  which 
receipt  the  said  words  shall  be  similarly  printed.  No  ice  for  packing  or  cooling  pur- 
poses shall  be  sold  or  delivered  in  the  City  of  Chicago  by  any  person,  tirin  or  cor" 
poration  without  such  permit,  or  ot lie r wise  than  in  conformity  with  the  provisions 
of  i  his  sect  ion.11 

2 Cambridge,  Ordinance,  29  December,  1897: 

"Section  1.     Every  person,  arm  or  corporation  before  selling  or  delivering  ice 

in  this   city  after   the  first   day  of    February,  A.  I).   1898,  shall    prior   to   such    sale    or 

delivery  register  at  the  office  of  the  board  of  health  the  name  and  location  of  the 
body  or  bodies  of  water  from  which  saiil  ice  so  to  he  sold  or  delivered  has  been  cut, 
<>r  from  which  the  water  has  Keen  taken  for  its  manufacture.  Such  registration 
shall  be  subscribed  and  sworn  to  bj  the  person  so  proposing  to  sell  or  cause  to  be 
delivered  said  ice,  or  in  the  case  of  a  firm,  by  one  of  the  members  of  the  Arm,  or  in 
the  case  of  a  corporation,  by  the  president,  general  manager,  or  one  of  the  board  of 
directors  of  the  corporal  ion. 

Sec.  -.  Everj  person,  firm  or  corporal  ion  who  sells,  delivers  or  causes  to  be 
delivered  ice  in  this  city  after  the  tirst  day  of  February,  V  I ».  1898,  shall  permit  the 
board  of  health  and  it-  inspectors  at  all  reasonable  times  to  have  access  to  and 
Ireel]  examine  the  ice  intended  for  such  sale  or  delivery,  and  shall  permit  samples 
to  be  taken  by  said  board  or  its  inspectors  tor  the  purpose  of  analysis. 

"Sec.  3.     The  hoard  of  health  shall  investigate  the  sources  ol  supply  of  i< 


296  WATER,   ICE,   AND    SEWERS. 

supply,  or  whether  or  not  permits  for  dealers  are  required,  an  inspection 
of  the  source  of  supply  and  examination  of  the  ice  may  be  carried  on 
with  advantage,  and  even  in  the  absence  of  all  legislation,  the  publish- 
ing in  reports  or  otherwise  of  the  results  of  such  examinations  may 
accomplish  much  in  improving  the  supply.  Among  cities  which  report 
examination  of  their  ice  supply  and  its  source  may  be  mentioned  Balti- 
more,1 Boston,2  Brookline,  Mass.,3  Cambridge,  Chicago,4  Cleveland,5 
Providence,6  and  Salt  Lake  City."  The  examination  consists  in  most 
cases  of  an  inspection  of  the  pond,  lake  or  river  from  which  the  ice  is 
cut  and  perhaps  an  inspection  of  more  or  less  of  the  drainage  area  from 
which  the  water  is  derived.  Samples  of  ice  are  also  analyzed  both 
chemically  and  bacteriologically.  The  water  from  the  melted  ice  is, 
of  course,  examined  in  these  tests  as  is  ordinary  water,  but  certain 
precautions  should  be  taken  in  securing  the  sample  of  ice  and  meltmg 
the  same,  to  insure  a  fair  sample  and  protection  from  accidental  con- 
tamination. 

Sewers. 

This  subject  will  not  here  receive  much  attention,  for  the  building 
and  construction  of  sewers  is  almost  always  in  charge  of  engineers  and 
public  works  officials.  The  problems  of  sewer  construction  are  engi- 
neering problems,  and  if  a  city  employs  skilled  engineers  the  health 
officer  need  not  worry  about  the  sewers.  Even  the  need  for  sewers  has 
scarcely  to  be  urged  by  health  officers.  The  public  so  well  appreciates 
their  advantages  that  they  are  usually  demanded  when  needed,  even  if 
they  must  be  entirely  paid  for  by  the  abutters.  Sometimes  the  health 
officer  may  be  of  service  in  hastening  the  action  of  a  dilatory  council. 
In  Boston8  the  board  of  aldermen,  when  the  board  of  health  so  requests 


sold  or  delivered  and  cause  inspection  and  analysis  to  be  made  of  the  ice  from  said 
sources.  And  if  upon  such  investigation,  inspection  and  analysis  and  upon  hearing, 
it  shall  deem  and  adjudge  ice  derived  from  any  source  to  be  impure  and  injurious  to 
the  public  health,  it  may  prohibit  the  sale  or  delivery  in  this  city  of  such  ice  or  of 
any  other  ice  which  has  been  intermingled  with  ice  from  such  source.  Notice  of 
such  prohibition  shall  be  given  in  the  manner  provided  by  law  for  giving  notice  of 
the  regulations  of  the  board  of  health,  and  such  notice  shall  be  deemed  legal  notice 
to  all  persons." 

1  Baltimore,  Report  of  Department  of  Health  (1898),  p.  72. 

2  Boston,  Report  of  Board  of  Health  (1809),  p.  87. 

3  Massachusetts,  Report  of  State  Board  of  Health  (1896),  p.  87o. 

4  Chicago,  Report  of  Department  of  Health  (1895-6),  p.  215. 

5  Cleveland,  Report  of  Health  Officer  (1896),  p.  36;  (1897),  p.  47. 

6  Providence,  Report  of  Superintendent  of  Health  (1889),  p.  48. 

■  Salt  Lake  City,  Report  of  Board  of  Health  (1897),  p.  61;  (1898),  p.  67. 
8  Massachusetts,  Chapter  450  of  1889,  Sec.  2. 


WATER,   K'K   AJSTB    SB  WEBS.  297 

and  states  that  the  public  health  requires  it,  must  provide  sewers,  but 
the  amount  to  be  so  expended  in  any  one  year  shall  not  exceed  810,000. 
In  only  a  few  cities  is  the  work  of  sewer  construction  undertaken  by 
the  health  department.  The  most  conspicuous  examples  are  Augusta, 
Ga.,  and  Memphis.  In  St.  Louis  in  1893  over  one-rlfth  of  the  appro- 
priation of  the  health  department  was  used  to  construct  shallow  tem- 
porary sewers  to  relieve  the  sewage  ditches  in  certain  parts' of  the  city. 

Ordinances  and  rules  in  regard  to  the  construction  and  maintenance 
of  sewers  are  occasionally  found,  and  they  are  sometimes  in  the  sanitary 
codes,  but  they  usually  date  back  to  the  time  when  sewers  or  drains 
Were  constructed  by  private  enterprise.  In  recent  times,  since  sewers 
have  been  constructed  by  the  municipality  and  with  engineering  advice, 
details  have  been  wisely  left  to  the  engineers.  While  local  boards  of 
health  rarely  advise  in  regard  to  sewer  construction,  it  is  otherwise  with 
the  state  board  of  health.  In  Massachusetts1  all  municipalities  apply- 
ing to  the  legislature  tor  authority  to  construct  sewers,  must  apply  to 
the  state  board  of  health  for  advice.  A  similar  provision  that  the  state 
board  is  to  be  consulted,  is  also  found  in  North  Carolina.2  A  number 
of  the  state  boards  frequently  advise  on  this  subject,  especially  for  the 
smaller  cities  and  villages.  Notable  among  such  are  those  of  Massa- 
chusetts, New  York,  and  ( )hio. 

Rules  to  prevent  putting  improper  substances  into  sewers  are  of 
course  not  infrequently  found  in  municipal  ordinances  and  codes. 
Among  the  concise  and  comprehensive  rules  of  this  kind  are  those  found 
in  the  District  of  Columbia,  but  such  rules  had  perhaps  better  be  sug- 
gested by  the  engineer  rather  than  the  health  officer: 

••  No  person  shall  throw,  cast,  lay,  deposit,  drop,  or  leave  in  <<r  upon  any  public 
sew.  rin  the  District  of  Columbia,  or  any  trap,  basin,  inlet,  grating,  manhole,  or 
other  appurtenances  of  any  public  sewer,  any  sticks,  stones,  brick,  earth,  gravel, 
dirt,  mud,  bay,  straw,  manure,  rubbish,  litter,  sweepings,  offal,  vegetables,  garbage, 
shrubs,  branches,  twigs,  leaves,  papers,  cinders,  or  refuse  matter  of  any  kind : 
Provided,  Thatthe  provisions  of  this  paragraph  shall  no!  apply  to  matter  discharged 
through  a  house  sewei  into  a  j  ■  1 1 1  >  1  i  <  -  sewer." 

Riveb   Pollution. 

The  pollution  of  public  water  supplies  ami  their  purification  have 
been  here  considered  because  of  the  direct  bearing  of  the  subjeci  upon 
public  health.  The  pollution  with  sewage,  manufacturers' wastes,  and 
other  offensive  substances  of  rivers  and   public  waters  which   are  not 

1  Massachusetts,  Chapter  ;:T.".  .a  :;. 

North  Carolina.     V  t   ol    1    Mar.  h,    I-'.':'..  Sec.   1'.'. 

Distrietol  Columbia,  Police  Regulations  (1898),   \ii.T. 


298  WATER,   ICE.    AND    SEWERS. 

used  for  drinking  purposes  does  not  affect  the  health  in  a  direct  manner, 
and  indeed  the  effect  on  health  of  such  nuisances  is  not  well  understood, 
and  has  in  the  past  probably  been  overestimated.  Excessive  pollution 
does,  however,  constitute  a  nuisance,  often  a  very  grievous  one,  and 
health  officers  are  always  expected  to  be  greatly  interested  in  all  efforts  for 
its  abatement.  That  they  are  thus  interested  is  sh<  >wn  by  their  reports,  for 
a  perusal  of  those  of  Augusta,  Ga.,  Baltimore,  Boston,  Bridgeport,  Cam- 
bridge, Chicago,  Cincinnati,  Denver,  Detroit,  Fitchburg,  Hartford,  Mil- 
waukee, Paterson,  Providence  and  Salem,  shows  that  the  health  depart- 
ment frequently  calls  attention  to  the  offense  caused  by  polluted  waters 
and  the  necessity  for  taking  some  action  to  remedy  it.  When  the  pollu- 
tion is  within  the  municipal  limits  and  is  caused  by  private  parties,  and 
especially  if  the  amount  of  pollution  by  any  one  party  is  not  very  great, 
the  health  department  is  quite  likely  to  take  action  under  the  nuisance 
laws,  and  order  the  nuisance  abated.  In  this  way  privies  are  removed 
from  over  streams,  drains  are  cut  off,  and  the  dumping  of  offensive  matter 
is  stopped.  More  rarely  is  action  brought  for  the  violation  of  some  ordi- 
nance or  statute.  But  when  the  pollution  is  considerable  in  amount, 
and  affects  a  large  body  of  water,  and  when  it  is  due  to  the  discharge 
of  municipal  sewage  or  wastes  from  large  manufactories,  and  especially 
when  the  pollution  takes  place  outside  of  the  limits  of  the  municipality 
affected,  the  local  board  of  health  has  little  power  to  act.  It  is  in  these 
cases  that  the  state  authorities  can  perform  useful  functions,  and  the 
investigations  made,  and  work  done  by  the  state  board  of  health  in 
Connecticut,  Massachusetts,  Minnesota,  New  Jersey,  Xew  York,  Ohio, 
and  Rhode  Island  are  well  known. 

There  is  a  good  deal  of  statutory  legislation  to  prevent  the  pol- 
lution of  waters  that  are  used  as  the  sources  of  domestic  supply,  but 
there  is  not  very  much  that  is  of  use  in  protecting  other  waters  from 
offensive  pollution.  A  number  of  states,  as  Arkansas,  Connecticut, 
Georgia,  Illinois,  Iowa,  Kentucky,  Michigan,  Ohio,  and  West  Virginia, 
forbid  the  deposit  of  dead  animals  in  streams  or  public  waters.  Some 
of  the  laws,  particularly  those  of  West  Virginia,  California,  and  Ohio, 
forbid  the  discharge  of  many  offensive  materials  into  public  waters,  and 
included  among  them  are  several  forms  of  manufacturers"  refuse,  as 
wastes  from  gas  works,  oil  refineries,  and  cheese  factories.  The  Ohio 
statutes  also  impose  a  penalty  for  "whoever  renders  impure  any  water 
course,  stream,  or  water." 

A  large  number  of  cities  have  adopted  rules  forbidding  pollution  of 
public  waters  by  the  deposit  of  filth,  night  soil,  offal,  dead  animals,  etc. 
Most  of  these  have  been  adopted  to  meet  some  local  condition  and  to 
prevent  some   special  pollution  occurring  within   the  city   limits.      <  hie 


WATER,    ICE,    AX I>    SEWERS.  299 

of  the  most  general  and  comprehensive  of  these  laws  is  that  of  the  City 
of  New  York.1 

These  local  regulations  are  generally  adopted  under  the  general 
grant  of  sanitary  powers,  hut  in  Illinois  and  Michigan,  cities  and  vil- 
lages are  especially  authorized  to  make  rules  for  the  protection  of  their 
public  waters. 

A  consideration  of  the  existing  legislation  in  regard  to  river  pol- 
lution reveals  the  fact  that  in  this  country  there  has  as  yet  heen  none 
which  can  he  of  much  value  in  preventing  any  serious  pollution.  Such 
pollution  is  almost  always  due  to  the  discharge  of  sewage  and  manu- 
facturers' wastes,  and  it  may  well  be  believed  that  a  statute  must  be 
most  carefully  drawn  to  make  it  possible  to  bring  a  criminal  action  with 
any  degree  of  success.  Most  of  the  efforts  to  prevent  river  pollution 
by  legal  means  have  been  made  by  manufacturers  and  have  been  by 
suits  at  common  law.  and  occasionally  municipalities  have  proceeded, 
and  been  proceeded  against  under  the  same  common  law.  ■ 

Some  of  the  statutes  relating  to  state  boards  of  health,  as  those  of 
Massachusetts,  New  Jersey,  and  New  York,  provide  for  the  prevention 
of  future  pollution  by  requiring  the  approval  of  the  board  for  all  pro- 
jects of  sewerage  and  sewage  disposal. 

The  chief  sources  of  water  pollution  are  municipal  sewage  and 
manufacturers'  wastes.  In  the  case  of  the  Latter,  if  the  manufactories 
are  situated  within  reach  of  the  city  sewers  the  usual  method  is  to 
require  them  to  discharge  into  such  sewers,  ami  then  if  necessary  the 
whole  volume  of  sewage  is  treated  together.  Sometimes  it  is  advisable 
in  the  cases  of  certain  wastes  that  would  injure  or  clog  the  sewers,  and 
in  other  cases  when  sewers  are  not  available,  it  is  necessary  to  compel 
the  manufacturers  to  purify  their  wastes.  This  cannot  usually  be 
accomplished  by  a  simple  order  of  the  board  of  health,  tor  manufac- 
turers who  have  establishments  Large  enough  to  make  a  serious  nuisance 

of  this  kind  usually  base  money  enough  to  make  a  strong  Lega]  fight, 
and  a  Legal  fighl  of  sneb  importance  is  not  usually  entered  into  nnlos 
ordered  by  t be  council.  If  manufacturers  are  to  purify  their  wastes, 
they  must  in  general  follow  much  the  same  plans  thai  cities  do  in  the 
proper  disposal   of  their  sewage.     Therefore   the   prevention   of  water 


1  Neu  York,  Sanitary  Code  (1899) : 
Sec.   L96.     That  no  person,  persons,  company  or  corporal  ion  shall  < -a  use.  permit 
or  allow  any  sewage,  drainage,  factor]  refuse  or  anj  foul  or  offensive  !i<|ni<l  or  other 

material  to  Bow,  leak,  escaj r  !"■  emptied  or  discharged  into  the  waters  "f  any 

river,  stream,  canal,  harbor,  bay,  or  estuary,  or  into  the  sea  within  the  city  limits, 
excepting  under  low-water  mark,  and  in  such  manner  and  under  such  nni.iith.ns 
tliai  uo  nuisance  can  or  shall  be  caused  thereby  or  as  a  result  thereof.11 


300  WATER,    ICE,   AND    SEWERS. 

pollution  resolves  itself  into  the  question  of  applying  the  best  system 
of  sewage  disposal  and  selecting  a  system  which  will  cause  the  least 
nuisance.  The  health  officer  is  interested  in  using  his  influence  to 
secure  the  adoption  of  the  best  and  at  the  same  time  the  most  econom- 
ical method.  Sewage  disposal  is  primarily  a  subject  for  engineering 
consideration,  but  the  health  officer  should  be  able  to  co-operate  intel- 
ligently with  the  engineer  in  securing  popular  support  for  the  work 
that  needs  to  be  done. 

Disposal  by  Discharge  into  Large  Bodies  of  Water. 

If  sewage  is  discharged  into  a  large  enough  body  of  water  in  such 
manner  that  it  quickly  becomes  diffused  through  it,  it  is  so  gradually 
oxidized  as  not  to  give  rise  to  any  serious  offense.  .Many  of  our 
largest  cities  are  fortunately  so  situated  that  this  can  readily  be  done,  as- 
New  York,  Philadelphia,  St.  Louis,  and  New  Orleans.  Other  cities  have 
not  been  so  fortunately  situated,  but  have  had  to  construct  expensive 
works  to  carry  their  sewage  to  such  a  point  that  it  would  be  sufficiently 
diluted.  Among  such,  the  most  notable  is  Chicago,  which  by  its  drainage 
canal  discharges  its  sewage  ultimately  into  the  Mississippi.  Another 
city,  Boston,  was  obliged  to  construct  long  and  expensive  sewers  and  to 
erect  pumping  engines  to  carry  its  sewage  into  deep  water.  Providence 
built  an  intercepting  sewer  to  carry  its  sewage  to  deeper  water,  but  the 
result  was  not  satisfactory  as  there  was  not  volume  enough  for  dilution, 
and  other  methods  had  to  be  adopted  as  was  advised  by  the  engineers 
in  the  first  place. 

Broad  Irrigation. 

By  this  is  meant  the  discharge  of  sewage  on  to  the  surface  of  large 
areas  in  such  a  manner  as  to  secure  the  gathering  of  crops  of  forage,  or 
other  agricultural  products.  It  is  thought  by  those  not  acquainted  with 
the  subject  that  owing  to  the  produce  secured,  this  ought  to  be  the  must 
economical  method  of  sewage  disposal.  The  large  area  required,  which 
near  cities  is  usually  expensive,  the  cost  of  preparation  and  the  labor 
of  maintenance  make  it  probably  the  least  economical  method.  Even  if 
not  prohibited  by  the  expense,  most  cities  would  be  prevented  from 
adopting  this  method  because  sufficient  land  cannot  be  obtained  near  the 
city  at  any  price.  It  is  usually  estimated  that  an  acre  is  required  for 
every  1,000  of  the  population.  Broad  irrigation  has  been  adopted  at  only 
a  few  cities  in  this  country.  One  of  the  first  of  these  was  Pullman,  111., 
but  the  works  were  not  always  adequate  to  care  for  all  the  sewage. 
Other  places  where  it  is  employed  are  Plainfield  and  Princeton,  N.  J., 
Oberlin,  O.,  Lyons,  N.  Y.,  Los  Angeles  and  Pasadena,  Cal.,  and  Helena, 
Mont. 


WATER,    ICE,    AND    SEWERS. 


301 


302  WATER,    K'E    AND    s  EWE  lis. 

Intermittent  Filtration. 

It  has  been  found  that  if  sewage  is  passed  at  intervals  through  prop- 
erly prepared  soil,  it  will  be  purified  to  a  greater  or  lesser  degree,  depend- 
ing upon  the  care  that  the  process  receives.  It  is  necessary,  however,  that 
sufficient  time  should  be  given  between  the  applications  of  sewage  for  air 
to  penetrate  the  bed.  It  is  only  in  this  way  that  it  is  possible  to  preserve 
the  activity  of  the  bacteria  which  oxidize  the  organic  matter  in  the 
sewage.  Very  much  less  area  is  required  than  for  irrigation,  and  the 
operation  of  the  system  is  less  expensive.  The  study  of  the  principles 
underlying  the  purification  of  sewage  by  intermittent  filtration  have  been 
most  carefully  carried  on  at  the  experiment  station  of  the  Massachusetts 
state  board  of  health  at  Lawrence,  and  the  work  there  done  has  placed 
the  practice  on  a  sound  basis  of  fact.  This  method  of  purifying  sewage 
is  probably  more  popular  in  the  United  States  than  any  other. 

Among  examples  of  intermittent  filtration  are  the  works  at  South 
Framingham,  Marlboro,  Brockton,  and  fifteen  other  towns  in  Massa- 
chusetts, Pawtucket,  and  Woonsocket,  R.  I.,  and  at  Danbury,  and  Meri- 
den,  Conn. 

A  modification  of  intermittent  filtration  has  recently  been  put  in  prac- 
tice at  Willow  Grove,  near  Philadelphia.  The  system  was  originated 
by  Colonel  Waring.  The  sewage  is  first  run  through  a  strainer  which 
receives  about  3,000,000  gallons  per  acre,  and  is  then  run  on  to  a  coke 
filter  which  is  aerated  by  air  driven  forcibly  through  it.  It  is  claimed 
to  care  for  800,000  gallons  of  sewage  per  day  per  acre. 

At  Reading  and  Atlantic  City  a  unique  method  of  treatment  has 
been  applied  for  a  number  of  years.  The  filter  bed  is  raised  several  feet 
above  the  ground,  and  the  sewage  after  filtering  through  the  bed  drops 
in  a  sort  of  rain  onto  the  gutters  below.  By  thus  passing  through  the 
air  it  is  supposed  to  be  oxidized,  but  it  is  said  to  be  merely  strained  in 
the  filter,  and  deodorized  below.     This  is  the  so-called  West  system. 

The  Septic  Tank. 

Quite  recently  a  new  method  of  sewage  disposal  has  been  much  dis- 
cussed and  to  some  extent,  utilized.  This  is  the  septic  tank  in  which 
the  sewage  is  allowed  to  rest,  and  be  subjected  to  the  oxidizing  action 
of  microbes.  It  may  be  used  alone  or  as  an  aid  to  intermittent  filtra- 
tion.     One  is  in  operation  at  Pawtucket,  R.  I. 

Chemical  Precipitation. 

The  application  of  chemicals  to  sewage,  sometimes  lime,  but  more 
often  salts  of  aluminum,  causes  a  coagulation  of  some  of  the  dissolved 
organic  matter  which  precipitates  and  carries  the  suspended  matter 
down  witli  it.     After  settling,  the  supernatant  clear  liquid  is  allowed  to 


ill  TE1L    I<  K    .  1  NB    S  E  WEE  \ 


303 


304  WATER,   ICE,   AND    SEWERS. 

flow  away,  and  the  precipitated  "  sludge  "  is  pumped  into  presses  and 
pressed  into  a  cake,  which  may  be  used  as  a  fertilizer,  burned,  or  used 
for  filling,  or  transported  to  sea.  This  method  of  treating  sewage  was 
adopted  at  Coney  Island,  Orange,  N.  J.,  the  World's  Fair  Grounds  in 
Chicago,  Worcester,  Providence,  Ilion,  N.  Y.,  Alt.  Vernon,  N.  Y.,  Chau- 
tauqua, N.  Y. 

Statutes  Consulted  in  the  Preparation  of  this  Chapter. 


California.     Criminal  Code  (1886),  Sees.  1357,  1376. 
Connecticut.     General  Statutes  (1888),  Sees.  2652-5. 

Chapters  28  and  203  of  1895. 
Delaware.     Revised  Code  (1893),  p.  926,  (Delaware  Laws,  Vol.  12,  Chapter  405.) 
Illinois.     Annotated   Statutes  (1896),  Chapter  38,  Sees.  369,  (2),  (3);  Chapter  24, 

Art.  10,  Sec.  2. 
Indiana.     Statutes  (1897),  Sees.  2017,  2195. 
Iowa.     Code  (1897),  Sec.  4979. 

Kansas.     General  Statutes  (1897),  Chapter  100,  Sees.  338-9. 
Kentucky.     Statutes  (1894),  Sec.  1278. 
Maine.     Chapter  82  of  1891. 

Maryland.     Public  General  Laws  (1888),  Vol.  I.,  p.  550,  Sec.  277. 
Massachusetts.     Public  Statutes  (1882),  Chapter  80,  Sees.  96-7,  101-2. 

Chapter  208,  Sees.  7-8. 

Chapter  172  of  1884. 

Chapter  274  of  1886. 

Chapter  160  and  375  of  1888. 
Michigan.     Compiled  Laws  (1897),  Sec.  11432. 
Minnesota.     Statutes  (1894),  Sees.  430-1,  6642. 
New  Hampshire.     Public  Statutes  (1891),  Chapter  108,  Sees.  13-15. 

Act  of  28  March,  1895. 
New  Jersey.     General  Statutes  (1895),  p.  1644,  Sec.  49,  (XII),  pp.  1107,  1109,  2215. 
New  York.     Revised  Statutes  (1895),  p.  2437,  Sees.  70-72d. 
North  Carolina.     Act  of  1  March,  1893,  Sees.  18-21. 
Ohio.     Annotated  Statutes  (1900),  Sees.  409(-26),  6921,  6923,  6925. 
Oregon.     Annotated  Laws  (1892),  Sec.  198. 
Tennessee.     Code  (1896),  Sec.  6869. 
Virginia.     Code  (1887),  Sec.  3812. 

Chapter  460  of  1892. 
West  Virginia.     Code  (1899),  Chapter  150,  Sec.  20b  and  c. 

Ice. 

Illinois.     Act  of  24  April,  1899,  Sec.  18. 

Massachusetts.     Chapter  287  of  1886  and  338  of  1895. 

New  Hampshire.      Acts  of  25  March  and  28  March,  1895. 

New  Jersey.     Revised  Statutes  (1895),  pp.  1650,  Sees.  87-90,  1695. 

Wisconsin.     Statutes  (1898),  Sec.  4607k. 


WATER,    /'A'.    AND    SEWERS. 


3(»5 


CHAPTER   VII. 

FOOD  OTHER  THAN  DAIRY  PRODUCTS. 

THE  consumption  of  adulterated  or  decayed  food  and  drink  is  popu- 
larly supposed  to  be  a  common  cause  of  ill  health,  and  the  pre- 
vention of  the  sale  and  use  of  such  is  considered  to  be  one  of  the  proper 
sanitary  functions  of  the  state.  There  seems  to  be  abundant  evidence 
that  adulterated,  infected,  and  impure  milk  and  milk  that  is  approach- 
ing', though  it  may  not  have  reached  the  stage  of  "  souring,"  is  most 
harmful,  particularly  to  young  children  of  whose  diet  it  forms  a  large 
part.  Rut  with  the  exception  of  what  has  been  proved  in  regard  to 
milk,  we  do  not  know  so  very  much  about  the  unwholesome  character 
of  food  adulteration  or  the  disease  producing  qualities  of  food  nearing, 
or  even  actually  undergoing  putrefactive  changes.  The  use  of  poison- 
ous substances,  as  the  salts  of  lead,  arsenic,  copper,  etc.,  in  coloring 
matters,  or  the  addition  of  indigestible  substances  like  "  terra  alba,"  or 
the  presence  of  infectious  material  capable  of  transmission  to  man  as 
trichina?,  are  of  course  recognized  as  dangerous ;  but  the  more  common 
adulterants,  like  glucose  in  sugars  and  molasses,  inert  substances  in  the 
spices  and  condiments,  chickory  in  coffee,  the  use  of  the  cheaper  fats, 
like  cottonseed  oil  and  tallow  in  lard  and  butter,  or  of  water  in  wines 
and  liquors,  probably  have  little  or  no  injurious  effect  upon  health,  and 
perhaps  may  even  sometimes  be  an  advantage.  So,  too,  in  regard  to 
stale  and  partially  decayed  food,  we  are  as  yet  very  much  in  the  dark 
as  to  what  is  and  what  is  not  really  unwholesome.  There  is,  it  is  true, 
plenty  of  evidence  of  the  occasional  formation  of  poisonous  ptomaines 
or  similar  substances  in  putrefying  food,  and  it  is  a  very  common  notion 
among  physicians  that  the  "  summer  complaints,"  as  they  are  called, 
are  due  to  the  eating  of  more  or  less  stale  food  containing  pathogenic 
bacteria  or  other  organisms.  Yet  we  are  after  all  very  uncertain  as  to 
the  exact  conditions  necessary  to  render  stale  food  unwholesome,  and 
we  know  that  large  quantities  of  stale  fermenting  and  putrefying  food 
are  eaten  with  impunity,  and  often  by  preference.  The  question  of  the 
harmfulness  of  eating  the  flesh  of  immature  or  diseased  animals  is  also 
not  fully  answered.  In  making  these  observations  it  is  not  meant  to 
deny  the  importance  of  the  subject,  for  it  is  a  very  important  one, 
but  the  writer  would  urge  its  further  study  and  meanwhile  the  exercise 


FOOD    OTHER    THAX  DAIRY  PRODUCTS.  307 

of  great  care  in  asserting  the  harmf illness  of  any  particular  food  sub- 
stance. 

In  the  light  of  our  present  knowledge  it  appears  that  the  condition 
of  food  sold,  with  a  few  important  exceptions,  is  an  economic  rather 
than  a  sanitary  affair.  Nevertheless,  there  are  reasons  why  the  control 
of  food  supplies  should  be  hi  the  hands  of  the  sanitary  authority. 
While  many,  perhaps  most  adulterants  are  harmless,  some  are  certainly 
not  so,  and  that  reason  and  the  fact  that  at  present  we  cannot  always 
draw  a  sharp  line  between  the  harmless  and  harmful  would  logically 
yest  their  control  with  the  health  department.  This  department  is 
more  often  perhaps  than  any  other,  able  to  deal  with  scientific  problems, 
and  the  analysis  and  examination  of  food  present  such  problems.  A 
municipal  laboratory  is  probably  best  administered  by  the  sanitary  de- 
partment. In  the  sphere  of  state  action  the  board  of  health  is  often 
well  equipped  for  this  work,  though  the  department  of  agriculture,  state 
experiment  station,  or  state  uniyersity,  where  such  are  established,  may 
be  the  best  agents  for  such  investigations.  A  disadvantage  of  having 
the  control  of  foods  in  the  hands  of  the  local  health  authorities  is  that 
on  that  account,  both  by  them  and  by  the  public  the  sanitary  phase  of 
the  work  is  made  unduly  prominent,  whereas  its  economic  bearings  are 
really  the  most  important.  What  lias  been  said  of  food  in  general  does 
not  apply  to  milk.  The  chemical  and  bacteriological  purity  of  milk  is 
of  prime  sanitary  importance,  and  its  control  lias  in  practice  hitherto 
almost  always  proved  best  in  the  hands  of  the  local  board  of  health. 
The  consideration  of  milk  will  be  deferred  to  the  succeeding  chapter, 
and  we  will  now  occupy  ourselyes  with  the  consideration  of  the  adul- 
terations and  other  possibly  unwholesome  conditions  of  other  food  sub- 
Stances. 

There  are  great  differences  in  food  laws  and  in  their  administration. 
The  control  of  food  substances  as  regards  both  legislation  and  execution 
is  sometimes  national,  sometimes  state,  and  sometimes  municipal.  The 
federal  government,  by  virtue  of  its  authority  to  control  interstate  ami 
foreign  commerce,  has  legislated  concerning  the  wholesomeness  and 
purity  of  food  supplies  and  has  a  large  force  of  inspectors  constantly  at 

work.     The  chief  held  covered   by  the  federal  officers  is  the  inspection 

of  cattle    intended    for  slaughter,  and    also  .if    the  various  products  sent 

out  Er tiie  slaughter-houses. 

Much  of  the  legislation,  especially  that  concerning  adulterations,  is 
state  Legislation,  and  the  execution  of  these  laws  is  vested  in  state  offi- 
cers. The  execution  of  milk  laws  i>  more  often  in  the  hands  of  local 
boards  of  health.  As  regards  the  use  of  food  from  diseased  animals 
state  laws  are  common  and  state  inspection  also.     Local  regulations  are 


308         FOOD    OTHER    THAN  DAIRY  PRODUCTS. 

of  course  found  on  all  of  these  subjects,  but  the  special  field  of  local 
legislation  is  the  control  of  the  sale  of  foods  which  are  undergoing 
putrefactive^changes.  Putrefaction  in  this  connection  of  course  is  not 
confined  to  its  popular  use,  but  embraces  any  of  those  degenerative 
changes  which  are  produced  by  the  action  of  saprophytic  organisms, 
though  the5 material  may  not  have  become  actually  rotten.  The  in- 
spection of  food  to  determine  whether  it  is  fresh  enough  for  use,  and 
the  seizure  of  such  that  has  passed  the  limit,  is  usually  the  function 
of  the  local  board  of  health,  and  the  rules  regulating  this  are  local 
rules. 

Unwholesome  Food. 

Some  of  the  earliest  legislation  in  regard  to  food  was  of  a  very  gen- 
eral character,  and  similar  laws  are  to-day  found  on  the  statute  books 
of  most  of  the  states.     In  1784  Massachusetts1  enacted  the  following: 

tl  If  any  person  shall  sell  any  such  diseased,  corrupted,  contagious,  or  unwhole- 
some provisions,  whether  for  meat  or  drink,  knowing  the  same  without  making  it 
known  to  the  huyer.     .     .     ." 

The  law  as  modified  by  subsequent  amendments  now  stands  on  the 
statute  books  as  follows : 

"  Whoever  knowingly  sells  any  kind  of  diseased,  corrupted,  or  unwholesome 
provisions,  whether  for  meat  or  drink,  without  making  the  same  fully  known  to  the 
huyer,  shall  be  punished  by  imprisonment  in  the  jail  not  exceeding  six  months,  or 
by  tine  not  exceeding  two  hundred  dollars."2 

This  has  been  copied  verbatim  by  at  least  ten  states,  Colorado,  Iowa, 
Kansas,  Maine,  Michigan,  Oregon,  South  Dakota,  Virginia,  West  Vir- 
ginia, and  Wisconsin,  and  in  Ohio,  Oklahoma,  and  by  Rhode  Island 
with  the  addition  of  the  word  adulterated.  It  also  appears  in  the  local 
legislation  of  several  cities. 

California,  Montana,  and  South  Dakota  have  the  provisions  shown 
below.3 

A  number  of  other  states  and  cities  have  laws  which  while  the  ex- 
act phraseology  of  the  Massachusetts  statute  is  not  adopted,  yet  attempt 
to  cover  the  same  ground  in  the  same  general  way.  These  laws  are 
sometimes  a  little  more  explicit  as  to   what  are  the   "  provisions,"  the 


1  Massachusetts,  Chapter  50  of  1784. 

2  Massachusetts,  Public  Statutes  (1882),  Chapter  208,  Sec.  1. 
a  California,  Penal  Code  (1886),  Sec.  383: 

"  Every  person  who  knowingly  sells,  or  keeps,  or  offers  for  sale,  or  otherwise 
disposes  of  any  article  of  food,  drink,  drug  or  medicine,  knowing  that  the  same  lias 
become  tainted,  decayed,  spoiled,  or  otherwise  unwholesome  or  unfit  to  be  eaten  or 
drunk,  with  intent  to  permit  the  same  to  be  eaten  or  drunk,  is  guilty  of  a  misde- 
meanor.11 


FOOD    OTHER    THAW  DAIRY  PRODUCTS.  309 

sale  of  which  is  to  be  regulated.  Thus  in  Maryland1  it  is  "unwhole- 
some provisions  such  as  poultry,  game,  flesh  or  preparation  of  flesh, 
fruits,  vegetables,  bread,  flour,  meal,  milk  or  other  things  intended  to 
be  used  for  human  food."  Fish  and  eggs  are  included  in  many  laws, 
and  sometimes  nuts. 

The  conditions  that  render  the  provisions  unwholesome  are  also 
specified  to  some  extent.  Thus  in  Ohio  and  Rhode  Island  the  word 
adulterated  is  added  to  the  law.  In  Louisiana  food  must  not  be 
"  tainted "  or  "  in  a  condition  of  decomposition  or  unfit  for  food." 
Stale,  impure,  putrid,  sour,  slimy,  diseased,  unhealthy,  emaciated,  un- 
sound, from  animals  that  have  died  or  are  too  young,  not  being  fresh  or 
properly  preserved,  are  expressions  frequently  used. 

The  following  rule,  or  one  substantially  like  it,  is  found  in  Buffalo, 
Bridgeport,  Cincinnati,  Cleveland,  Memphis,  Newark,  New  York,  and 
Rochester: 

"That  no  cased,  blown,  plaited,  raised,  stuffed,  putrid,  impure  or  unhealthy  or 
unwholesome  meat  or  fish,  bird  or  fowl  shall  beheld,  bought  <>v  Mild  or  offered  for 
sale  for  human  food,  or  held  or  kept  in  any  market,  public  or  private,  or  any  public 
place  in  said  city."'2 

Besides  the  regulations  which  have  just  been  considered  and  which 
are  of  a  rather  general  character,  there  are  numerous  rules  found  mostly 
in  municipal  codes  which  are  intended  to  apply  to  special  conditions  or 
particular  kinds  of  food. 

Diseased   Food. 

Food  from  animals  which  are  diseased  at  the  time  of  killing  Is 
assumed  to  be  unwholesome.  In  many  instances  this  is  without  doubt 
the  case.  The  flesh  from  animals  suffering  from  trichinosis  is  quite 
likely  to  produce  the  disease  if  eaten  without  thorough  cooking,  and 
the  meal  of  tuberculous  animals  and  those  afflicted  with  aetininiycosis 
is  often  dangerously  infected.  Other  diseases  we  know-  less  about,  but 
it  is  perhaps  a  not  unreasonable  safeguard  to  require   that    no  material 

from  diseased  animals  shall  be  offered  as  food.     When,  as  is  so  conn i 

in  genera]  laws  on  this  subject,  the  sale  of  "diseased  "'  provisions  is  for- 
bidden, it  may  be  assumed  thai  food  from  diseased  animals  is  meant. 
Sometimes,  however,  this  meaning  is  made  (dear  in  the  law.  Thus  in 
Louisiana8  it  is  enacted  ••  Thai  it  shall  be  unlawful  for  any  person  or 
persons  to  slaughter  for  food  and  offer  for  sale  an\  cattle,  hogs  or 
sheep  the  same  being  in  an  unhealthy  condition.'"     A  similar  provision 


1  Maryland,  Chapter  804  ox  L890,  Sec.  52. 
New  York  City  Similar;  Code  I  1899),  S( 
Louisiana,  A-  I  of  3  Mar<  h,  L880,  Sec.  8. 


310  FOOD    OTHER    THAN  DAIRY  PRODUCTS. 

is  found  in   Indiana,  Kentucky,  Maine,  Missouri,   Nebraska  and  Penn- 
sylvania cities  of  the  second  class.1     In  St.  Louis  :  2 

"Any  person  .  .  .  who  shall  sell  .  .  .  meats  from  any  cattle,  hogs, 
sheep  or  calves  that  were  unsound,  sick  or  diseased  or  out  of  condition  at  the  time 
they  were  slaughtered  shall  be  guilty  of  a  misdemeanor    .     .     ." 

In  Iowa  it  is  unlawful  to  buy,  sell  or  give  away  diseased  swine.3 
In  Minnesota4  it  is  unlawful  to  use  any  part  of  a  diseased  animal  for 
the  preparation  of  food  and  its  use  for  other  purposes  must  be  licensed 
by  the  state  board  of  health. 

It  is  usually  in  these  rules  provided  that  all  sickly  animals  shall  be 
reported  to  the  board  of  health.  Much  of  the  legislation  concerning 
contagious  diseases  of  animals  has  reference  to  the  prevention  of  the 
use  for  food  and  the  proper  disposition  of  all  animals  suffering  from 
these  diseases.  Then  again  the  Federal  inspection  of  animals  is  in- 
tended to  prevent  the  slaughter  for  food  of  all  diseased  animals  so  that 
much,  perhaps  most,  of  the  control  of  "  diseased  "  food  depends  upon 
other  means  than  food  laws  proper. 

Food  from    Over-heated  and  Feverish  Animals. 

Animals  become  feverish  from  driving  or  transportation,  and  many 
cities  forbid  their  being  slaughtered  under  such  conditions.  Such  a 
regulation  is  found  in  Atlanta,  Bridgeport,  Chicago,  Elmira,  Memphis, 
the  City  of  New  York,  Yonkers,  and  other  cities,  and  in  Paterson  it  is 
added  that  they  shall  not  be  slaughtered  until  twenty-four  hours  after 
unloading.  The  New  Orleans  ordinance  forbids  the  use  of  food  from 
animals  "  run  down  by  dogs." 

Wounded  Animals  Not  to  be    Used  for  Food. 

Indiana  and  a  number  of  cities,  as  Atlanta,  New  Orleans,  and  Penn- 
sylvania cities  of  the  second  class,  forbid  the  use  of  maimed  or  wounded 
animals  as  food.  The  following  is  the  regulation  in  Atlanta  and  is 
very  specific  in  many  other  respects  as  well  as  in  regard  to  wounded 
animals : 

"  That  no  animals  or  fish  that  died  by  disease  or  accident,  no  carcass  of  any  calf, 
pig  or  lamb,  which,  at  the  time  of  being  killed  was  less  than  six  weeks  old,  and  no 
meat  therefrom,  nor  any  animal,  nor  meat  therefrom,  killed  while  feverish,  bruised, 
disabled,  injured  with  broken  limbs,  or  otherwise;  heavy  with  young,  jaded  or 
fatigued  from  long  driving  or  shipping,  shall  be  used  as  food."  5 


1  Pennsylvania,  Chapter  258  of  1895,  Sec.  13. 

2  St.  Louis,  Ordinances  (1893),  Chapter  14,  Sec.  359. 
s  Iowa,  Chapter  113  of  1898. 

4  Minnesota,  Cliapter  175  of  1899. 

5  Atlanta,  Regulations  of  Board  of  Health,  Sec.  101. 


FOOD    OTHER    1HAJST  DAIRY  PRODUCTS.  311 

Pregnant  Animals  Not  to  be    Used  for  Food. 

In  Atlanta,  as  above,  and  also  in  Cincinnati,  it  is  forbidden  to  use 
the  flesh  of  pregnant  animals  for  food. 

Food  from  Emaciated  Animals. 

In  Bridgeport,  Chicago,  New  York,  and  Pennsylvania  cities  of  the 
second  class,  it  is  forbidden  to  slaughter  or  use  the  food  from  "  meagre  " 
or  "  emaciated  "  or  "  famished  "  animals. 

Food  from  Dead  Animals. 

It  is  very  common  to  forbid  the  sale  of  meat  of  animals  that  have 
died,  either  from  disease  or  accident.  Such  a  regulation  is  found  in 
Albany,  Atlanta,  Augusta,  Ga.,  Camden,  Chicago,  Minneapolis,  New- 
burgh,  New  Orleans,  New  York,  Paterson,  Utica,  and  Yonkers.  The 
following  are  the  words  of  the  New  Orleans  ordinance  : 2 

••  No  person  shall  sell  .  .  .  the  flesh  of  any  animal  which  died  from  disease, 
accident,  or  casualty  or  other  means  than  the  usual  manner  of  slaughtering  animals 
for  food/' 

In  Chicago2  it  is  forbidden  to  carry  the  carcass  of  a  dead  animal 
within  the  precints  of  any  slaughter-house  in  the  city ;  and  in  Buffalo3 
it  is  the  duty  of  the  cattle  inspector  that 

"  He  shall  immediately  notify  the  owner,  agent  or  consignee  of  any  dead  cattle, 
hogs,  sheep  or  lambs  that  may  arrive  in  the  city  of  Buffalo,  to  take  the  same  to  some 

b< yard  within  one  hour  after  the  train  upon  which  they  arrive  is  unloaded.     In 

case  any  such  owner,  agent  or  consignee  shall  refuse  or  neglect  to  so  take  the  same 
within  the  time  herein  prescribed,  it  shall  be  the  duty  of  the  inspector,  and  he  shall 
have  power,  to  forthwith  remove  the  same  to  some  bone-yard  and  dispose  of  the 
same  to  the  best  advantage.1' 

Animals  must  be  Bled,  Cleaned,  and  Cooled. 

All  large  animals  must  be  so  treated  before  they  can  be  ottered  for 
Bale  according  to  the  rules  of  Chicago,  Denver,  Memphis,  Minneapolis, 
Omaha,  and  New  York.  The  following  is  the  rule  in  New  York  and 
has  been  copied  very  generally  bythe  other  cities  mentioned  : 

"Thai  oo  meal  or  dead  animal  above  the  size  of  a  rabbit  shall  be  taken  to  any 
public  or  private  markel  for  food,  until  the  same  shall  have  fully  cooled  after  kill- 
ing, nor  until  the  entrails,  heads,  and  feet  (ezcepl  of  poultry  and  game,  and  except 
the  head  and  feet  of  swine)  shall  have  been  removed."  4 

1  N.'w  Orleans,  Ordinance  No.  U56,  C.  S.,  as  amended  by  Ordinance  4274,  5917, 
and  0691,  Sec.  L3. 

'Chicago,  Ordinance  of  I  January,  is'.»7,  Sec.  I. 
Buffalo,  Ordinances  (1897),  Chapter  26,  s.'".  108. 
\.  u  Xork,  Sanitary  Code  |  L899),  s''<-.  17. 


312  FOOD    OTHER    THAN  DAIRY  PRODUCTS. 

Side  of   Undrawn  Poultry. 

The  question  as  to  whether  poultry  should  be  sold  without  having 
the  viscera  removed  has  been  much  discussed.  If  the  entrails  remain 
the  odors  and  taste  from  the  offensive  matter  in  the  gut  are  absorbed 
by  the  surrounding  tissues  which  are  therefore  more  or  less  disagreeable 
to  the  consumer.  On  the  other  hand  it  is  claimed  by  the  dealers,  decom- 
position of  the  muscular  tissue  takes  place  sooner  when  the  viscera  are 
removed.  The  consumer  then  would  naturally  prefer  that  the  poultry 
be  promptly  drawn,  while  the  dealers  prefer  that  they  should  not  be,  as 
they  thus  keep  longer  in  a  saleable  condition.  The  Massachusetts  law 
requires  that  they  shall  be  drawn,  but  in  Boston  at  least  it  is  a  dead 
letter.1  In  Minnesota2  plucked  poultry,  and  game,  and  rabbits  must  be 
drawn.  A  similar  rule  is  found  in  Cincinnati,  Buffalo,  and  Erie.  In 
Detroit  the  crops  of  poultry  must  be  removed  before  they  are  sold. 

Blown   Veal  and  Mutton. 

The  practice  of  blowing  carcasses  i.  e.,  injecting  air  under  the  super- 
ficial fascia,  is  resorted  to  to  a  considerable  extent  in  order  that  the 
meat  shall  present  a  better  appearance,  as  the  air  in  the  tissues  makes 
it  look  like  fat.  It  is  a  reprehensible  practice  as  it  is  in  the  nature  of  a 
fraud,  and  furthermore  it  is  not  desirable  to  have  saliva  from  a  butcher 
injected  into  the  animal  through  a  dirty  pipe  stem ;  an  accident  which 
doubtless  sometimes  occurs.  Hence  in  a  number  of  cities  mentioned  on 
page  306  the  sale  of  meat  so  treated  is  forbidden  by  a  rule  there  given. 
It  is  also  the  rule  in  Cleveland,  and  the  superintendent  of  markets  is 
directed  to  see  that  it  is  strictly  enforced.  In  New  Orleans3  it  is  pro- 
vided that  the  carcasses  shall  only  be  blown  by  means  of  a  bellows  and 
that  no  animals  over  fifteen  months  of  age  shall  be  blown  at  all.  The 
practice  in  that  city  is  to  ship  calves  to  market  blown  and  with  the 
hides  on.  They  present  a  bloated  and  disgusting  appearance  and  the 
inspector  in  that  city  is  decidedly  of  the  opinion  that  blowing  should 
be  forbidden.  It  is  the  opinion  of  the  inspector  that  blowing  hastens 
decomposition  and  it  is  likely  that  this  is  so,  as,  if  bellows  are  used, 
the  air  pumped  in  must  carry  many  micro-organisms  directly  into  the 
tissues. 


1  Massachusetts,  Chapter  94  of  1887: 

"No  poultry,  except  it  be  alive,  shall  be  sold  or  exposed  for  sale  until  it  has  been 
properly  dressed,  by  the  removal  of  the  crop  and  entrails  when  containing  food." 

2  Minnesota,  Chapter  211  of  189.",. 

3  New  Orleans,  Ordinances,  No.  421  C.  S.,  adopted  28  August,  1883. 


FOOD    OTHER    THAN  DAIRY  PRODUCTS.  313 

Food  from  Immature  Animals. 

It  is  generally  assumed  that  the  flesh  of  immature  animals  is  neither 
as  wholesome  or  nutritious  as  that  of  adults,  and  that  the  flesh  of  very 
young  animals  is  often  positively  injurious.     However  the  facts  may  be, 
there  is  a  very  general  attempt  to  forbid  the  sale  of  such  in  the  United 
States.     General  provisions  that  immature  animals  shall  not  be  used  for 
food  are  sometimes  found  as  in  Pennsylvania  cities  of  the  second  class  : l 
but  usually  such  regulations  are  of  a  specific  character  and  state  definitely 
the    age   limit  of  the  animals.     The  animals   usually   referred   to,    are 
calves,  pigs,  and  lambs.     There  is  not   very  much   temptation   to  send 
young  lambs  to  market,  neither  is  the  demand  for  young  pigs  very 
great.     By  far  the  most  important  traffic  in  young  animals  is  in  calves. 
Veal  is  a  popular  article  of  food,  and  it  is  not  considered  profitable  by 
dairymen  to  keep  the  calves  any  longer  than  is  necessary.     The  demand 
for  the  milk  of  the  cow  leads  them  to  dispose  of  the  calf  at  the  earliest 
moment.     Hence  a  very  large  number  of  young  calves  are  thrown  upon 
the  market.     To   prevent  the  sale  of  such  immature  animals  for  food, 
statutes  are  found  in  several  states  and  local  regulations  in  many  cities.2 
Nunc    of  the   statutes   except    that  of   Vermont,    refer    to    any   animal 
Other  than  calves,  but  nearly  all  of  the  local  rules  including  those  of 
cities  in    the   states   mentioned    include  calves,   lambs,  and  pigs.     The 
Limit  prescribed  for  the  different  animals  is  in  almost  all  cases  for 
calves,  four  weeks;  for  pigs,  five  weeks;  for  lambs,  eight  weeks.      The 
exceptions    are  two  weeks   for  calves  in  Portland.  Ore.,    three  weeks  in 
Pennsylvania,  one  month   in    Buffalo,  five  weeks  in   Hartford,  and   six 
weeks  in  Missouri,  Atlanta,  and   Spokane,  but  according  to  a  statement 
in  -.Municipality  and   County."'  Vol.  :'>.  page  161,   "As  a  matter  of  pre- 
cedent and    standard,  calves  weighing   less   than    fortj    to  sixty    pounds 
and    under  six  weeks,  are   in    Buffalo  unconditionally  condemned,"   by 
the   slaughter-house  inspectors.      In   New   York   the  duty  of  enforcing 
the   law  is  placed   upon  the   commissioner  of  agriculture,  and  it  is   for- 
bidden to  transport  veal    without  a  tag.      For  pigs  the  time  is  in    Scran- 
ton,  three  weeks;   New  Orleans,  Cincinnati,  and  Qtica,  four  weeks ;   and 
in  Atlanta  and   Spokane,  six  weeks.     In   addition  to  the  time   limit  the 
ordinance  in   Rochester  requires  thai  a  veal  shall  weigh  at  least  seventy 
pounds,  and   in  New  York  City  forty-five  pounds.     In  the  enforcement 


1  Pennsylvania,  Chapter  258  01  1895,  Sec.  18. 

Indiana,    Maim-.    Massachusetts,    Missouri,    x>  u    Fork,    Ohio,  Oregon,    Penn- 

s>  Ivania,  and  Rhode  Islam!  all  have  laws  upon  this  subject,  and  manj  cities  outside 

ol  these  states  may  be  mentioned  as  Atlanta,  Bridgeport,  Buffalo,  Camden,  Chicago, 

Denver,  Erie,  Hartford,  Minneapolis,  Newark,  New  Orleans,  Omaha,  and   Paterson. 


314  FOOD    OTHER    THAN  DAIRY  PRODUCTS. 

of  these   laws,  the  question  as  to  whether  an  individual  veal  is  of  the 

age  required  is  to  be  settled  by  the  judgment  of  the  inspector  or  other 

witnesses.     To   arrive   at  a  correct  conclusion  is  not  always  an  easy 

matter,  and  if  a  weight  limit  was  fixed  by  law  probably  the  laws  could 

be  better  enforced.     In  some   cities  the  inspectors  fix  a  weight  limit 

which  shall  be  the  guide  for  their  judgment  as  to  whether  a  particular 

carcass  is  under  age  or  not. 

The  best  of  the  state  laws  is  that  of  Rhode  Island :  1 

"  Every  person  who  shall  kill,  or  cause  to  be  killed,  for  the  purpose  of  sale,  any 
calf  less  than  four  weeks  old,  or  shall  sell,  or  have  in  his  possession  with  intent  to 
sell,  the  flesh  of  any  calf  which  he  knows  to  have  been  killed  when  less  than  four 
weeks  old,  shall  be  fined  not  exceeding  twenty  dollars." 

The  Maine,  Massachusetts,  and  Ohio  laws  insert  the  word  know- 
ingly, thus  making  proof  of  violation  more  difficult.  This,  however, 
does  not  apply  to  the  killing,  but  only  to  the  selling,  thus  rendering  it 
easier  to  convict  of  the  former  than  of  the  latter  offence.  The  Mas- 
sachusetts law  is,  however,  superior  in  this  respect,  that  it  provides  for 
inspection  and  seizure  :  2 

"Said  inspectors  may  inspect  all  veal  found  in  said  cities  or  towns  or  offered  or 
exposed  for  sale  or  kept  with  intent  to  sell  therein,  and  if  said  veal  is,  in  the  judg- 
ment of  the  inspector,  that  of  a  calf  killed  under  four  weeks  old,  he  shall  seize  the 
same  and  cause  it  to  be  destroyed  or  disposed  of  as  provided  in  the  preceding  sec- 
tion, subject,  however,  to  the  provisions  therein  contained  concerning  appeal  and 
the  disposal  of  moneys.'" 

Cleanliness  of  Markets. 

It  is  highly  desirable  that  markets  should  be  kept  in  as  neat  and 
clean  condition  as  possible.  ^Esthetic  reasons  alone  are  sufficiently 
weighty  to  require  this ;  but  there  are  other  reasons  more  imperative. 
Provisions,  especially  meat,  fish,  milk  and  dairy  products,  very  readily 
become  dirty  and  are  not  readily  cleaned.  They  easily  become  infected. 
Putrefaction  which  it  is  desirable  from  every  point  of  view  to  prevent 
or  put  off  as  long  as  possible  is  hastened  by  exposure  to  filth.  Hence 
regulations  have  been  adopted  in  many  cities  to  secure  greater  cleanliness 
in  markets.  Below3  are  the  rules  which  have  been  adopted  in  Chicago 
and  Atlanta. 

i  Rhode  Island  General  Statutes  (1896),  Chapter  282,  Sec.  3. 

2  Massachusetts,  Public  Statutes  (1882),  Chapter  58,  Sec.  3. 

3  Chicago,  Ordinances  (1881),  Sec.  1405: 

"  That  every  person  being  the  owner,  lessee,  or  occupant  of  any  room,  stall  or 
place  where  any  meat,  fish  or  vegetables  designed  or  held  for  human  food  shall  be 
stored  or  kept,  or  shall  be  held  or  offered  for  sale,  shall  put  and  keep  such  room, 
stall  and  place  and  its  appurtenances  in  a  clean  and  wholesome  condition;  and  every 
person  having  charge,  or  being  interested,  or  engaged  whether  as  principal  or  agent, 
in  the  care,  or  in  respect  to  the  custody  or  sale  of  any  meat,  fish,  birds,  fowl  or 
vegetables  designed  for  human  food,  shall  put  and  preserve  the  same  in  a  clean  and 


FOOD    0 THER    TH AX  DAIR  Y  PR OD UC Ts.  3 1 5 

In  New  Orleans1  each  market  stall  must  be  provided  with  a  covered 

garbage  barrel  in  which  all  refuse  must  be  placed  and  none  thrown  on 

the  floor ;  and  2 

"  During  the  half  hour  immediately  after  the  closing  of  said  market  butchers  or 
other  persons  hiring  or  occupying  their  respective  stalls,  stands  and  tables  shall  be 
bound  to  scrape,  wash  and  cleanse  the  same,  so  as  to  keep  the  said  stalls,  stands  and 
tables  in  the  highest  state  of  cleanliness,  and  every  person  neglecting  to  comply 
punctually  with  the  terms  and  conditions  of  this  section,  or  who  shall  not  quit  the 
said  market  at  the  hour  specified,  shall  be  subject  to  the  penalties  stipulated  in  sec- 
tion 32  of  this  ordinance.11 

Iii  Cincinnati  fish  must  not  be  cleaned  in   a  market.     The  follow- 
ing is  the  rule  in  Asbury  Park8  in  regard  to  fish  markets  : 

"All  portions  of  the  floor,  and  the  side  walls  to  a  height  of  three  feet  above  the 
floor  of  every  store,  market  or  apartment  where  fish  or  shellfish  or  other  substance 
subject  to  rapid  decay  is  held  for  sale  or  stored  shall  be  constructed  of  tiling,  flag- 
ging stone  or  cement  concrete,  and  be  made  water  tight.  All  such  floors  shall  be 
properly  graded  and  drained,  and  all  offal,  refuse  and  unwholesome  or  offensive 
matter  shall  be  removed  therefrom  at  least  once  in  every  twenty-four  hours,  and  said 
floors  and  side  walls  shall  at  all  times  be  kept  clean  and  free  from  offensive  odors.11 

Iii  New  York  and  Chicago  it  is  forbidden  to  slaughter  any  animals 

in  a  market;  and  in  many  other  cities,  and  indeed  in  these  cities,  the 

same  end  is  accomplished  by  the  regulations  governing  slaughter-houses 

and   slaughtering;  but  "animal''  in  this  connection  is  not  assumed  to 

include  poultry.     The  killing  of  poultry  in  markets  is  also  forbidden  in 

some  cities,  as  Newark4  and  Boston. 


wholesome  condition,  and  shall  not  allow  the  same  or  any  part  thereof  to  be  poi- 
soned, infected,  or  rendered  unsafe  or  unwholesome  for  human  food.11 
Atlanta,  Rules  and  Regulations  of  Board  of  Health,  Sec.  101: 
■•  Nil  animal  shall  be  .  .  .  killed  or  kept  in  same  building,  or  in  so  close  prox- 
imity with  fumes  of  gas  or  diseased  or  other  spoilt  meats,  or  dead  carcasses,  as  to  be 
contaminated  therefrom  or  rendered  unwholesome  or  unhealthy  thereby,  or  hauled 
in  the  same  vehicle,  or  manipulated  with  tools  used  on  diseased  or  other  dead  car- 
casses as  aforesaid,  or  dressed  or  kept  in  any  building  wherein  animals,  or  parts  of 

animals,  dead  from  injury  or  disease  are  Stored,  kept  or  rendered,  or  wherein  decom- 
posed, putrid  or  offensive  meals  of  any  kind  are  kept,  or  within  one  hundred  feet  of 
any  building  wherein  animals  dead  as  aforesaid,  or  other  unsound  meats  are  stored, 
kept  or  rendered,  or  dressed,  or  kept  in  any  house  or  upon  premises  which  are  not 
clean  and  maintained  in  a  pure  and  wholesome  condition  bj    necessary  disinfection, 

flushing,    washing,    scalding   and    lime    washing,  and    the    removal    therefrom    of    all 

accumulations  of  filth  and  of  all  decomposing  and  offensive  matter,  shall  be  brought 
into  said  city,  or  in  said  city  sold,  held,  oi  ottered  for  sale  ;is  food." 

1  New  Orleans,  Ordinance  1155,  C.  s..  as  amended  i,\  Ordinances  1724,5917,  6691, 
L6. 

New  Orleans,  Ordinance  1155,  C.  s--  as  amended  by  Ordinances  1724,  •  «o  17.  6691, 
24. 

Lsbury  Park.  Sanitary  Code  (1897),  Sec.  87. 

1  Newark.  Sanitary  ('ode  (1888),  Sec.  15: 

"Thai   no  person  Or    persons    <.r   corporation    shall    kill,  scald,    pick    Or   dress   any 

chicken,  turkey,  duck,  goose  or  other  feathered  animal  within  the  limits  of  any  mar- 
ket,  public  or  private,  within  the  City  of  Newark." 


316  FOOD    OTHER    THAN  DAIRY  PRODUCTS. 

The  Hebrew  method  of  killing  fowl  in  houses  and  small  markets  is 
productive  of  much  offence  where  many  of  this  race  congregate.  In 
Boston  public  killing  places  for  poultry  have  been  established.  Licenses 
are  granted  for  these  places  and  the  proprietor  then  rents  coops  at  a  rate 
approved  by  the  board  of  health.  An  elaborate  set  of  rules1  were 
adopted  for  their  control  and  they  are  frequently  inspected,  but  at  the 
best  they  are  offensive  places.  In  New  York  also  a  license  is  required 
for  killing  fowl. 

Control  of  Markets. 

A  most  important  means  of  controlling  markets  is  by  the  establish- 
ment of  public  markets  or  market  places.  In  some  cases  these  markets 
are  the  property  of  the  city,  and  in  others  they  are  owned  by  quasi  public 
chartered  corporations.  In  either  case  the  business  done  by  the  indi- 
viduals or  firms  who  occupy  them  is  more  easily  controlled  than  it  is 
when  separate  markets  are  scattered  all  over  the  city.  In  the  case  of 
public  markets  the  superintendent  and  his  subordinates  may  easily  serve 
as  inspectors,  and  being  constantly  on  the  premises  their  services  in  this 
direction  are  very  efficient.  In  a  number  of  cities  they  are  directly 
charged  with  the  enforcement  of  the  rules  concerning  the  wholesomeness 
of  the  food  exhibited.  Thus  in  Cincinnati 2  the  superintendent  is  to 
seize  all  unwholesome  or  otherwise  proscribed  provisions.  A  large  pro- 
portion of  the  cities  of  the  United  States  have  such  public  markets. 
They  have  been  established,  however,  not  so  much  for  sanitary  as  for 
economic  reasons.  In  the  city  of  the  writer  there  is  no  such  market, 
but  there  has  been  for  years  much  agitation  of  the  subject  and  there  is 
a  strong  desire  on  the  part  of  many  that  the  city  should  establish  such 
a  market.  Both  in  cities  where  there  is  and  in  those  where  there  is  not 
a  public  market,  there  are  private  markets  and  peddlers'  wagons.  In 
some  cities  the  license  system  of  control  is  adopted  for  these,  parti- 
cularly the  peddlers'  wagons.  Among  the  cities  in  which  markets  are 
licensed  may  be  mentioned  Chicago,  Denver,  and  New  Orleans.  In 
Denver  the  application  must  be  approved  by  the  health  commissioner 
and  the  fire  and  police  boards.  In  Chicago  the  fee  for  a  market  license 
is  fifteen  dollars  per  annum,  in  Denver  it  is  fifty  dollars. 

The  licensing  of  peddlers'  carts  is  more  common  than  the  licensing 
of  markets.  Sometimes  a  nominal  fee  is  charged  for  these  licenses  on 
the  ground  that  no  burden  should  be  placed  upon  men  of  moderate 
means  engaged  in  a  legitimate  business.  At  other  times  a  considerable 
fee,  as  twenty-five  to  fifty  dollars  is  charged,  the  idea  being  to   obtain  a 


1  Boston,  Report  of  Board  of  Health  (1800),  p.  96. 

2  Cincinnati,  Manual  of  Department  of  Health  (1898),  p.  111. 


FOOD    OTHER    THAN  DAIRY  PRODUCTS.         317 

rental  for  the  use  of  the  streets  to  do  business  in.  In  Denver  the 
license  fee  for  peddlers  is  four  hundred  dollars  and  is  doubtless  in- 
tended to  be  prohibitive. 

By  a  system  of  license  it  is  possible  to  require  a  properly  constructed 
market  or  wagon  before  the  license  is  granted,  and  strong  after-control 
is  exercised  by  making  use  of  the  power  to  revoke  whenever  it  is  found 
that  improper  food  is  sold.  It  is  necessary  that  rules  should  be  framed 
to  secure  the  cleanliness  of  these  wagons.  The  Boston  rules  are  given 
below.1 

In  Brooklyn  it  was  required  that  the  wagon  boxes  of  fish  peddlers 
be  lined  with  zinc  as  must  the  boxes  in  front  of  markets. 

In  New  ( Orleans,  no  crabs  or  shrimps  shall  be  sold  in  any  market 
after  ten  a.  m.,  or  from  any  cart  from  1  May  to  1  October. 

In  Denver  and  Erie  the  cleanliness  of  employes  as  well  as  of  mar- 
kets is  prescribed.2 

In  Rochester  filthy  barrels  and  boxes  must  not  be  used  for  holding 
food.3 

The  exposure  of  meat  to  the  dust  of  the  streets  is  considered 
dangerous  and  is  forbidden  in  the  City  of  New  York.4     See  also  the 


i  Boston,  Ordinances  (1890),  Chaper  49,  Sees.  2  and  88: 

■  No  person  shall,  at  any  time,  have  in  his  possession  with  intent  to  sell,  fish  of 
any  kind,  except  flounders,  smelts,  and  other  small  tish,  salmon,  and  shad,  until  the 
same  have  been  cleansed  of  their  entrails  and  other  refuse  parts,  nor  fish  of  any 
kind,  unless  they  are  kept  in  covered  stalls,  or  fish-boxes,  or  in  covered  carts,  which 
shall  be  clean  and  in  good  order,  and  well  secured  from  the  cays  of  the  sun. 

■  No  hawker  or  peddler  shall  carry  or  convey  any  articles  enumerated  in  section 
,,n.-  of  chapter  sixty-eight  <>f  the  Public  Statutes  in  any  manner  thai  will  tend  to  in- 
jure or  anie>y  the  public  health  or  comfort,  n<>r  otherwise  than  in  vehicles  or  recep- 
tacles which  are  neat  and  clean  and  do  noi  leak,  and  have  printed  mi  them  in  letters 
and  figures  al  leasi  two  inches  in  height  the  name  of  the  person  selling,  and  the 
number  given  him  by  the  Board  of  Health,  and  which  are  approved  on  the  firs! 
Monday  in  every  month  by  the  Board  of  Health."' 

Erie,  Rules  of  Board  of  Health,  Sec.  •!-. 

■  No  i  ni  tdicr.  or  other  person  in  his  employ,  shall  appear  for  the  purpose  of  eut- 
ting,  handling  or  rending  meat,  unless  he  shall  be  neatly  dressed  in  a  white  Erock, 
or  with  a  white  a | Ton  and  whit.-  oversleeves  extending  above  the  elbows." 

Rochester,  Board  of  Health  Ordinances,  No.  22,  Sec.  1: 

No  person  or  persons,  linn  or  corporation,  shall    keep    or   convey    flour   or  any 

article  of  human  food  in  barrels,  casks,  boxes  or  any  receptacle  that  has  become 
musty  or  otherwise  polluted,  under  a  penalty  of  ten  dollars  ($10.00)  for  each  and 
ever;  offense." 

■  New  York  Sanitarj  I  ode  1 1899),  Sec.  IT: 
".    .     .     nor  shall  the  body  or  an]  part  thereof  of  any  animal  which  is  to  b< 
B8  food  be  carted  or  carried  through  the  streets,  excepl  \\  be  covered  so  as  to  pro- 

teet  ii  from  dust  or  dirt,  and  n eat,  poultrj  or  game  shall  be  hung  or  exposed  for 

sale  outside  of  any  shop  or  store  in  this  city  or  in  the  open  windows  or  doorways 
thereof.'1 


318  FOOD    OTHER    THAN  DAIRY  PRODUCTS. 

Boston  rules.  A  similar  rule  is  found  in  San  Francisco  and  Portland, 
Ore.,  and  in  Minnesota1  a  statute  provides  that  fresh  meat  in  transit 
shall  be  covered  to  keep  off  flies.  In  Colorado  Springs  fruit  must  be 
covered  to  keep  off  the  dust.2 

The  most  common  place  to  find  filth  in  markets  is  the  ice-box,  and 
regulations  concerning  its  care  are  found  in  Chicago,  New  York,  Mem- 
phis, and  Scranton.  In  Scranton  the  inspector  is  required  to  inspect 
ice-boxes  as  often  as  possible  and  see  that  they  are  kept  clean,  and  this 
is  doubtless  the  practice  of  the  inspectors  of  other  cities  where  it  is  not 
prescribed.     The  other  cities  mentioned  above  have  the  .following  rule  : 

"  That  no  butcher  or  dealer  shall  keep  in  any  market  any  refrigerator  or  ice-box, 
unless  the  same  shall  be  lined  with  lead  or  some  proper  metalic  substance,  so  as  to 
be  water-tight,  nor  unless  the  same  be  provided  with  a  pipe  of  lead,  zinc  or  copper, 
leading  therefrom  to  the  nearest  gutter  or  proper  waste  pipe."3 

Bakeries. 

Connecticut,  Massachusetts,  Minnesota,  New  Jersey,  New  York, 
Ohio,  Pennsylvania,  and  Wisconsin  have  laws  in  regard  to  the  construc- 
tion and  management  of  bakeries,  mostly  of  quite  recent  passage,  and 
Baltimore  by  a  special  act  is  authorized  to  inspect  bakeries.4  These 
laws  have,  perhaps,  aimed  as  much  to  improve  the  sanitary  conditions 
under  which  the  bakers  labor  as  to  secure  cleaner  and  better  bread. 
They  have  received  the  support,  and  have  perhaps  been  passed  in  some 
cases  at  the  instance  of  the  bakers'  unions.  The  best  law  appears  to  be 
that  of  Pennsylvania,  though  it  does  not  differ  in  essentials  from  that 
of  other  states.     The  provisions  of  the  act  are  shown  below.5 


1  Minnesota,  Chapter  200  of  1895. 

2  Colorado  Springs,  Ordinances  of  18  January,  1894,  Sec.  21 : 

"All  fruit  intended  to  be  eaten  in  the  form  in  which  it  is  sold,  such  as  dates,  figs, 
and  raisins,  shall,  when  kept  or  offered  for  sale,  be  securely  covered  with  glass  or 
wooden  cases  so  as  to  protect  the  same  from  contact  with  flies  and  dust." 
New  York  Sanitary  Code  (1899),  Sec.  53. 

4  Maryland,  Chapter  273  of  1896. 

5  Pennsylvania,  Act  of  27  May,  1897 : 

"Section  2.  All  buildings  or  rooms  occupied  as  a  biscuit,  bread,  pretzel,  pie 
or  cake  bakery,  or  maccaroni  establishment,  shall  be  drained  and  plumbed  in  the 
manner  directed  by  the  rules  and  regulations  governing  the  house  drainage  and 
plumbing  as  prescribed  by  law,  and  all  rooms  used  for  the  purpose  aforesaid  shall 
be  ventilated  by  means  of  air  shafts,  windows  or  ventilating  pipes,  so  as  to  insure  a 
free  circulation  of  fresh  air.  No  cellar  or  basement,  not  now  used  for  a  bakery, 
shall  hereafter  be  occupied  and  used  as  a  bakery,  unless  the  proprietor  shall  have 
previously  complied  with  the  sanitary  provisions  of  this  act. 

"Section  3.     Every  room  used  for  the  manufacture  of  flour  or  meal  food  pro- 
ducts shall  have  an  impervious  floor,  constructed   of  cement  or  of   tiles   laid   in 


FOOD    OTHER    THAN  DAIRY  PRODUCTS.  319 

In  New  Jersey,  Ohio,  and  Pennsylvania,  the  factory  inspector  is  to 
enforce  these  laws  and  may  give  certificates  that  the  law  has  been  com- 
plied with.  In  Massachusetts  the  local  board  of  health  is  to  enforce 
the  law.  The  report  of  the  Brooklyn  (X.  Y.),  health  department  for 
1896  shows  that  the  inspectors  found  the  bakeries  in  that  city  in  good 
condition  and  in  the  cities  of  Massachusetts  flagrant  violations  by  bakers 
of  sanitary  principles  are  not  common.  In  180(3  Milwaukee  passed  an 
ordinance  providing  that  all  bakeries  and  candy  manufactories  should 
be  kept  clean  and  wholesome.  It  is  reported1  that  some  of  the  bakeries 
in  that  city  were  in  bad  condition  and  many  of  them  were  so  in  New 
Haven2  and  San  Francisco.3 


cement,  or  of  wood  of  which  all  the  crevices  shall  be  filled  in  with  putty,  and  the 
whole  surface  treated  with  oil  varnish.  The  inside  walls  and  ceiling  shall  be  plas- 
tered and  either  be  painted  with  oil  paint,  three  (3)  coats,  or  be  lime-washed,  or  the 
side  walls  plastered  and  wainscoted  to  the  height  of  six  (6).  feet  from  the  floor,  and 
painted  or  oiled;  when  painted,  shall  be  renewed  at  least  once  in  every  five  years 
and  shall  be  washed  with  hot  water  and  soap  at  least  once  in  every  three  (3)  months; 
when  lime-washed  the  lime-washing  shall  be  renewed  at  least  once  in  every  three  (3) 
months.  The  furniture  and  utensils  in  such  room  shall  be  so  arranged  that  the 
furniture  and  floor  may  at  all  times  be  kept  in  a  thoroughly  sanitary  and  clean 
condition.  Xo  domestic  or  pet  animal  shall  be  allowed  in  a  room  used  as  a  biscuit, 
bread,  pie  or  cake  bakery,  or  in  any  room  in  such  bakery  where  flour  or  meal  pro- 
ducts are  stored. 

"SECTION  4.  The  manufactured  flour  and  meal  food  products  shall  be  kept  in 
perfectly  dry  and  airy  rooms,  so  arranged  that  the  floors,  shelves  and  all  other 
places  for  storing  the  same  can  be  easily  and  perfectly  cleaned. 

"  Section  5.  Every  such  bakery  shall  be  provided  with  a  proper  wash-room 
and  water  closet  or  closets,  apart  from  the  bakeroom  or  rooms  where  the  manufac- 
ture of  such  food  products  is  conducted,  and  no  water  closet,  earth  closet,  privy  or 
ash  pit  shall  be  within  or  communicate  directly  with  the  bake  room  of  any  bakery, 
hotel  or  public  restaurant. 

11  Section  <>.  Every  sleeping  room  for  persons  employed  in  every  bakery  shall 
be  kept  separate  from  the  room  or  rooms  where  flour  or  meal  products  are  manu- 
factured or  stored,  and  shall  be  provided  with  one  or  more  external  glazed  wind- 
ows, eaeh  of  which  shall  be  at  least  nine  (9)  superficial  feet  in  area,  of  winch  at 
least  four  and  one-half  (4£)  superficial  feet  shall  be  made  to  open  for  ventilation; 
and  such  sleeping  places  when  they  are  on  the  same  Ihn.r  as  the  bakery,  shall  be  in- 
spected in  order  to  maintain  them  in  a  condition  of  cleanliness. 

"Sei  i  ion  t.  No  employer  shall  knowingly  require,  permil  or  suffer  any  person 
to  work  in  his  bakeshop  who  is  affected  with  consumption  of  the  lungs,  or  with 
■crofulous  diseases,  or  with  any  veneral  diseases,  or  with  any  communicable  skin 
affection,  and  every  employer  is  hereby  required  to  maintain  himself  and  his  em- 
ployees in  a  clean  condition  while  engaged  in  the  manufacture,  handling  or  sale  of 
such  food  products,  and  it  is  hereby  made  die  duty  of  the  Board  of  Health  to  en- 
force the  provisions  of  this  section/1 

Milwaukee,  Reporl  of  Health  Commissioner  (1896  7),  p.  20. 

\eu  Haven,  Reporl  of  Board  oi   Health  (1897),  p.  29. 

San  Francisco,  Reporl  of  Department  of  Health  (1897),  p.  196. 


320  FOOD    OTHER    THAR  DAIRY  PRODUCTS. 

In  Erie  a  regulation  has  been  adopted  by  the  board  of  health  requir- 
ing that  bakers7  delivery  wagons  must  be  kept  clean.1 

New  Orleans  has  a  bakery  ordinance  and  the  following  is  the  schedule 
of  items  inquired  into  by  the  inspectors : 

Inspection  of  Bakery  No 

Owned  by 

Condition  of  Drainage 

Condition  of  Premises  and  Yards 

Condition  of  Privy  Vault  and  Kind 

Condition  of  Floor  of  Bake  Shop 

Condition  of  Sponge  Trough  and  Moulding  Bench 

Condition  of  Raising  Box .' 

Condition  of  Cushions  and  Covers 

Condition  of  Bread  Pans  and  Moulds 

Water  Supply 

Hydrant,  is  it  Filtered  ? 

Cisterns,  number Capacity 

Distance  from  Cisterns  to  Privy  Vaults 

Condition  of  Stable 

Distance  from  Stable  to  Bake  Shop 

Amount  of  Flour  Used  per  Day 

Kind  of  Flour  Used 

Kind  of  Yeast  Used 

Sickness  on  Premises Acute 

Chronic Infectious 

General  Remarks 


Inspection  Made 189. . 

By  Officer 

Hotels  "in/  Restaurants. 

Those  who  framed  the  food  laws  undoubtedly  intended  them  to 
apply  to  markets,  peddlers,  wholesale  provision  houses,  etc.  The  sale 
of  provisions  however  takes  place  in  hotels  and  restaurants,  and  the 
laws  might  fairly  be  interpreted  to  cover  such  sales ;  but  it  has  been 
deemed  advisible  to  make  special  provisions  for  this  in  the  rules  of 
Chicago,  Denver,  District  of   Columbia,  New  York  City,2  and   Omaha. 

iErie,  Rules  of  Board  of  Health: 

"  All  vehicles  from  which  any  biscuit,  bread,  pretzel  or  other  bakeshop  product 
is  sold  in  the  city  of  Erie  shall  be  kept  in  a  clean  and  sanitary  condition,  and  all 
baskets,  boxes,  or  other  receptacles  in  which  any  of  the  aforesaid  products  are  con- 
veyed through  the  streets  shall  be  closely  covered  in  a  way  and  manner  that  will 
protect  them  from  any  pollution  whatsoever.1' 

2  City  of  New  York,  Sanitary  Code  (1899) : 

"  Sec.  49.  That  no  person,  being  the  manager  or  keeper  of  any  saloon,  board- 
ing-house, or  lodging-house,  or  being  employed  as  clerk,  servant,  or  agent  thereat, 
shall  therein  or  thereat,  offer  or  have,  for  food  or  drink,  or  to  be  eaten  or  drank, 
any  poisonous,  deleterious,  or  unwholesome  substance,  nor  allow  anything  therein 
to  be  done  or  to  occur,  dangerous  to  life  or  prejudicial  to  health." 


FOOD    OTHER    THAN  DAIRY  PRODUCTS.         321 

A  more  explicit  rule  in  regard  to   kitchen  cleanliness  is  found  in  Colo- 
rado Springs.1 

In  Denver  the  health  commissioner  is  directed  to  inspect  hotels  and 
restaurants  at  frequent  intervals. 

Vegetables  <<u<l  Fruit. 

Special  rules  are  sometimes  found  in  regard  to  vegetables  and  fruit. 

"  No  person  shall  land  on  any  wharf  or  other  place,  or  shall  bring  into  the  city, 
any  decayed  or  damaged  vegetables  <>r  fruits. 

"  Xo  person  shall  hold,  sell  or  offer  for  sale,  or  bring  into  the  city,  any  decayed 
or  damaged  vegetables  or  fruit." 

"It  shall  be  unlawful  for  anyone  to  sell,  offer  for  sale,  or  have  in  his  possession 
with  intent  to  sell,  any  unripe,  over-ripe,  decayed  or  unwholesome  fruit  or  vege- 
tables; and  the  health  officer  and  all  officers  of  the  department  of  health  are  author- 
ized and  directed  to  immediately  confiscate  and  destroy  any  such  fruit  or  vegetables 
when  offered  for  sale. "  - 

"  No  person  shall  bring  into  the  city,  or  have  in  his  possession  with  intent  to  sell, 
or  sell,  any  vegetables,  excepting  green  peas  or  beans  in  the  pods,  and  green  corn  in 
the  inner  husks,  which  have  not  previously  been  divested  of  all  parts  not  commonly 
used  for  food;  and  no  person  shall  have  such  parts  in  his  possession  in  any  market- 
place, nor  in  a  cart  or  vehicle  used  for  the  sale  of  vegetables  or  other  articles  of 
food."  3 

in  San  Francisco4  fruit  and  berries  must  be  packed  in  new,  clean 
boxes.  In  the  report  of  the  board  of  health  of  Asbury  Park  for  1892, 
opposite  page  26,  is  a  photograph  showing  berry  boxes  culled  out  of  a 
garbage  dump  for  subsequent  use,  so  thai  it  would  appear  that  the  San 
Francisco  rule  is  nol  uncalled  for. 

Flesh  of  Unclean  Animate. 

".    .     .     Nor  shall  any  person  sell  or  expose  or  offer  for  sale  the  flesh  <>f  any  dog, 
cat,  or  any  unclean  animal."5 

Metal  Soda  Fountains. 

"In  t  he  sal<-  of.  or  keeping  for  sale,  any  beverage  or  drink,  qo  person  shall  keep 
or  use  any  tap,  faucet,  tank,  fountain  or  vessel,  or  any  pipeor  conduii  in  connection 
therewith,  which  shall  be  composed  of  or  made  with  brass,  lead,  copper,  or  other 
metal  or  metallic  substances  thai  are  or  will  be  affected  by  liquids  so  t  kit  dangerous, 
unwholesome  or  deleterious  compounds  are   formed  therein  or  thereby,   or  such 

I  Colorado  Springs,  Sanitary  ('ode.  Sec.  IT: 

II  In  the  kitchen  of  restaurants  and  hotels  and  in  all  places  where  the  floor  may 
receive  moisture,  ftlth,  or  decomposed  matters  the  flooring  shall  be  made  of  water- 
proof material.  No  such  Hour  shall  bave  under  ii  spaces  which  are  not  readily 
accessible,  and  th<'  drainage  shall  in  all  cases  be  sufficient  to  remove  the  waste  from 
t  lie  building  in  a  manner  satisfactory  to  the  health  officer.11 

Cincinnati,  Manual  of  Health  Department  (1898),  p.  98. 
Boston,  ■  Ordinances  i  L890),  Chapter  49,  Sec.  •". 
lSan  Francisco,  Reporl  of  Board  of  Health  (1897),  p.  s- 
New  Orleans,  Ordinance  No.  H55,  s'-<-.  18. 


322  FOOD    OTHER    THAN  DAIRY  PRODUCTS. 

that  beer,  soda  water,  syrups  or  other  liquids,  or  any  beverage,  drink  or  flavoring 
material  drawn  therefrom  shall  be  unwholesome,  dangerous  or  detrimental  to 
health."1 

Fish- Cars  near  Sewers. 

"No  fish-car,  lobster-car,  ark,  or  other  receptacle  for  fish  or  lobsters,  shall  be 
kept  or  put  within  one  hundred  and  fifty  feet  of  the  mouth  of  any  sewer.11  2 

Much  has  of  late  been  written  about  the  clanger  of  keejDing  oysters 
in  sewage  polluted  waters,  but  there  does  not  appear  to  be  any  legisla- 
tion on  the  subject. 

Bread. 

The  earliest  food  regulation  that  the  writer  has  found  was  an  act  of 

the  Pennsylvania  legislature,  18  March,  1775,  in  regard  to  bread: 

1 '  If  any  person  or  persons  shall  adulterate  or  mix  any  improper  and  unwhole- 
some ingredient  in  any  kind  of  flour  of  which  bread  shall  be  made  as  aforesaid,  every 
such  person  or  persons,  being  thereof  legally  convicted  before  any  magistrate  or 
justice  of  the  city,  borough  or  county  where  such  bread  shall  be  so  made,  sold,  or 
exposed  to  sale,  who  is  hereby  authorized  and  empowered  to  hear,  try  and  deter- 
mine the  same,  shall  forfeit  and  pay  the  sum  of  five  pounds  for  every  such  offence.11 

An  almost  identical  provision  has  recently  been  adopted  in  New 
Jersey3  and  a  similar  law  is  on  the  statute  books  of  Kentucky.4  In  the 
District  of  Columbia  bread  must  not  contain  any  alum,  sulphate  of 
copper,  borax,  sulphate  of  zinc,  or  other  poisonous  ingredient,  and  it 
must  not  contain  more  than  31  per  cent,  of  moisture,  2  per  cent,  of  ash, 
or  less  than  6.25  per  cent,  of  albuminoids.5 

Canned  Goods. 

The  danger  in  the  use  of  canned  goods  has  been  much  discussed  and 
the  likelihood  of  finding  spoiled  goods  or  metallic  poisons  in  the  cans 
is  not  a  remote  one.  There  has  not,  however,  been  much  legislation  on 
the  subject. 

Iowa  and  Michigan  have  the  following : 6 

"It  shall  hereafter  be  unlawful  in  this  state  for  any  packer  of,  or  dealer  in, 
hermetically  sealed,  canned  or  preserved  fruits,  vegetables,  or  other  articles  of  food, 
to  knowingly  offer  such  canned  or  preserved  articles  for  sale  for  consumption  in  this 
state  after  October  1,  1886,  unless  the  cans  or  jars  which  contain  the  same  shall  bear 
the  name,  address  and  place  of  business  of  the  person,  firm  or  corporation  that 
canned  or  packed  the  articles  so  offered,  or  the  name  of  the  wholesale  dealer  in  the 
state  who  sells  or  offers  the  same  for  sale,  together  in  all  cases  with  the  name  of  the 


*New  York,  Sanitary  Code  (1899),  Sec.  191. 

2  Newport,  Rules  of  the  Board  of  Health,  Sec.  15. 

3  New  Jersey,  Public  Laws  (1890),  p.  2G1. 

4  Kentucky,  Statutes  (1894),  Sec.  1273, 

5  Act  of  Congress  of  17  February,  1898,  Sec.  3. 
*  Iowa,  Code  (1897),  Sees.  4994-5. 


FOOD    OTHER    THAN  DAIRY  PRODUCTS.         323 

state,  city,  town  or  village,  where  the  same  were  packed,  plainly  printed  thereon, 
preceded  by  the  words,  L  packed  at,'  such  name,  address  and  place  of  business  shall 
be  plainly  printed  on  the  label,  together  with  the  mark  or  term  indicating  clearly 
the  grade  <>r  quality  of  the  articles  contained  therein. 

•All  packers  of,  and  dealers  in  soaked  goods  or  goods  put  up  from  products  dried 
or  cured  before  canning,  shall  in  addition  to  complying  with  provisions  of  section 
one  of  this  act,  cause  to  be  plainly  branded  on  the  face  of  the  label  in  good,  legible 
{type,  one-half  of  an  inch  in  height,  and  three-eighths  of  an  inch  in  width,  the  word 
'  soaked.'  " 

There  is  a  similar  law  in  Kentucky,  except  that  in  the  latter  state 
the  name  of  maker  and  quality  of  goods  must  be  stamped  on  the  can. 
An  earlier  law,  but  one  not  as  good  as  the  above,  was  enacted  in 
Illinois  in  1885.  Laws  have  also  recently  been  enacted  in  Ohio, 
Massachusetts,  and  Wisconsin.  Maryland  formerly  had  a  law  of  this 
kind,  but  it  was  recently  repealed.1 

Misrepresentation   Forbidden. 

New  York  and  Memphis  have  the  following: 

"  That  do  meat,  fish,  fruit,  vegetables  or  milk,  or  unwholesome  liquid  shall 
knowingly  be  bought,  sold,  held,  offered  for  sale,  labeled,  or  any  representation 
made  in  respect  thereof,  under  a  false  name  or  quality,  or  as  being  what  the  same  is 
not,  as  respects  wholesomeness,  soundness,  or  safety  for  food  or  drink." - 

Such  a  rule  would  prevent  the  sale  of  shark  for  halibut  as  happened 
in  Sun  Francisco,3  or  of  cats  for  rabbits,  or  horse  meat  for  beef.  In 
New  Jersey  a  recent  law  allows  local  boards  of  health  to  regulate  the 
suit-  of  horse  flesh. 

Misbranding. 

The  selling  of  one  food  substance  in  place  of  another  is  forbidden  in 

a  number  of  general  food  laws.     Tims  the  Massachusetts  laws  and  those 

copied  from  it,  forbid  the  sale  of  food  "if  it  is  an  imitation  of  or  is  sold 

under  the  name  o.    another  article."      The  provisions  of    this  law  which 

permit  the  sale  of  mixtures  or  c pounds  that  are  so  labeled,  implies 

the    prohibition  of  any  false   label.     The   laws   in   regard   to  milk,  lard, 

butterine,  vinegar,  wines,  etc.,  ;\\s<>  have  sections  which  provide  a  penalty 

for  marking  goods  with  a  false   label   or  failing  to  mark   with  a  true 

label.     Tims  in  Michigan  :  ' 

"  Wl vet  shall  falsely  brand,  mark,  stencil,  or  label  an  article  or  product  re- 
quired bj  this  act  to  be  branded,  marked,  stenciled,  or  labeled,  or  sball  remove, 
alter,  deface,  mutilate,  obliterate,  imitate,  or  counterfeit  any  brand,  mark,  stencil, 
or  label  so  required,  shall  be  deemed  guilty  of  a  misdemeanor.     .     .    ." 


1  Maryland,  Chapter  148  ol  1898. 

\ru  fork,  Sanitary  Code  (1899),  Sec.  51. 
'  San  Francisco,  Report  of  Board  of  Health  (1897),  p.  7. 

Michigan,  Compiled  Laws  (1897),  Sec.  5027. 


324  FOOD    OTHER    THAN  DAIRY  PRODUCTS. 

Citizens'  Reports. 

Most  of  the  regulations  which  forbid  the  sale  of  flesh  of  diseased 
animals  require  that  all  persons  having  a  knowledge  of  such  diseased 
animals  shall  report  them  to  the  proper  authorities.  Also  the  laws 
and  regulations  in  regard  to  contagious  disease  of  animals  have  the 
same  requirement.  The  ordinances  of  Chicago  and  Minneapolis  go 
farther  than  this : 

"  That  it  shall  be  the  duty  of  every  person  knowing  of  any  fish,  meat,  fowls, 
birds  or  vegetables  being  bought,  sold  or  offered  or  held  for  sale  as  food  for  human 
beings,  or  being  in  any  market  public  or  private  in  said  city,  and  not  being  sound, 
healthy  or  wholesome  for  such  food,  to  forthwith  report  such  facts  and  the  particu- 
lars relating  thereto,  to  the  department  of  health  or  to  one  of  its  officers  or  in- 
spectors." 1 

ADULTERATION    AND    SUBSTITUTION. 

Laws  in  regard  to  adulteration  are  found  in  both  federal  and  state 
statutes  and  in  municipal  ordinances.  Of  these  by  far  the  most  import- 
ant are  the  state  laws.  The  only  federal  statute  in  regard  to  adultera- 
tions forbids  the  importation  of  adulterated  foods,  drugs,  or  liquors.2 
Some  sort  of  state  legislation  on  the  subject  of  adulteration  of  food  is 
found  in  every  state  and  territory  except  Texas. 

In  a  few  of  the  states,  as  Rhode  Island,  the  terms  of  the  act  are 
very  general  and  vague,  but  in  most  states  the  laws  are  sufficiently 
explicit  to  make  them  of  value  in  dealing  with  this  subject.  Besides 
such  laws,  which  are  designed  to  cover  adulterations  in  general,  there 
are  many  special  provisions  and  separate  acts  relating  to  special  materi- 
als, as  milk,  butter,  drugs,  vinegar,  molasses,  etc.,  which  will  be  referred 
to  in  detail. 

General  Prohibitions. 

The  Ohio  and  Rhode  Island  laws  simply  forbid  the  sale  of  "  adul- 
terated provisions,  whether  for  food  or  drink,"  and  the  Louisiana  law 
is  nearly  as  concise.  The  following  somewhat  more  explicit  form  was 
adopted  in  Michigan,  and  has  been  in  substance  copied  by  Colorado, 
Idaho,  Indiana,  Kansas,  Maryland,  and  Montana ;  but  some  of  these 
states  have  further  provisions  defining  the  terms  used : 

"  If  any  person  shall  fraudulently  adulterate,  for  the  purpose  of  sale,  any  sub- 
stance intended  for  food,  or  any  wine,  spirits,  malt  liquor,  or  other  liquor  intended 
for  drinking,  he  shall  upon  conviction  be  punished  by  imprisonment  in  the  county 
jail  not  more  than  one  year,  or  by  fine  not  exceeding  three  hundred  dollars,  and  the 
article  so  adulterated  shall  be  forfeited  and  destroyed."  3 


1  Chicago,  Ordinances  (1881),  Sec.  1407. 

2  Act  of  Congress,  Approved  30  August,  1890,  Sees.  2-4. 

3  Michigan,  Compiled  Laws  (1897),  Sec.  11406. 


FOOD    OTHER    Til  AX  DAIRY  PRODUCTS.  325 

Somewhat  similar  legislation  is  found  in  Georgia,  Maine,  Missouri, 
South  Carolina,  Vermont,  Virginia,  and  West  Virginia,  and  also  in 
states  in  which  the  laws  are  more  extensive  and  explicit,  general  provi- 
sions are  also  found. 

Another  form  of  general  prohibition  in  regard  to  adulteration  and 
the  sale  of  adulterated  products  was  enacted  in  Illinois  and  has  been 
closely  copied  by  Iowa  and  New  Mexico: 

"That  no  person  shall  mix,  color,  stain,  or  powder,  or  ordei  <>r  permit  any  other 
person  in  his  or  her  employ  to  mix,  color,  stain,  or  powder  any  article  of  food  with 
any  ingredient  or  material  so  as  to  render  the  article  injuries  to  health  or  depreciate 
the  value  thereof,  with  intent  that  the  same  may  he  sold;  and  no  person  shall  sell 
or  offer  for  sale  any  such  article  so  mixed,  colored,  stained  or  powdered.  Xo 
person  shall  mix,  color,  stain,  or  powder  any  article  of  food,  drink,  or  medicine,  or 
any  article  which  enters  into  the  composition  of  food,  drink,  or  medicine,  with  any 
other  ingredient  or  material,  whether  injurious  to  health  or  not,  for  the  purpose  of 
gain  or  profit,  or  sell  or  offer  the  same  for  sale,  or  order  or  permit  any  other  person 
to  sell  or  offer  for  sale,  any  article  so  mixed,  colored,  stained,  or  powdered,  unless 
tin-  same  he  so  manufactured,  used,  or  sold,  or  offered  for  sale,  under  its  true 
and  appropriate  name,  and  notice  that  the  same  is  mixed  or  impure  is  marked, 
printed,  or  stamped,  upon  each  package,  roll,  parcel,  or  vessel  containing  the 
same,  so  as  to  be  and  remain  at  all  times  readily  visible,  or  unless  the  person 
purchasing  the  same  is  fully  informed  by  the  seller  of  the  true  name  and  ingre- 
dients (if  other  than  such  as  are  known  by  the  common  name  thereof)  of  such 
article  of  food,  drink,  or  medicine,  at  the  time  of  making  sale  thereof,  or  offering  to 
sell  the  same.*' 1 

Some  of  the  laws  that  have  been  referred  to  define  with  more  or  less 
definiteness  what  substances  are  not  to  be  adulterated  and  in  what 
adulteration  consists:  but  those  states  in  which  the  subject  has  received 
the  most  attention  and  where  active  measures  are  taken  to  prevent  and 
punish  adulteration  usually  define  these  things  with  the  utmost  exact- 
ness. Massachusetts  has  long  waged  an  active  warfare  against  adulter- 
ation and  her  statute  may  be  given  as  a  good  example.  Other  states 
with  similar  laws  which  sometimes  closely  follow    that  of    .Massachusetts 

are  California,  Connecticut,  District  of  Columbia,  Illinois,  Indiana, 
Kansas,  Kentucky,  Michigan,  Mississippi,  Nebraska,  New  Jersey,  New 
York.  North  Carolina,  Ohio,  Oregon,  Pennsylvania,  South  Dakota, 
Tennessee,  and  Wisconsin  : 

"An  article  shall  be  deemed  to  be  adulterated  within  the  meaning  of  this  act, — 

"(a)     In  the  case  of  drags,     (1.)  [f,  when  sold  under  or  by  a  name  recognized 

bj  t  lie  I  cited  Mates  Pharmacopoeia,  it  differs  from  the  standard  of  strength,  quality, 

or  purity  laid  down  therein,  unless  tl -der  calls  foi  an  article  inferior  to  such 

staiiilanl.  or  unless  such  difference  is  made  known  or  so  appears  i"  the  purchase]  at 

the  ti f  such  sale;  (2.)  tf,  when  sold  underor  by  a  name  nol  recognized  in  the 

United  states  Pharmacopoeia  but  which  is  found  in  some  other  pharmacopoeia,  ox 
other  standard   work  on  materia   medica,  i\  differs  materially    tr the  standard  of 


1  Illinois,  Annotated  Statutes  (1896),  Chapter  88,  Sec.  27. 


326  FOOD    OTHER    THAN  DAIRY  PRODUCTS. 

strength,  quality,  or  purity  laid  down  in  such  work;  (3.)  If  its  strength  or  purity 
falls  below  the  professed  standard  under  which  it  is  sold: 

11  (6. )  In  the  case  of  food, —  (1. )  If  any  substance  or  substances  have  been  mixed 
with  it  so  as  to  reduce,  or  lower,  or  injuriously  affect  its  quality  or  strength;  (2.)  If 
any  inferior  or  cheaper  substance  or  substances  have  been  substituted  wholly  or  in 
part  for  it;  (3.)  If  any  valuable  constituent  has  been  wholly  or  in  part  abstracted 
from  it;  (4.)  If  it  is  an  imitation  of,  or  is  sold  under  the  name  of,  another  article; 
(5.)  If  it  consists  wholly  or  in  part  of  a  diseased,  decomposed,  putrid,  or  rotten 
animal  or  vegetable  substance,  whether  manufactured  or  not,  or,  in  the  case  of  milk, 
if  it  is  the  produce  of  a  diseased  animal;  (6.)  If  it  is  colored,  coated,  polished,  or 
powdered,  whereby  damage  is  concealed,  or  if  it  is  made  to  appear  better  or  of 
greater  value  than  it  really  is;  (7.)  If  it  contains  any  added  poiso.ious  ingredient, 
or  any  ingredient  which  may  render  it  injurious  to  the  health  of  a  person  consum- 
ing it. 

"  The  provisions  of  this  act  shall  not  apply  to  mixtures  or  compounds  recognized 
as  ordinary  articles  of  food  or  drinks,  provided  that  the  same  are  not  injurious  to 
health,  and  are  distinctly  labeled  as  mixtures  or  compounds.  And  no  prosecutions 
shall  at  any  time  be  maintained  under  said  act  concerning  any  drug  the  standard  of 
strength  and  purity  whereof  has  been  raised  since  the  issue  of  the  last  edition  of 
the  United  States  Pharmacopoeia,  unless  and  until  such  change  of  standard  has  been 
published  throughout  the  Commonwealth.1'' l 

The  act  relating  to  the  District  of  Columbia  contains  eleven  other 
definitions  of  special  foods  and  gives  evidence  of  being  a  carefully  pre- 
pared law. 

Additional  definitions  of  an  adulterated  food  found  in  the  Con- 
necticut law  are,  "  if  made  to  appear  of  greater  value  than  it  is  "  or  "  if 
it  contain  any  antiseptic  or  preservative  not  evident  or  not  known  to 
the  purchaser  or  consumer." 

In  Ohio  mixtures  are  allowed  only  if  "  each  and  every  package  sold 
or  offered  for  sale  be  distinctly  labled  as  mixtures  or  compounds  with  the 
name  and  per  cent,  of  each  ingredient  therein,  and  are  not  injurious  to 
health."  The  following  are  the  provisions  of  the  Connecticut  and  Ten- 
nessee laws  in  regard  to  compounds  and  the  addition  of  legitimate  sub- 
stances : 

'■'■Provided,  that  an  article  or  food  product  shall  not  be  deemed  adulterated  or 
misbranded  within  the  meaning  of  this  act  in  the  following  cases:  (a)  In  the  case 
of  mixtures  or  compounds  which  may  be  now  or  from  time  to  time  hereafter  known 
as  articles  of  food  under  their  own  distinctive  names,  and  not  included  in  definition 
fourth  of  this  section;  (6)  in  the  case  of  articles  labeled,  branded,  or  tagged,  so  as 
plainly  and  correctly  to  show  that  they  are  mixtures,  compounds,  combinations,  or 
blends;  (c)  when  any  matter  or  ingredient  is  added  to  a  food  because  the  same  is 
required  for  the  protection  or  preparation  thereof  as  an  article  of  commerce  in  a  fit 
state  for  carriage  or  consumption,  and  not  fraudulently  to  increase  the  bulk,  weight, 
or  measure  of  the  food  or  to  conceal  the  inferior  quality  thereof;  (d)  when  a  food  is 
\mavoidably  mixed  with  some  extraneous  matter  in  the  process  of  collection  or 
preparation."  2 


1  Massachusetts,  Chapter  263  of  1882,  Sec.  3,  as  amended  by  Chapter  280  of  1884, 
Sees.  5  and  7. 

2  Connecticut,  Chapter  235  of  1895,  Sec.  3. 


FOOD    OTHER    Til  AX  DAIRY  PRODUCTS.  327 

The  Michigan  law  requires  that  all  compounds  shall  bear  011  the 
package  the  name  of  the  manufacturer.1 

These  laws  relate  to  the  adulteration  of  food  and  drugs,  and  the 
word  "food"'  in  them  is  variously  defined.  The  definition  of  the  Mas- 
sachusetts law  includes  "  confectionery,  condiments,  and  all  articles 
used  as  food  or  drink  by  man  "  and  the  same  is  found  in  New  Jersey  and 
New  York.  One  section  of  the  Maryland  law  refers  to  "  any  article  of 
food  or  dietetics."  In  Connecticut  food  is  anything  "  used  as  food  or 
drink  of  man,  horses,  or  cattle." 

Besides  the  laws  in  regard  to  adulterations  in  general  there  are  many 
statutes  dealing  specifically  with  various  kinds  of  food. 

Ih-n./x  and  M<  dicines. 

The  adulteration  of  drugs  is  specifically  forbidden  in  seventeen  states. 
but  usually  the  term  is  used  in  connection  with  "  food,  liquors,"  etc.,  in 
a  general  law,  or  else  perhaps  a  single  brief  paragraph  is  devoted  to 
them.  No  more  explicit  prohibitions  are  found  than  in  the  general 
adulteration  law  of  Massachusetts  which  has  been  copied  by  very  many 
states. 

TAquor%  <m<l  Wines. 

In  Colorado,  the  District  of  Columbia,  Indiana,  Iowa,  Kansas,  Mary- 
land, Michigan,  Missouri,  Montana,  Nebraska,  New  Hampshire,  South 
Dakota,  and  Wisconsin  "wine,  spirits,  malt  liquors,  and  liquors"  are 
mentioned  in  the  law  which  forbids  adulteration,  and  wines  and  liquors 
are  also  specified  in  the  general  adulteration  law  of  Georgia,  Kentucky. 
Maine,  and  Rhode  Island.  More  extensive  legislation  is  found  in 
Indiana,  .Massachusetts,  Minnesota,  New  York,  Ohio,  Pennsylvania,  and 
Rhode  Island.  These  laws  provide  that  wines  and  liquors  shall  not  be 
adulterated.2  In  the  District  of  Columbia  wines,  malt  liquors,  and  cider 
must  not  contain  salicylic  acid.  The  .Minnesota  law  forbids  adultera- 
tion with  substances  that  are  injurious  when  the  wine  or  liquor  is  used 
as  a  beverage. 

New  York  and  Ohio  also  have  \er\  specific  regulations  in  regard  to 
the  production  and  composition  of  wines,  both  of  these  states  being 
large   wine   producers.     By  section    16  of  the   Public   Health   haw  of 


Michigan,  Compiled  Laws  (1897),  Sec.  5012. 
-  Massachusetts,  Public  Statutes  (1882),  Chapter  208,  Sec.  4: 
•■  Whoever  adulterates,  for  the  purpose  of  sale,  any   liquor  used  or  intended  for 

drink,  with  Indian  cockle,  vitriol,  grains  of  paradise,  opium,  alum,  capsicum,  cop- 
peras, laurel-water.  Logwood,  Brazil  wood,  cochineal,  sugar  of  lead.  ..1  an]  other 
substance  which  is  poisonous  or  injurious  to  health,  ami  whoever  knowingly  sells 
any  such  liquor  so  adulterated,  shall  be  punished  by  imprisonment  in  the  state 
prison  not  exceeding  three  years;  and  the  articles  so  adulterated  shall  he  forfeited." 


328  WOOD    O THE  11    THAN  DAIRY  PliODUCTS. 

New  York  the  adulterations  of  wine  are  defined ;  by  section  47,  pure 
wine  is  defined  as  containing  seventy-five  per  cent,  pure  fruit  juices,  and 
by  section  48,  "  wine  which  contains  less  than  seventy-five  per  cent,  and 
more  than  fifty  per  cent,  of  pure  grape  or  other  undried  fruit  juice  and 
is  otherwise  pure,"  shall  be  labelled  "  half  wine,"  and  if  it  contains  less 
than  fifty  per  cent,  pure  shall  be  labeled  "  made  wine."  The  Ohio  law 
is  very  similar  to  this,  but  it  requires  the  labeling  of  "  pure  wine  "  as 
such  with  the  addition  of  the  name  of  the  manufactory.  Michigan  and 
Pennsylvania1  have  a  similar  provision  in  regard  to  all  alcoholic  bever- 
ages.    Ohio2  has  a  penalty  for  the  improper  use  of  branded  packages. 

In  Nebraska  it  is  forbidden  to  put  adulterated  wines  in  packages 
marked  as  containing  wine  grown  in  the  state. 

Missouri  has  a  law3  which  forbids  the  use  in  the  manufacture  of 
beer  of  anything  except  hops,  barley,  malt,  and  pure  yeast. 

In  New  York  the  law  provides  for  the  yearly  analysis  of  samples 
from  breweries  and  distilleries  in  the  state.4 

The  penalties  for  the  violation  of  these  laws  are  usually  more  severe 
than  for  the  violation  of  general  adulteration  laws,  the  maximum  often 
being  |1,000  fine  or  one  year  imprisonment  and  also  the  cost  of  analysis. 
The  goods  also  are  often  forfeited.  Proof  of  guilt  is  rendered  easy  by 
the  provisions  in  Michigan,  Pennsylvania,  and  Rhode  Island,  that  the 
having  in  possession  of  adulterated  liquor  is  prima  facie  evidence  of 
violation  of  the  law. 

Vinegar. 

Vinegar  is  especially  mentioned  in  nearly  a  dozen  states  as  among 
the  substances  not  to  be  adulterated.  The  Massachusetts  law,  which 
has  been  copied  in  most  of  its  features,  has  the  following  as  its  most 
important  sections : 

"  Every  person  who  manufactures  for  sale,  or  offers  or  exposes  for  sale  as  cider 
vinegar,  any  vinegar  not  the  legitimate  product  of  pure  apple  juice,  known  as  apple 

1  Pennsylvania,  Act  of  14  April,  1863,  Sec.  2: 

"It  shall  be  the  duty  of  any  person  or  persons  engaged  in  the  manufacture  and 
sale  of  intoxicating  malt  or  alcoholic  liquors,  or  in  rectifying  or  preparing  the  same 
in  any  way,  to  brand  on  each  barrel,  cask  or  other  vessel  containing  the  same,  the 
name  or  names  of  the  person  or  persons  manufacturing,  rectifying  or  preparing  the 
same,  and  also  these  words,  "containing  no  deleterious  drugs  or  added  poison; " 
and  shall  also  certify  the  same  fact  or  facts  to  the  purchaser  over  his,  her  or  their 
own  proper  signature.1' 

2  Ohio,  Annotated  Statutes  (1900),  Sec.  7074: 

"Whoever  puts  into  any  barrel,  cask  or  other  vessel,  branded  or  marked  pure  by 
any  inspector  in  this  state,  adulterated  liquors,  or  knowingly  sells  or  offers  for  sale 
such  liquors  so  branded,  shall  be  imprisoned  in  the  penitentiary  not  more  than 
twelve  months." 

3  Missouri,  Revised  Statutes  (1889),  Sec.  3889. 

4  New  York,  Revised  Statutes  (1895),  p.  2418  (Public  Health  Law,  Sec.  43.) 


FOOD    OTHER    Til  AX  DAIRY  PRODUCTS.  329 

cider  or  vinegar,  not  made  exclusively  of  said  apple  cider  or  vinegar,  into  which  any 
foreign  snhstance,  ingredients,  drugs  or  acids  have  been  introduced,  as  may  appear 
by  proper  tests,  shall  for  each  such  offence  be  punished  by  fine  of  not  less  than  fifty 
BOX  more  than  one  hundred  dollars. 

"  Every  person  who  manufactures  for  sale,  or  offers  or  exposes  for  sale,  any  vine- 
gar found  upon  proper  tests  to  contain  any  preparation  of  lead,  copper,  sulphuric 
acid  or  other  ingredients  injurious  to  health,  shall  for  each  such  offence  be  punished 
by  fine  of  not  less  than  one  hundred  dollars. 

"All  vinegars  shall  be  without  artificial  coloring  matter,  and  shall  have  an  acidity 
equivalent  to  the  presence  of  not  less  than  four  and  one-half  per  cent,  by  weight  of 
absolute  acetic  acid,  and  in  the  case  of  cider  vinegar  shall  contain  in  addition  not 
less  than  two  per  cent,  by  weight  of  cider  vinegar  solids  upon  full  evaporation  over 
boiling  water,  and  if  any  vinegar  contains  any  artificial  coloring  matter  or  less  than 
the  above  amount  of  acidity,  or  in  the  case  of  cider  vinegar,  if  it  contains  less  than 
the  above  amount  of  acidity  or  of  cider  vinegar  solids,  it  shall  be  deemed  to  be  adul- 
terated within  tiie  meaning  of  this  act.11  * 

Iii  Illinois  the  requirement  is  one  and  one-quarter  per  cent,  of  vine- 
gar solids,  in  the  District  of  Columbia  it  is  four  per  cent,  of  acetic  acid. 

In  several  of  the  states,  as  Maine,  Wisconsin,  Minnesota,  Indiana, 
and  Rhode  Island  it  is  forbidden  to  "label,  brand  or  sell  as  cider  vine- 
gar, or  as  apple  vinegar,  any  vinegar  not  the  legitimate  product  of  pure 
apple  juice,  or  not  made  exclusively  from  apple  cider."  In  Minnesota2 
and  Wisconsin  there  arc  also  stringent  regulations  in  regard  to  the 
in, irking  on  the  package  of  tin-  strength  of  the  vinegar. 

In  Massachusetts  and  Rhode  Island  the  inspectors  <»f  milk  and  in 
Several  of  the  other  states  the  dairy  or  food  commissioners  are  intrusted 
with  the  enforcement  of  this  law.  These  officers  are  usually  given 
the  power  l<>  enter  premises  and  collect  samples,  and  all  persons  are  for- 
bidden under  penalties  to  obstruct  them,  and  the  reports  of  public 
analysts  are  prima  facie  evidence. 

The  proof  required jfor  a  conviction  for  the  violation  of  vinegar  laws 
is  well  stated   in  (  'onnect  iciil  :  ;; 

1  Massachusetts,  Public  Statutes  (1882),  Chapter  60,  Sees.  69  To,  Chapter  257  of 
1883,  and  Chapter  150  of  1885. 

"  Minnesota,  Statutes  1 1.894),  Sec.  7020: 

"All  manufacturers  of  vinegar  in  the  state  of  Minnesota,  and  all  persons  who 
reduce  or  rebarrel  \  inegar  in  this  state,  and  all  persons  who  bandle  vinegar  in  lots  of 
one  barrel  or  more,  are  hereby  required  to  stencil  or  mark  in  black  figures  at  least 
one  inch  in  length,  at  the  head  of  each  barrel  of  vinegar  boughi  or  sold  bj  1  hem.  the 
kind  of  vinegar  contained  in  each  package  or  barrel,  together  with  the  name  of  the 
manufacturer  and  location  of  the  factory  \\  here  the  same  is  made,  and  the  standard 
strength  of  the  vinegar  contained  in  the  package  or  barrel,  which  latter  shall  he 
denoted  bj  the  number  of  grains  of  pure  bi-carbonate  of  potash  required  to  neu- 
tralize one  fluid  ounce  of  vinegar.  \n\  neglecl  so  to  mark  or  stencil  each  pack- 
1  barrel,  or  any  false  marking  of  packages  or  barrels,  shall  be  deemed  a  misde- 
meanor, and  shall  be  punished  by  a  line  of  ttol  less  than  twenty-five  (25)  dollars,  aoi 
more  thai ■  hundred  (100)  dollars  and  costs." 

8  Connecticut,  Chapters  W  and  284  of  1889,  Sec.  S. 


330  FOOD    OTHER    THAN  DAIRY  PRODUCTS. 

"  .  .  .  No  person  shall  sell,  or  offer,  or  expose  for  sale,  or  exchange,  cr  solicit, 
or  receive  any  order  for  the  sale  or  delivery  within  this  state  or  for  delivery  without 
this  state  for  shipment  into  this  state:  first,  any  vinegar,  as  cider  vinegar,  not  wholly 
produced  from  the  juice  of  apples;  or  second,  any  vinegar,  or  article  sold  or  to  be 
sold  as  vinegar,  in  which  has  been  added  any  drug,  or  any  hurtful  or  foreign  sub- 
stance, or  any  coloring  matter,  or  any  acid  other  than  acetic;  or  third,  any  vinegar 
not  having  an  acetic  acidity  equivalent  to  the  presence  therein  of  not  less  than  four 
per  centum  by  weight  of  absolute  acetic  acid,  and  in  case  of  cider  vinegar,  not  less 
than  two  per  centum  by  weight  of  cider  vinegar  solids  upon  full  evaporation  over 
boiling  water;  or  fourth,  any  vinegar  made  in  this  state  and  purchased  by  the  person 
last  mentioned  of  the  maker  in  a  barrel,  cask,  keg,  or  other  package  not  branded, 
stenciled,  or  painted  as  required  by  a  previous  section  of  this  act.  Any  person  vio- 
lating this  section  of  this  act  shall  be  fined  ten  dollars  for  a  first  offense,  and  for  a 
second  or  later  offense  fifty  dollars.  The  delivery  of  any  of  the  above  mentioned 
articles  upon  any  order  solicited  or  received  within  this  state  shall  be  conclusive 
evidence  that  the  order  upon  which  such  delivery  was  made  was  for  such  articles, 
and  shall  render  the  person  soliciting  or  receiving  such  order  liable  to  the  penalty 
above  prescribed.'1 

Molasses,  Sugar,  Honey,  etc. 

The  chief  adulterant  of  these  food  materials  is  glucose  and  its  use 
for  this  purpose  is  forbidden  by  a  statute  which  is  found  in  Colorado, 
Iowa,  Maryland,  Michigan,  New  York,  and  Vermont.  This  law  forbids 
any  one  to  mix  glucose  with  syrup  or  sugar  in  Iowa,  and  with  syrup, 
honey,  or  sugar  in  the  other  states  ;  but  in  each  of  the  states  it  is  per- 
missible so  to  use  glucose  provided  the  per  cent,  of  glucose  is  marked 
on  the  package  and  made  known  to  the  buyer.  In  Maryland  glucose 
may  be  used  in  candy.  The  following  is  the  Connecticut  law  in  regard 
to  molasses  : 

"Any  person  who  shall  adulterate  any  molasses,  or  who  shall  sell,  or  offer  or 
expose  for  sale,  or  who  shall  solicit  or  receive  any  order  for  the  sale  or  delivery 
within  this  State,  or  for  delivery  without  this  State  for  shipment  into  this  State  of 
any  molasses  adulterated  with  salts  of  tin,  terra  alba,  glucose,  dextrose,  starch 
sugar,  corn  syrup,  or  other  preparations  of  or  from  starch,  shall  be  fined  not  more 
than  five  hundred  dollars,  or  imprisoned  not  more  than  one  year  or  both.'"  1 

In  Massachusetts  syrup  and  molasses  must  bear  the  maker's  name. 

A  similar  provision  is  also  found  in  the  same  state  in  regard  to  sugar,  and 

in  Maine  in  regard  to  both  sugar  and  molasses.     Louisiana  being  the  chief 

seat  of  the  manufacture  of  molasses  it  is  not  surprising  that  explicit 

laws  are   found   in  that   state   and   also  additional  ordinances   in   New 

Orleans  : 

lt  Be  it  enacted  by  the  General  Assembly  of  the  State  of  Louisiana,  That  who- 
ever shall  knowingly  sell  or  offer  for  sale,  ship  or  place,  upon  the  market  for  sale, 
either  by  sample,  hogshead,  barrel,  package  or  otherwise,  any  sugar  or  molasses 
adulterated  with  glucose  or  any  foreign  substance,  without  branding  or  stamping  it 
as  such  in  clear,  legible  letters,  shall  be  punished  by  imprisonment  not  exceeding 
six  months,  and  by  a  fine  of  not  less  than  two  hundred  dollars  nor  more  than  one 
thousand  dollars  for  each  offense.'"  2 


1  Connecticut,  General  Statutes  (1888),  Sec.  2622. 

2  Louisiana,  Chapter  49  of  1886. 


FOOD    OTHER    THAX  DAIRY  PRODUCTS.  33] 

"That  it  shall  be  unlawful  for  any  person  or  persons  to  engage,  employ,  or  hire 
any  one  to  adulterate  any  molasses,  syrup,  or  other  liquid  or  saccharine  matter,  with 
zinc,  tin  or  other  chemical  deleterious  and  injurious  to  public  health. 

"  That  it  shall  be  unlawful  for  any  person  or  persons  to  sell,  cause  to  be  sold, 
buy  or  cause  to  be  bought,  to  dispose  of,  or  cause  to  be  disposed  of  in  any  way  or 
manner,  any  molasses,  syrup,  or  any  liquid,  or  saccharine  matter,  adulterated  with 
zinc,  tin,  or  any  other  chemical  injurious  or  deleterious  to  public  health."  1 

The  following  is  found  in  Vermont  : 

"A  person  who  adulterates  maple  sugar,  maple  syrup,  or  bees1  honey  with  cane 
sugar,  glucose,  or  any  substance  whatever,  for  the  purpose  of  sale,  or  who  know- 
ingly sells  maple  sugar,  maple  syrup,  or  bees'  honey  that  has  been  adulterated,  shall 
be  punished  by  a  fine  of  not  more  than  two  hundred  dollars  and  not  less  than  fifty 
dollars  for  each  offense.     One-half  of  such  fine  shall  go  to  the  complainant."  2 

Honey. 

In  California,  Minnesota,  New  York,  youth  Dakota,  and  Wisconsin 
a  special  provision  is  made  in  regard  to  honey  : 

"  It  shall  be  unlawful  f<>r  any  person  or  persons  within  the  State  of  Minnesota  to 
offer  for  sale  or  have  in  their  possession  with  intent  to  sell,  sell  or  cause  to  be  soldr 
honey  compounded,  manufactured  from,  or  mixed  with  glucose,  sugar  syrup  of  any 
kind,  or  any  substance  whatever  not  the  legitimate  and  exclusiue  product  of  the 
honey  bee,  unless  the  package  containing  same  is  so  marked  and  represented  as  such 
and  bearing  the  label  upon  the  package  printed  thereon  in  heavy  Gothic  capitals, 
eighteen  point,  the  name  of  the  person  or  persons  having  compounded,  manufac- 
tured, or  mixed  the  same,  and  the  name  of  the  substance  or  material  from  which  it 
is  compounded,  manufactured,  or  mixed  with. 

"It  shall  be  unlawful  for  any  person  or  persons  within  the  State  of  Minnesota  to 
offer,  or  have  in  their  possession,  for  sale,  sell,  or  cause  to  be  sold,  honey  which  has 
not  been  made  by  the  bees  from  the  natural  secretion  of  flowers  and  plants,  but 
which  has  been  stored  or  made  by  the  bees  from  glucose,  sugar,  syrup,  or  any  other 
material  or  substance  fed  to  them;  unless  the  same  is  marked,  represented  and 
designated  as  such,  and  bearing  a  label  upon  each  package  printed  in  heavy  Gothic 
capitals,  eighteen  point,  thereon,  the  name  of  the  person  or  persons  who  fed  or 
caused  to  be  fed,  the  substance  or  material  from  which  the  same  is  stored  or  made, 
and  the  name  of  the  substance  or  material  from  which  the  said  honey  is  stored  or 
made." 

"Flour  "it'/  Bread. 

•  \o  manufacturer  or  other  person  shall  sell,  prepare,  deliver,  put  up,  expose, 
•  if  offer  tor  sale  any  article,  substance,  of  com  pound  under  or  by  the  name  of  wheat, 
meal,  graham  meal,  or  graham  dour  made  in  imitation  of  pure  wheal  meal  and  not 
oonsisting  exclusively  and  wholly  of  pure  wheat  meal,  unless  every  box,  bucket, 
barrel,  or  wrapper  in  or  under  which  said  article  is  sold,  delivered,  or  exposed  for 
■ale  bears  on  the  top  oi  outer  side  thereof,  in  letters  noi    less  than  half  an  inch  in 

h  and  plainlj   exposed  to  \  iew    the  wards  Ll  compound  wheat."  ' 

The  adulteration  of  grain  and  meal  is  also  forbidden  in  Vermont. 


1  New  Orleans.  Ordinance  No.  10086,  11  December,  1894. 

Vermont,  Statutes  (1894),  s^ .  1844. 
J  Minnesota,  Statutes  (1894),  Sees.  7088  0. 
1  Maine,  supplement  of  Laws  (1896),  p.  506,  Chapter 267  of  1889. 


332  FOOD    OTHER    THAN  DAIRY  PRODUCTS. 

In  Illinois  bread  is  the  first  food  named  in  the  general  adulteration 
law,  and  it  is  also  mentioned  in  the  Missouri  law. 

The  adulteration  of  wheat  flour,  with  other  cereals,  particularly 
maize,  has  increased  very  much  of  late  and  the  war  revenue  law1  takes 
cognizance  of  this  fact  and  attempts  to  prevent  the  fraudulent  sale  of 
the  compound.  The  law  provides  that  makers  of  mixed  flour  shall  pay 
a  tax  of  $12  per  year  and  that  all  packages  shall  be  marked  with  the 
words  "  mixed  flour  "  in  plain  black  letters  not  less  than  two  niches 
high,  also  with  the  weight  of  the  contents,  the  names  of  the  ingredients 
and  the  name  of  the  packer  and  place  of  packing..  There  shall  be 
affixed  to  the  package  the  following  notice  : 

"  Notice. —  The  manufacturer  (or  packer,  as  the  case  may  be)  of  the  mixed  flour 
herein  contained  has  complied  with  all  the  requirements  of  law.  Every  person 
is  cautioned  not  to  use  this  package  or  label  again  or  to  remove  the  contents  with- 
out destroying  the  revenue  stamp  thereon,  under  the  penalty  prescribed  by  law  in 
such  cases." 

The  flour  also  pays  a  tax  of  four  cents  per  barrel,  two  cents  per  one- 
half  barrel,  one  cent  per  one-quarter  barrel,  and  one-half  cent  per  one- 
eighth  barrel  or  less,  the  tax  to  be  paid  by  stamps.  There  is  also  a  pro- 
vision for  the  marking  and  stamping  of  all  imported  mixed  flours. 

Fumigated  Grrain. 

•'Any  person  who  shall  fumigate  any  barley,  wheat,  or  other  grain  by  the  use  of 
sulphur  or  other  substance,  or  shall  in  any  way,  or  by  the  use  of  any  chemical, 
material,  or  process,  affect  the  color  or  healthfulness  of  such  grain,  or  who  shall 
sell,  or  offer  for  sale,  any  such  grain,  knowing  that  the  same  has  been  fumigated,  or 
the  color  or  healthfulness  so  affected,  shall  be  punished  by  imprisonment  in  the 
county  jail  not  more  than  one  month  or  by  fine  not  exceeding  fifty  dollars.'1  2 

The  sale  of  fumigated  grain  is  also  forbidden  in  Illinois. 

Buckwheat  Flour. 

In  Michigan  adulterated  buckwheat  flour  is  defined  as  follows : 

"Sec.  2.  Buckwheat  flour  shall  be  deemed  to  be  adulterated  within  the  mean- 
ing of  this  act,  first,  if  any  substance  or  substances  have  been  mixed  with  it  so  as  to 
to  lower  or  depreciate  or  injuriously  affect  its  quality,  strength  or  purity;  second,  if 
an  inferior  or  cheaper  substance  or  substances  have  been  substituted  wholly  or  in 
part  for  it;  third,  if  any  valuable  constituent  or  ingredient  has  been  wholly  or  in  part 
abstracted  from  it;  fourth,  if  it  is  sold  under  the  name  of  another  article;  fifth,  if  it 
contains  an  added  substance  or  ingredient  which  is  poisonous  or  injurious  to  the 
health.1'3 

Substitutes  and  compounds  must  be  labeled. 


1  Act  of  Congress,  13  January,  1898,  Sees.  35  to  49. 

2  Wisconsin,  Statutes  (1898),  Sec.  4606. 

3  Michigan,  Compiled  Laws  (1897),  Sec.  4995. 


FOOD    OTHER    THAN  DAIRY  PRODUCTS.         333 

Saleratus  and  Cream  of  Tartar. 

'•Every  person  who  shall  sell  saleratus,  bicarbonate  of  soda  or  cream  of  tartar, 
which  has  been  adulterated  and  thereby  rendered  an  impure  article,  shall  be  fined 
twenty  dollars,  together  with  the  cost  of  testing  and  analyzing  such  impure  article."  3 

The  law  also  provides  for  the  appointment  of  inspectors  by  the 
towns  and  cities,  but  as  the  only  compensation  is  a  fee  to  be  paid  by 
any  person  who  presents  a  sample  for  analysis,  it  is  not  surprising  that 
the  law  is  never  enforced. 

Baking  Poivch  rs. 

The  question  of  the  injurious  effects  of  alum  in  baking  powders  has 
been  much  discussed  and  a  very  extended  consideration  of  the  subject 
may  be  found  in  a  bulletin  issued  by  the  Department  of  Agriculture.2 
Opinions  differ  as  to  whether  the  small  amount  of  alum  remaining  in 
food  in  which  alum  baking  powder  is  used  is  injurious,  and  consequently 
opinions  differ  as  to  the  advisability  of  legislation  on  the  subject.  In 
most  states  there  is  no  prohibition  of  such  a  use  of  alum,  but  in  Min- 
nesota there  was  a  very  stringent  law  to  forbid  the  sale  of  baking 
powders  containing  alum  unless  that  fact  is  plainly  marked  upon  the 
package.  This  was  afterwards  repealed,  and  the  present  law.  which  is 
very  explicit,  requires  that  all  baking  powders  shall  have  the  ingredi- 
ents and  amounts  marked  on  the  package.8 

In  South  Dakota  all  compounds  containing  alum  must  be  plainly 
so  marked.4 

•  Poisonous  lii'jr<  dients. 

The  following  is  from  Missouri: 

"  It  shall  he  unlawful  for  any  person  or  corporation  (hung  business  in  this  state 
to  manufacture,  sell,  or  offer  to  sell  any  article,  compound  or  preparation  for  the 

purpose  'if  being  used,  or  which  is  intended    to  he  used  in  the  preparation  Of  tin  id  in 

which  article,  compound  or  preparation  there  is  any  arsenic  calomel,   bismuth, 
ammonia  or  alum."  "' 

Poisonous  ( 'oloriny  Matter. 

The  following  are  some  of  the  laws  and  rules  relating  to  such  color- 
ing matter  : 

•■  Whoever  bj  himself  01  by  his  servant  or  agent,  or  as  theservanl  or  agent  of  anj 
other  person,  manufactures,  sells  or  exchanges,  or  lias  in  his  custody  or  possession 
wiili  i ii i in i  to  sell  or  exchange,  or  exposes  or  offers  for  sale  or  exchange,  any  ehil- 

1  Rhode  Island,  General  haws  (1896),  Chapter  138. 

Hull,  iin  I  ;    Division  of  Chemistry,  U.  S.  Department  of  Agriculture,  p.  571. 

Minnesota,  Chapter  245  of  L899. 
1  South  Dakota,  Chapter  B9  of  1899. 

Missouri,  Act  of  1 1  May.  L899. 


334  FOOD    OTHER    THAN  DAIRY  PRODUCTS. 

droit's  toys  or  confectionery,  containing  or  coated  wholly  or  in  part  with  arsenic, 
shall  be  punished  by  fine  of  not  less  than  fifty  nor  more  than  one  hundred  dollars."  1 

"  That  no  person  by  himself  or  his  agent  or  servants,  nor  as  an  agent  or  servant 
shall  manufacture,  sell,  offer  for  sale,  expose  for  sale,  or  have  in  his  possession  with 
intent  to  sell,  any  cakes  or  biscuits  in  which  yolka,  yolkaline,  tumeric,  chrome  yel- 
low or  any  other  substitute  for  eggs  of  like  nature  has  been  used,  except  there  be 
displayed  in  a  public  manner  on  the  package  in  which  such  cakes  and  biscuits  are 
carried,  or  on  the  place,  receptacle  or  holder  in  which  such  articles  are  placed  for 
sale  a  label,  show  card  or  sign,  on  which  shall  be  printed  in  letters  oi  the  English 
language  at  least  three  inches  high  and  one  and  one-half  inches  wide  the  words, 
4  these  cakes  and  biscuits  are  colored  with  an  artificial  substitute  for  eggs.1  "  2 

Candy. 

A  little  manual  published  in  1897  by  the  National  Confectioners' 
Association3  gives  all  the  state  legislation  concerning  the  adulteration 
of  candy  in  force  1  April,  1897.  The  association  lias  evidently  been 
very  active  and  claimed  to  have  secured  legislation  in  twenty  states. 
The  avowed  purpose  of  the  association  is  to  secure  laws  against  noxious 
adulterant  as  distinguished  from  fraudulent  ones. 

The  act  as  drawn  up  by  this  association  has  evidently  served  as  the 
basis  of  the  law  in  at  least  twenty-six  states,4  though  as  is  usual  in  such 
cases  it  has  been  variously  modified  by  the  wisdom  of  committees  and 
legislatures,  but  unlike  many  such  acts,  its  main  purpose  does  not  seem 
to  have  been  subverted  by  any  such  amendments.  The  writer  does  not 
know  what  was  the  form  of  the  act  as  drawn  by  the  association,  but  the 
law  in  Minnesota  would  appear  to  be  typical  of  this  class  of  legislation : 

"  No  person  shall,  by  himself,  his  servant  or  agent,  or  as  the  servant  or  agent  of 
any  other  person  or  corporation,  manufacture  for  sale  or  knowingly  sell  or  offer  for' 
sale  any  candy  adulterated  by  the  admixture  of  terra  alba,  barytes,  tale  or  any  other 
mineral  substance,  by  poisonous  colors  or  flavors  or  other  ingredients  deleterious  to 
health."  5 

In  Maine  in  addition  to  the  substances  usually  specified  as  "  dele- 
terious "  there  are  named  "  brandy,  whiskey,  rum,  wine  or  any  alcoholic 
liquor  in  liquid  form,"  and  it  is  also  forbidden  to  "  offer  for  sale  any 
candy  under  the  name  of  brandy,  whiskey,  rum,  or  wine  drops,''  and  the 


1  Massachusetts,  Chapter  374  of  18!>1 : 

2  New  Jersey,  Laws  of  1895,  p.  473. 

8  The  secretary  in  1897  was  F.  D.  Seward,  of  the  F.  D.  Seward  Confectionery  Com- 
pany, St.  Louis.  The  book  bears  the  imprint  of  the  Confectioners'  Journal  Print, 
Philadelphia. 

1  The  states  which  have  this  form  of  law  are  Alabama,  Connecticut,  California, 
Delaware,  Georgia,  Illinois,  Indiana,  Maine,  Maryland,  Michigan,  Minnesota,  Mis- 
souri, Montana,  Nevada,  New  Hampshire,  New  Jersey,  North  Dakota,  Ohio, 
Pennsylvania,  Rhode  Island,  South  Carolina,  South  Dakota,  Tennessee,  Utah, 
Vermont,  and  Wyoming. 

5  Minnesota,  Act  of  25  April,  1895. 


FOOD    0  THE R    Til  AX  DAIRY  PRODUCTS.         335 

prohibition  relates  to  -lozenges"'  as  well  as  candy.  In  Maryland  a 
narcotic  is  not  to  be  added  to  candy.  The  following  is  the'  Massachu- 
setts law  in  regard  to  alcohol  in  candy: 

"  Xo  person  shall  sell  to  any  child  under  sixteen  years  of  age  any  randy  or  other 
artii ,-le.  inclosing  liquid  or  syrup  containing  more  than  one  per  centum  of  alcohol."  ' 

Besides  the  states  mentioned,  several  have  provisions  in  their  fend 
laws  in  regard  to  candy.  In  Massachusetts  "confectionery"  is  included 
in  the  definition  of  food  by  Chapter  171  of  1886  and  the  same  word  is 
found  in  the  similar  law  in  New  York,  and  in  the  Wisconsin  and  Ken- 
tucky adulteration  law  it  is  '•candy  or  sweetmeat.'*  and  in  Illinois 
u  candy  and  confection,"  and  in  Mississippi  "candy,  confects,  and  sweet- 
meats" that  are  controlled  by  the  law. 

The  Montana  law,  and  the  Vermont  law  referred  to  on  page  331, 
appear  to  be  the  only  laws  which  forbid  the  use  of  glucose  in  candy. 

For  the  use  of  arsenic  in  candy  see  the  Massachusetts  law  on  page 
833. 

Fruit  Jelly. 

■•  No  person,  firm,  or  corporation  in  this  Mate  shall  manufacture  for  sale,  or  sell, 
or  offer  or  expose  for  sale,  as  fruit  jelly  or  fruit  butter,  any  jelly  or  imitation  fruit 
butter  or  other  similar  compound  made  oi  composed  in  whole  or  in  part  of  gl 
dextrine,  starch  or  other  substances,  and  colored  in  imitation  of  fruit  jelly  or  fruit 
butter:  nor  shall  any  such  jelly,  fruit  butter  or  compound  be  manufactured,  or  sold. 
or  offered  cor  sale,  under  any  name  or  designation  whatever,  unless  the  same  shall 
be  composed  entirely  of  ingredients  not  injurious  to  health,  and  shall  not  be  colored 
in  imitation  of  fruit  jelly,  and  every  can,  pail,  or  package  of  such  jelly  or  butter 
•old  in  this  State  shall  be  distinctly  ami  durably  labeled  ••Imitation  fruit  jelly  or 
butter."  with  1  lie  name  of  the  manufacturer  and  the  place  where  made.  Whoever 
violates  the  provisions  of  this  section  shall  be  deemed  guilty  of  a  misdemeanor,  and 
when  convicted  thereof  shall  be  punished  by  a  fine  of  nol  less  than  fifty  nor  more 
than  live  hundred  dollars,  or  by  imprisonmenl  in  the  county  jail  or  State  House  of 
Correction  and  Reformatory  at  Ionia  for  nol  less  than  ninety  days  nor  more  than 
£wo  years,  or  by  both  such  fine  and   imprisonmenl  in  the  discretion  of  the  court."3 

A  more  extensive  and  carefully  prepared  law  on  this  subjed  is  also 
found  in  Minnesota.3     South  Dakota  and   Illinois  also  have  jelly  laws. 

Coffee. 

The  adulteration  of  ground  coffee  is  very  common  and  the  manu- 
facture of  the  coffee  berries  themselves  is  nol  unknown,  yel  there 
appears  to  be  \<i\  little  special  legislation  on  this  subject.  Adultera- 
tions of  coffee  are  usually  punished  through  the  general  laws.  The 
following  is  found  in  Michigan  : 

■  No  person  shall  manufacture  "i  sell,  or  offer  tor  s;iie.  any  manufactured  or  arti- 
ficial coffee  berry  in  imitation  of  the  genuine  berry.     No  person  shall  manufacture, 

1  Massachusetts,  chapter  883  of  1891. 

-  Michigan,  Compiled  Laws  (1897),  Sec.  5022. 

'•  Minnesota.  Chapter  I'm  oi  1897. 


336  FOOD    OTHER    THAX  DAIRY  PRODUCTS. 

sell  or  offer  for  sale  any  ground  or  prepared  coffee,  which  is  adulterated  withchicoiy 
or  other  substances  not  injurious  to  health,  unless  each  package  thereof  shall  he 
distinctly  labeled  or  marked  "Coffee  compound,11  together  with  the  name  and 
address  of  the  manufacturer  or  compounder  thereof.11  a 

In  the  District  of  Columbia  coffee  must  be  made  entirely  of  the 
seed  of  caffea  arabica. 

Olive  Oil. 

The  statute  in  California2  provides  that  the  producer  or  dealer  in 
olive  oil  may  prepare  a  label  and  file  the  same  with  the  state  board  of 
agriculture  together  with  the  affidavit  that  the  oil  will  be  pure.  The 
manufacture  or  sale  of  adulterated  oil  is  forbidden.  In  the  District  of 
Columbia  olive  oil  must  be  made  exclusively  from  the  olive  berry  (olea 
Europcea). 

Catsup. 

The  San  Francisco  Board  of  Health3  has  established  a  standard  of 
tomato  catsup.  It  must  contain  twenty-five  per  cent,  of  organic  solids 
including  ash,  and  be  free  from  antiseptics  and  coloring  matter. 

Eggs. 

Artificial  eggs  are  said  by  the  lay  press  to  be  manufactured  by 
ingenious  Parisian  artisans,  but  they  do  not  appear  to  have  been  heard 
of  in  this  country.  Nevertheless  a  substance  has  been  sold  which  is 
intended  for  use  by  bakers  to  make  cake  appear  as  if  eggs  had  been 
used.     See  the  New  Jersey  Law  on  page  334. 

Lard. 

The  practice  of  adding  beef  suet  and  cotton  seed  oil  to  lard  met 
with  great  opposition  among  the  manufacturers  of  pure  lard  and  as  a 
result  of  the  agitation  laws  against  the  adulteration  of  lard  are  found 
in  a  number  of  states.  Good  laws  in  regard  to  lard  adulteration  or 
lard  mixtures  are  found  in  Maine,  Michigan,  Minnesota,  and  Massachu- 
setts.    The  law  in  the  latter  state  is  as  follows : 

"  No  manufacturer  or  other  person  shall  sell,  deliver,  prepare,  put  up,  expose  or 
offer  for  sale  any  lard,  or  any  article  intended  for  xise  as  lard,  which  contains  any 
ingredient  hut  the  pure  fat  of  swine,  in  any  tierce,  bucket,  pail,  or  other  vessel  or 
wrapper,  or  under  any  label,  bearing  the  words  "  pure,11  "refined,1'  "family,11  or 
either  of  them,  alone  or  in  combination  with  other  words,  nor  unless  every  vessel, 
wrapper,  or  label,  in  or  under  which  such  article  is  sold  or  delivered,  or  prepared, 
put  up,  or  exposed  for  sale,  bears  on  the  top  or  outer  side  thereof,  in  letters  not  less 
than  one-half  inch  in  length  and  plainly  exposed  to  view,  the  words: — Compound 
Lard.11  * 


1  Michigan,  Compiled  Laws  (1897),  Sec.  5024. 

2  California,  Chapter  47  of  1891. 

3  San  Francisco,  Report  of  Board  of  Health  (1897),  pp.  8,  209. 
*  Massachusetts,  Chapter  449  of  1887,  Sec.  1. 


FOOD    OTHER    THAN  DAIRY  PBDOUCTS.         337 

The  most  stringent  and  complete  law  is  that  of  Minnesota.1  This 
law  forbids  the  sale  "as  lard  of  any  substance  not  the  legitimate  and 
exclusive  product  of  the  fat  of  the  hog,*'  unless  it  shall  be  labeled  in 
letters  imt  less  than  one  inch  in  length,  and  shall  have  the  name  of  the 
manufacturer  and  the  location  of  the  manufactory  in  letters  of  the 
same  size,  and  the  names  and  proportions  of  the  ingredients  in  letters 
one-half  inch  in  length.  If  it  is  a  "  mixture  or  componnd  of  animal  or 
vegetable  oils  or  fats  other  than  hog  fat  in  the  form  of  lard,"  it  shall  be 
labeled  "  hard  Substitutes."  If  it  is  a  mixture  of  the  above  with  lard 
it  shall  be  labeled  "Adulterated  Lard."  Dealers  and  traders  must  also 
mark  goods  in  a  similar  manner  with  letters  half  the  above  size,  and 
must  give  a  card  to  the  customer  stating  the  facts.  Keepers  of  hotels 
and  restaurants  are  controlled  by  the  following: 

"Every  person  who  manufactures  tor  sale,  or  who  offers  or  exposes  for  sale  or 
sells,  or  who  serves  to  guests  as  keeper  of  hotel,  restaurant,  dining  room,  or  in  any 
other  capacity,  articles  of  food  which  have  been  prepared,  either  wholly  or  in  part, 
with  lanl  substitutes,  or  adulterated  lard  as  herein  before  defined,  shall  at  the  time 
of  sale  furnish  to  the  purchaser  a  card  upon  which  is  distinctly  and  legibly  printed 
the  words.  'This  food  is  prepared  with  lard  substitute  (or  adulterated  lard),' or  in 
case  no  bill  of  fare  is  provided,  there  shall  be  kept  constantly  posted  upon  each  of  the 
sides  of  the  dining  room,  in  a  conspicuous  position,  cards,  upon  the  face  of  which  is 
distinctly  and  legibly  printed  in  the  English  language,  and  in  letters  of  sufficient  size 
to  be  visible  from  all  parts  of  the  room.  l  Lard  substitute  (or  adulterated  lard)  is 
used  in  the  preparation  of  the  food  served  here."'" 

The  state  dairy  commission  is  to  enforce  the  law  and  has  the  power 

of  search  and  seizure.  The  penalty  is  twenty-live  dollars  to  titty  dollars 
or  i  bitty  to  sixty  days. 

EXECUTION    OF    FOOD    LAWS. 

Food  laws  may  be  executed  by  the  ted,. nil  governmenl  and  by  the 
states  and  by  municipalities.  The  Laws,  as  bias  been  shown,  are  federal, 
Btate  and  local,  but  most  laws  are  of  little  value,  unless  there  are  efficient 
officers  charged  with  their  execution.  Tins  is  must  assuredly  true  of 
food  laws.  Greal  pecuniary  rewards  often  tempi  their  \i<»lati<>n  and 
often   the  nature  of  the  offence  is  such  that  it  escapes  detection  unless 

there  is  aii  expert  constant  1\  on  the  alert  to  discover  it.  The  whole 
value  of  these  Laws  depends  on  the  efficiency  of  their  execution.  There 
must   be  not  only  statutes  ami  ordinances,  but   inspectors  and  chemists. 

The    latter    are    even     inmv    important     than    the    former,   fur    the    mere 

exposure  and  publication  of  frauds  even  if  there  are  no  laws  to  reach 
the  offender,  often  have  ;i  must  wholesome  deterrent  effect. 


[Minnesota,  Statutes  (1894),  Sees.  f02fl  37. 


338  FOOD    OTHER    THAX  DAIRY  PRODUCTS. 

I.     Federal  Inspection. 

The  federal  government  has  laws  against  the  importation  of  adulter- 
ated food  and  drugs,  the  importation  of  adulterated  tea,  and  the  impor- 
tation of  diseased  cattle.  There  is  also  the  oleomargarine  law  and  the 
flour  law.  The  United  States  has  also  by  virtue  of  its  control  of  inter- 
state commerce  forbidden  the  transportation  of  diseased  meat  from  one 
state  to  another.  The  enforcement  of  the  importation  law  is  in  the 
hands  of  the  secretary  of  the  treasury,  who  makes  use  of  the  regular 
custom  house  inspectors  and  employs  such  experts  as  may  be  necessary. 
The  oleomargarine  law  is  executed  by  the  internal  revenue  commis- 
sioner and  is  administered  chiefly  from  a  revenue  point  of  view. 

The  government  also  inspects  the  exports  of  cattle  and  meat,  but 
this  is  of  value  to  the  producers  of  our  own  country  and  the  consumers 
of  other  countries  and  does  not  affect  our  own  consumers. 

The  control  and  inspection  of  interstate  commerce  in  meat  and 
other  slaughter-house  products  is  by  far  the  most  important  sanitary 
work  of  the  government  relating  to  foods.  By  the  act  of  3  March  1891, 
the  inspection  of  the  slaughtering  of  animals  intended  for  interstate  or 
foreign  trade  was  inaugurated  under  the  control  of  the  bureau  of  animal 
industry  of  the  department  of  agriculture.  It  is  intended  that  this 
inspection  shall  cover  all  the  animals  slaughtered  for  these  trades,  but 
at  first  it  was  possible  to  inspect  at  only  a  few  of  the  most  important 
slaughtering  centres.  Even  now  the  inspection  does  not  include  all 
animals  even  for  the  interstate  trade,  though  in  1898  these  inspections 
were  carried  on  at  138  abattoirs  in  thirty-five  cities.  The  number  of 
animals  inspected  was  51,335,398,  of  which  116,176  were  condemned. 
Two  million  eight  hundred  and  two  thousand  eight  hundred  and  forty- 
six  samples  of  pork  were  examined  microscopically,  of  which  about 
one  per  cent,  were  condemned.  All  animals  are  inspected  by  a  veteri- 
narian before  killing  and  if  they  are  not  passed  they  are  sent  to  special 
pens,  the  most  are  slaughtered  and  so  disposed  of  that  they  cannot  be 
used  for  food.  The  rest  are  kept  until  they  recover  or  die.  Pregnant 
animals  are  sent  to  the  country  until  such  times  as  they  may  be  fit  to 
kill.  Veterinary  inspectors  are  constantly  on  the  killing  floor  and 
examine  the  viscera  of  each  animal  slaughtered.  Every  quarter  of  beef 
bears  a  numbered  tag.  In  the  case  of  hogs,  one  or  more  samples  are 
cut  from  each  carcass  which  is  tagged  and  the  samples  numbered  in  dupli- 
cate. Each  sample  is  twice  examined  microscopically  for  trichinosis. 
Piece  examination  of  bacon  and  ham  is  carried  on  to  some. extent  and 
the  packages  that  are  passed  are  stamped.  The  carcasses  that  are  con- 
demned should  be  sent  at  once  to  the  tankage  room,  but  their  disposi- 
tion cannot  always  be  controlled  by  the  federal  inspectors,  and  for  this 


FOOD    OTHER    Til  AX  DAIRY  PRODUCTS.         339 

reason  the  co-operation  of  the  local  inspectors  is  always  to  be  desired. 
The  cost  of  the  inspections  in  1898  was  0.8  cent  per  head. 

II.     State  Inspection. 

The  inspection  of  meat,  fish,  vegetables,  fruit,  milk,  and  other  per- 
ishable material  is  usually  in  the  hands  of  the  local  authorities  as  the 
State  could  not  without  an  army  of  inspectors  properly  do  this  work. 
This  is  not  true  of  Maryland  where  food  inspectors  are  appointed  by 
the  state  board  of  health,  who  look  after  meat,  fish,  fruit,  and  animals 
intended  for  slaughter  :  but  the  state  hoard  of  health,  besides  the  special 
inspectors  employed  by  it.  invests  all  local  health  officers  with  the 
authority  of  inspectors.1 

The  control  of  adulterations  and  substitutions  is  however  usually  a 
stat<-  charge  and  is  not  given  much  attention  by  the  cities  and  towns. 
In  some  states,  as  Indiana.  Maryland.  Massachusetts,  New  Hampshire, 
and  New  York  the  state  board  of  health  is  required  to  take  cognizance 
of  these  matters:  but  in  other  states  it  is  the  dairy  or  food  commis- 
sioner wlio  is  invested  with  this  control.  The  states  having  such  a 
commission  are  Colorado,  Connecticut,  Illinois,  Michigan,  Minnesota, 
Hew  Jersey,  Ohio,  Oregon,  Pennsylvania,  Washington,  and  Wisconsin. 

In  .Massachusetts  three  members  of  the  state  board  of  agriculture 
appointed  by  the  governor  constitute  a  dairy  bureau,  and  in  New  York 
the  commissioner  of  agriculture  enforces  the  law  in  regard  to  dairy 
products,  but  not  in  regard  to  other  foods.  In  Kentucky  the  director 
of  the  agriculture  experimenl  station  is  to  appoint  food  inspectors  and 
fix  the  standard  for  food  materials  when  they  are  not  fixed  by  statute. 
Such  food  commissioners  are  usually  appointed  by  the  governor,  but  in 
Ohio  the  commissioner  is  elected  by  the  people,  and  in  Oregon   b\  the 

legislature,  in  New  Jersey  he  is  appointed    by  the  state  board  of    health, 

and  in  Pennsylvania  by  the  state  board  of  agriculture.  The  term  of 
office  is  two  years,  and  the  salary  varies  from  $1,000  in  Oregon  to 
|2,000  iii  New  Jersej  and  Pennsylvania,  and  in  Wisconsin  $2,500. 
The  commissioner  usually  has  a  clerk  or  secretary  and  has  one  or  more 
assistants  provided,  or  may  appoinl  inspectors.  The  stale  board  of 
health  or  the  food  commissioners  are  usually  empowered  to  appoinl  or 
employ  chemists  ami  analysts:  but  in  Wisconsin  the  analyses  arc  to  ]»■ 
made  al  the  -tat"  university,  in  Colorado  at  the  state  agricultural  col- 
and  in  Connecticut  and  Kentucky  at  the  experiment  station  oi- 
ly an\  state  chemist,  and  in  the  District  of  Columbia  the  commissioner 
of  internal  revenue  shall  make  the  analysis.     In  Ohio  an)  chemist  may 


1  Maryland,  Report  ..f  State  Board  of  Health  (1891),  p.  26,  Rule  L. 


340  FOOD    OTHER    THAN  DAIRY  PRODUCTS. 

be  employed.     It  is  usually  provided  that  the  official  analysis  shall  be 
'prima  facie  evidence. 

The  following  are  the  rules  governing  the  inspectors  and  analysts  in 
New  Jersey : 

DUTIES    OF    INSPECTORS. 

"1.  The  Inspector  is  to  buy  samples  of  food  or  drugs,  and  to  seal  each  sample 
in  the  presence  of  a  witness,  if  prosecution  is  intended. 

"2.  The  Inspector  must  affix  to  each,  sample  a  label  bearing  the  number  as 
authorized  for  that  purpose. 

"3.  Under  no  circumstance  is  the  inspector  to  inform  the  analyst  as  to  the 
source  of  the  sample  before  the  analysis  shall  have  been  completed. 

"  4.     Inspectors  are  to  keep  a  record  of  each  sample  as  follows: 

(1)  Number  of  sample. 

(2)  Date  and  time  of  purchase.    » 

(3)  Xame  of  witness  to  sealing. 

(4)  Xame  and  address  of  seller. 

(5)  Name  and  address  of  producer,  manufacturer,  or  wholesaler,  when  known, 

with  marks  on  original  package. 

(6)  Name  of  analyst  and  date  of  sending. 

(7)  How  sent  to  analyst. 

"5.  If  the  seller  desires  a  portion  of  the  sample,  the  inspector  is  to  deliver  it 
under  seal.  The  duplicate  sample  left  with  seller  should  have  a  label  containing  the 
the  same  marks  as  are  affixed  to  the  portion  taken  by  the  inspector. 

"6.  The  inspector  is  to  deliver  the  sample  to  the  analyst,  taking  his  receipt  for 
same,  or  he  may  send  it  by  registered  mail,  express,  or  special  messenger. 

"  1.  The  chemist  or  analyst  is  to  analyze  the  samples  immediately  upon  receipt 
thereof. 

"1.  Samples,  with  the  exception  of  milk  and  similar  perishable  articles,  are  to 
be  divided  by  the  analyst  and  a  portion  sealed  up,  and  a  copy  of  the  original  label 
affixed,  or  the  original  package  preserved,  after  removing  sufficient  for  analysis,  for 
three  months. 

"3.  Should  the  result  of  an  analysis  be  disputed  in  any  case  in  which  analysis 
has  been  ordered  by  the  state  board  of  health,  the  defendant  or  person  selling  the 
sample  in  question,  or  his  attorney,  may  appeal  to  said  board  through  its  secretary, 
and  said  secretary  shall  then  require  another  chemist  to  repeat  the  analysis,  using  a 
duplicate  portion  of  the  original  sample.  But  when  such  an  appeal  shall  be  made, 
a  sum  of  money  sufficient  to  cover  the  expenses  of  the  second  analysis  shall  be 
deposited  with  the  secretary  of  the  state  board  of  health;  which  sum  shall  be  paid 
to  the  analyst  designated,  as  required  above,  to  make  said  second  analysis,  in  case 
the  analysis  shall  be  found  to  agree  with  the  first  in  all  essential  particulars.  But 
in  case  the  sample  has  been  procured  by  the  dairy  commissioner,  or  inspectors 
appointed  by  him,  any  such  appeal  shall  be  to  the  dairy  commissioner,  and  the 
money  deposit  for  the  second  analysis  be  made  with  him,  subject  to  the  conditions 
above  stated. 

"  4.  In  the  case  of  all  articles  having  a  standard  of  purity  fixed  by  any  of  the 
laws  of  the  state,  the  certificate  of  the  analyst  should  show  the  relation  of  the  article 
in  qnestion  to  that  standard. 

"  5  Eacli  analyst  should  keep  a  record-book,  in  which  should  be  entered  notes 
as  follows: 

(1)  From  whom  the  sample  is  received. 

(2)  Date,  time  and  manner  of  receiving  the  sample. 

(3)  Marks  on  package,  sealed  or  not. 

(4)  Results  of  analysis  in  detail. 


WOOD    OTHER    THAN  DAIRY  PRODUCTS.         341 

"G.     At  the  completion  of  the  analysis,   a  certificate  in  the   form  given  below 
shall  be  forwarded  to  the  board  of  health  if  the  analysis  had  been  ordered  through 
•sit,  or  to  the  dairy  commissioner  if  ordered  through  him. 

CERTIFICATE. 

To  whom  it  linn/  concern  : 

"I, ,  a  Chemist  appointed  by  the  State 

Board  of  Health  of  New  Jersey,  under  the  provisions  of  an  act  entitled  'An  act  to 
prevent  the  adulteration  of  food  or  drugs."  approved   March   25th,  1881.  do  hereby 

certify  that  1  received  from on  the 

day  of 188 . .  a  sample  of 

sealed  as  required  by  the  rules  of  said  Board,  and  bearing  the  following  marks  to 
wit: 

"I  carefully  mixed  said  sample  and   have  analyzed  the  same,  and  hereby  certify 
and  declare  the  results  of  my  analysis  to  be  as  follows: 

[Signature.] 

■•  T.     Samples  sent  to  analysts  are  to  be  retained  for  the  space  of  three  months." 

Massachusetts  has  probably  done  more  than  any  other  state  to  stop 
adulteration.  The  work  of  the  state  hoard  of  health  was  begun  in 
1vvi!.  and  up  to  November,  1899,  110,000  samples  had  been  examined,1 
1,500  prosecutions  entered,  of  which  thirty-live  were  appealed  to  the 
supreme  court.  About  110,000  annually  are  expended  and  the  average 
eosl  of  collection,  examination,  and  prosecution  per  sample  is  $1.34. 
During  the  period  covered  by  the  operations  of  the  hoard  the  per  cent- 
age  of  adulterations  has  diminished  one-half.  Investigations  in  the 
aeighboring  state  of  Rhode  Island  where  there  is  no  attempl  to  sup- 
press adulteration  show  that  it  is  much  more  common  than  in  Massa- 
chusetts. There  can  be  little  doubt  that  the  amount  expended  for  this 
Service  in   Massachusetts  is  saved  many  times  to  the  citizens. 

///.      Local  Inspection. 

The  authority  to  appoint   inspectors  is  usually  exercised  by  cities  hy 

virtue  <>f  their  grant  of  general  sanitary  powers,  but  it  is  sometimes 
specifically  conferred.  Thus  in  Massachusetts- it  is  provided  that  the 
board   of  health  shall  appoint   ■  or  more  persons  to  be  inspectors  of 

provisions  and  of  animals  intended  tor  slaughter  or  the  production  of 
milk.  In  Utah  cities  of  10,000  and  over  are  required  to  appoint  meat 
inspectors  who  are  to  inspect  all  cattle  before  slaughtering,  and  also  the 
carcasses  after  slaughter  and  tag  them.  They  may  also  he  required  to 
perform  other  duties  relating  to  food   inspection.     In    Mississippi  ;  the 


1  Paper  by  Dr.  S.  W.  Abbott,  Papers  American  Publii  Bealth   Association,  Vol.26, 
277. 

v..  sacbusetts,  Chapter  W8  ol  1899,  Sec.  20. 

Mississippi,  Code  1 1892),  Sec.  2098. 


342  FOOD    OTHER    THAN  DAIRY  PRODUCTS. 

county  supervisors  and  mayors  and  aldermen  have  similar  powers, 
but  the  law  is  permissive.  In  Louisiana1  the  law  requires  the  regular 
police  to  enforce  the  food  laws,  but  it  is  useless  to  expect  any  efficient* 
action  without  special  officers,  and  in  New  Orleans  special  inspectors 
are  employed.  A  few  cities,  as  Providence,2  and  Baltimore,3  have 
authority  granted  by  special  acts.  Most  cities  of  50,000  inhabitants  or 
over  and  a  number  which  are  smaller  than  this  have  one  or  more  special 
inspectors  of  provisions  exclusive  of  milk  inspectors.  In  smaller  cities 
and  towns  the  labor  of  looking  after  the  food  supply  is  performed  by  a 
general  sanitary  inspector  or  perhaps  by  the  health  .officer  himself  and 
is  only  one  of  his  multifarious  duties.  Even  in  communities  of  con- 
siderable size,  the  inspection  of  food  is  joined  to  the  other  duties  of  a 
single  officer.  Thus  in  Knoxville,  whatever  food  inspection  there  is,  is 
done  by  the  secretary  of  the  board  of  health.  In  Terra  Haute  it  is  one 
the  duties  of  the  sanitary  inspector,  and  in  Youngstown,  O.,  of  the 
sealer  of  weights  and  measures.  In  Nashville  the  food  inspector  also 
fumigates  and  inspects  houses.  It  might  be  imagined  that  the  duties  of 
food  inspector  could  be  well  joined  with  those  of  milk  inspector,  but 
this  is  not  often  done.  The  reason  presumably  is  that  a  milk  inspector 
is  usually  a  chemist  and  whether  or  not  all  his  time  is  given  to  the  com- 
munity his  services  are  too  valuable  to  permit  of  his  making  routine 
inspection  of  markets  and  slaughter-houses.  The  duties  of  the  two 
offices  are,  however,  coupled  in  Atlanta  (where  formerly  the  same  officer 
was  inspector  of  plumbing),  Allegheny,  Cleveland,  Colorado  Springs, 
Columbus,  Evansville,  Kansas  City,  Lynn,  Meadville,  Penn.,  Oakland, 
Cal.,  Rochester,  Salt  Lake  City,  Scranton,  Tiffin,  O. ;  but  in  Atlanta 
the  inspector  only  collects  samples  and  the  analyses  of  the  milk  are 
made  by  the  city  chemist,  and  in  Columbus  and  Lynn  samples  of  milk 
are  not  analyzed  by  the  inspector,  but  are  sent  to  a  chemist.  In  Cleve- 
land the  milk  and  food  inspector,  who  is  a  chemist,  has  the  assistance  of 
a  messenger  and  a  sanitary  policeman,  and  much  of  the  control  of  mar- 
kets is  in  the  hands  of  the  superintendent  of  markets. 

In  San  Francisco  the  market  inspectors  are  required  to  visit  all 
public  institutions  and  inspect  the  meat  to  see  if  the  contracts  are  ful- 
filled.4 

In  those  cities  which  own  or  control  public  markets,  whether  or  not 
this  department  is  under  the  control  of  the  board  of  health,  as  it  is  in 
Cincinnati,  the  superintendent  of  markets  and  his  subordinates  perform 

1  Louisiana,  Act  of  3  March,  1880. 

2  Rhode  Island,  Act  of  5  March,  1858. 

3  Maryland,  Chapter  53  of  1891. 

4  San  Francisco,  Rule  of  Board  of  Health,  20  January,  1802. 


FOOD    OTHER    TIIAX  DAIRY  PRODUCTS.         343 

a  large  part  of  the  work  of  supervision  of  the  character  of  the  goods 
sold.  Sometimes  this  is  simply  an  implied  part  of  their  duties,  but 
again  it  is  strictly  prescribed,  as  in  Cincinnati 1  and  Reading,  and  in  the 
latter  city  the  commissioner  of  markets  is  also  sealer  of  weights  and 
measures,  but  a  special  food  inspector  is  desired. 

In  the  larger  cities  more  than  one  inspector  is  needed  to  look  after 
foods,  and  sometimes  the  different  inspectors  have  their  duties  some- 
what specialized.  In  St.  Paul  there  is  one  live  stock  inspector,  and 
one  meat  inspector  who  looks  after  provisions  in  general.  In  Boston 
there  is  a  like  arrangement,  only  there  are  two  provision  inspectors. 
In  the  District  of  Columbia  there  is  besides  the  three  food  inspectors, 
an  inspector  of  marine  products2  and  a  dairy  inspector.  In  Baltimore, 
Minneapolis,  and  San  Francisco  there  is  a  special  inspector  for  bakeries. 
In  Pittsburgh  there  is  a  meat  inspector  and  a  vegetable  inspector. 
In  Xew  York  there  were  in  1896,  three  fruit  inspectors,  three  meat 
inspectors  and  two  fish  inspectors.  In  Philadelphia  the  meat  inspect- 
ors are  in  the  bureau  of  police. 

There  are  three  general  classes  of  food  inspectors,  although  the  dis- 
tinction litt ween  them  is  not  always  well  marked  and  the  functions  of 
each  are  in  some  cases  performed  by  one  and  the  same  person. 

First.  There  is  a  live  stock  inspector.  He  must  have  some  knowl- 
edge of  veterinary  science  and  to  be  entirely  successful  should  be  a  skilled 
veterinarian  and  have  a  thorough  knowledge  of  pathological  processes 
and  be  an  adept  in  the  use  of  the  microscope.  Such  inspectors  are 
mostly  in  the  employ  of  the  United  States  at  the  great  slaughtering 
centres,  but  they  are  also  found  as  local  inspectors  in  a  few  cities,  as 
Boston.  Buffalo,  Denver,  Nashville,  Xew  Orleans,  Omaha,  and  St.  Paul- 
Some  smaller  places,  as  Brookline  and  Haverhill,  Mass.,  and  Oakland, 
Cal.,  employ  veterinarians  for  the  routine  market  inspections. 

Seem  id.  There  is  the  inspector  of  groceries,  drugs,  condiments,  etc. 
Such  inspectors  are  in  some  cases  skilled  chemists.  In  other  cases  they 
are  raerel)  collectors  of  samples  for  analysis,  also  obtaining  evidence 
for  the  prosecution  of  offenders.  This  class  of  inspectors  are  mostly 
state  officials. 

Lastly.  There  are  the  "meat,"  "food,"  and  "provision"  inspectors 
wliosc  (lni\  it  is  to  make  frequenl  inspection  of  markets,  peddlers' 
wagons,  shops,  wholesale  and  commission  houses,  wharves  and  vessels, 
and  to  determine  the  wholesomeness  of  the  Broods  offered  for  sale.     The 


'Cincinnati,  Manual  Health  Department  1898,  pp.  ill    118. 
Most  of  bis  work  is  done  on  the  wharf  where  oysters  and  crabs  are  discharged 
ami  in  the  summer  when  the  oyster  trade  is  small   he  inspects  watermelons  and 
'it her  1  ruck  brought  by  boat. 


344  FOOD    OTIIEIi    THAN  DAIRY  PRODUCTS. 

goods  examined  by  such  inspectors  are  such  as  meat,  fish,  poultry,  fruit, 
vegetables,  etc.  Inspectors  of  this  kind  are  usually  employees  of  the 
cities  and  towns  and  are  members  of  the  health  department. 

Sometimes,  as  in  Mississippi,  inspectors  are  under  bond  (in  that 
state  #500),  to  "perform  their  duties  without  fraud,  favor,  or  par- 
tiality."    In  St.  Louis  the  meat  inspectors  are  under  #4,000  bonds. 

The  following  list  shows  how  many  inspectors  are  employed  and 
what  salaries  are  paid  in  a  number  of  important  cities : 

Number  of  -  Annual 

City.  Inspectors.  Salary. 

Allegheny 1  meat  and  milk $1,000 

Baltimore 1  meat  and  provision 1,000 

1  bakery 1,200 

Boston 1  veterinarian 2,200 

1  inspector 1,000 

1  inspector 1,200 

1   inspector 900 

Brookline 1  provision  and  milk 600 

Brooklyn  ( Borough  of) 1  chief 2,500 

4  food 1,000 

4  meat 1,200 

1  meat 1,000 

1  meat 900 

Chicago 1  meat 1,200 

5  meat 1,000 

3  ice 900 

Cleveland 1  food  and  milk 1,000 

1  food  and  milk 900 

1  food  and  milk 600 

1  food  and  milk 300 

Columbus 1  meat  and   milk 1,000 

Denver 1  meat 1,080 

1  meat 900 

District  of  Columbia 3  food 1,200 

Evansville 1  food  and  milk 900 

Fitchburg 1  food 900 

Haverhill 1  meat  and  provision 900 

Louisville 1  live  stock 1,200 

1  live  stock 900 

Lynn 2  food  and  milk 800 

Milwaukee 4  food 1,100 

Minneapolis 1  meat 1,350 

1  bread  and  milk 1,100 

Newark 2  food 1,000 

New  Orleans 1  veterinarian 1,500 

13  food 600 

New  York  (Borough  of  Manhattan) .  .    1  chief 2,500 

8  fruit 1,200 

4  meat 1,200 

3  fish 1,200 

1  fish 600 


FOOD    OTHER    THAN  DAIRY  PRODUCTS.         345 

Number  of  Annual 

City.  Inspectors.  Salary. 

Philadelphia 1  meat 1,350 

1  meat 1,000 

1  meat 925 

1  veterinarian 1,000 

Pittsburgh 1  meat 1,800 

1  vegetable 900 

Providence 1  provision 1,200 

St.    Louis 6  food 1,440 ' 

St.   Paul 1  meat 900 

1  live  stock 900 

San  Francisco 8  food  and  milk 900 

1  bakery 900 

'>  market 900 

Syracuse 1  food T-J>  l ' 

All  inspectors  of  whatever  class  must  have  free  access  to  all  goods 
to  be  examined,  and  must  often  have  power  to  take  samples  for  further 
examination.  Such  power  is  specifically  given  by  statute  in  many 
states,  and  is  also  conferred  by  the  regulations  of  many  cities.  Among 
tin-  states  which  have  such  laws  or  laws  fori  lidding  interference  with 
inspectors  may  be  mentioned,  Colorado,  Massachusetts,  .Minnesota.  New 
Jersey.  Ohio.  Oregon,  and  Wisconsin.  The  Massachusetts  law  merely 
forbids  any  one  to  hinder,  obstruct,  or  in  any  way  interfere  with  any 
properly  appointed  inspector,  analyst,  or  other  officer  in  the  performance 
of  his  duty. 

The  Massachusetts  law  provides  that  when  it  is  believed  that  an\ 
unwholesome  provisions  are  concealed,  the  inspector  may.  on  complaint 
to  the  proper  magistrate,  obtain  a  search  warrant  and  seize  the  goods. 
In  these  cases  the  magistrate  is  to  determine  whether  the  articles  shall 
be  destroyed  or  returned  to  the  owner. 

The  most  stringenl  law  is  that  of  Minnesota  in  regard  to  dairy  pro- 
ducts : 

•■  The  said  commissioner  and  assistant  commissioners,  and  such  experts,  chemists, 
agents,  and  counsel  as  they  shall  duly  authorize  for  the  purpose,  shall  have  access, 
Ingress,  and  egress  to  all  places  of  business,  Factories,  farms,  buildings,  carriages, 
vessels,  and  cans  used  in  the  manufacture  and  sale  of  any  dairy  product  or  any 
imitations  thereof.  They  also  shall  have  power  and  authority  t"  open  anj  package, 
i  a n.  <>r  vessel  containing  such  articles  which  maj  be  manufacl ured,  sold,  or  exposed 
for  sale,  in  violation  of  the   provisions  of  this  act,  and   may  inspect   the  contents 

therein,  ami  may  take  samples  therefrom  tor  analysis." 

Ill  order  to  prevent  adulteration  frauds  it  is  iieeessan  for  samples 
to  lie  taken  from  the  suspected  goods.  This  is  provided  for  in  the 
Minnesota  law  referred   to  above  where  the  dairv  commissioner  and   his 


Inspectors  are  required  to  furnish  their  own  horse  ami  buggy, 
-  Minnesota,  Statutes  i  L894),  Sec.  7000. 


346  FOOD    OTHER    THAN  DAIRY  PRODUCTS. 

assistants  may  "  take  samples  for  analysis."     The  following  is  the  Ten- 
nessee law : 

"  Be  it  further  enacted,  That  every  person  who  manufactures  or  offers  for  sale  or 
delivers  to  a  purchaser  any  articles  of  food  or  drink  shall  furnish  upon  demand  a 
sample  of  such  article  of  food  or  drink  to  any  person  duly  authorized  by  the  state 
hoard  of  health  to  receive  the  same,  and  who  shall  apply  to  such  manufacturer  or 
vender  or  person  delivering  to  any  purchaser  such  article  of  food  or  drink  for  such 
sample  for  such  use  in  sufficient  quantities  for  the  analysis  of  any  such  article  or 
articles  in  his  or  her  possession  and  in  the  presence  of  such  dealer  and  an  author- 
ized agent  of  the  said  state  board  of  health  if  so  desired  by  either  party,  said  sample 
shall  be  divided  into  three  parts,  and  each  part  shall  be  sealed  by  the  seal  of  the 
state  board  of  health,  one  part  shall  be  left  with  dealer,  one  delivered  to  the  state 
board  of  health,  and  one  to  be  deposited  with  the  district  attorney  for  the  district 
in  which  the  sample  is  taken.  Said  manufacturer  or  dealer  may  have  the  sample 
left  with  him  analyzed  at  his  own  expense  and  if  the  results  of  said  analysis  differ 
from  those  of  the  state  board  of  health,  the  sample  in  the  hand  of  the  district  attor- 
ney shall  be  analyzed  by  a  third  chemist  or  expert  who  shall  be  chosen  and  agreed 
upon  by  the  said  dealer  and  the  state  board  of  health,  and  the  whole  evidence  shall 
be  laid  before  the  court.11  1 

The  above  law  provides  fur  no  compensation  for  the  sample,  but 
most  states  follow  the  Massachusetts  law  which  provides  for  the  com- 
pulsory purchase  of  samples  : 

"Every  person  offering  or  exposing  for  sale,  or  delivering  to  a  purchaser,  any 
drug  or  article  of  food  included  in  the  provisions  of  this  act,  shall  furnish  to  any 
analyst  or  other  officer  or  agent  appointed  hereunder,  who  shall  apply  to  him  for 
the  purpose  and  shall  tender  to  him  the  value  of  the  same,  a  sample  sufficient  for 
the  purpose  of  the  analysis  of  any  such  drug  or  article  of  food  which  is  in  his  pos- 
session.11 2 

The  next  section  of  the  statute  imposes  a  penalty  for  refusing  to  sell 
to  any  person. 

In  order  to  protect  the  seller  it  is  necessary  to  carefully  guard  the 
sample  so  that  it  shall  not  be  tampered  with,  and  this  is  accomplished 
by  dividing  it  into  parts  which  are  held  by  different  persons  as  shown 
in  the  laws  above  quoted. 

Special  methods  have  to  be  pursued  and  special  rules  devised  in 
regard  to  the  inspection  of  slaughtering.  In  New  Orleans3  the  follow- 
ing rules  are  in  force  : 

"All  livers,  lungs  (lights),  spleens  (melts),  and  tongues  of  beeves  and  cows,  shall 
be  hung  on  racks,  provided  for  that  purpose,  immediately  after  the  slaughtering  and 
removal  from  the  carcasses  of  the  animals,  and  shall  there  remain  until  the  meat 
inspector  of  of  the  board  of  health  shall  have  examined  and  inspected  the  same,  and 
shall  not  be  removed  therefrom  except  by  the  permission  of  said  inspector,  and  all 
such  organs  shall  be  marked  by  the  butchers,  on  placing  them  on  the  rack  herein- 
before provided,  in  such  manner  that  the  said  organs  canbe  easily  identified  with  the 


1  Tennessee,  Chapter  260  of  1897,  Sec.  6. 

2  Massachusetts,  Chapter  263  of  1882,  Sec.  6. 

3  Louisiana,  Report  of  State  Board  of  Health  (1893-4),  p.  73. 


FOOD    OTHER    Til  AX  DAIRY  PRODUCTS.  347 

carcasses  from  which  they  have  been  removed:  provided,  however,  that  in  the  event 
of  the  failure  of  the  inspector  to  make  such  inspection  before  G.30  p.  m.  in  summer 
(April  1,  to  September  30).  and  5.30  p.  m.  in  winter  (October  1  to  March  31)  each 
day,  permission  is  hereby  granted  to  the  butchers  to  remove  such  organs. 

"At  least  one  inch  of  the  diaphragm  or  skirt  of  all  carcasses  of  all  slaughtered 
animals  shall  be  left  on  the  animal  slaughtered,  until  the  meat  inspector  shall  have 
exa7)iined,  inspected,  and  passed  the  same,  and  that  the  parietal  pleurae  or  the  lining 
of  the  chest  cavity,  and  the  parietal  peritoneum  or  casing  of  the  abdominal  cavity, 
ordinarily  removed  in  the  process  commonly  known  as  "stripping,11  shall  be  allowed 
to  remain  upon  the  carcass,  and  shall  not  be  removed  therefrom  by  the  process 
known  as  "stripping"  until  after  the  inspections  of  the  meat  inspector. 

"  In  the  event  of  the  rejection  of  any  animal  by  the  said  inspector,  permission  is 
hereby  granted  to  the  owner  of  said  animal  so  rejected  to  kill  another  one  in  order 
to  replace  same,  even  after  the  hours  aforementioned. 

In  New  ( )rleans  all  meat  imported  into  the  city  and  all  slaughtered  in 
the  city  must  he  stamped  by  the  inspector  before  it  is  offered  for  sale. 
In  Colorado  Springs,  Fall  River,  and  Haverhill  a  similar  rule  is  in 
force. 

The  inspection  of  animals  immediately  before  or  at  the  time  of 
slaughter  is  now  largely  in  the  hands  of  the  federal  authorities.  Yet 
the  government  inspectors  are  not  located  at  any  but  the  larger  estab- 
lishments so  that  there  is  still  a  considerable  field  for  local  work.  More- 
over the  federal  inspectors  have  no  authoritative  control  over  the 
disposal  <»f  any  diseased  animal  or  carcass  unless  it  is  destined  for 
interstate  or  foreign  trade.  It  can  be  used  tor  any  purpose  within  the 
state  where  slaughtered.  The  assistance  of  local  inspectors  is  needed 
t<>  see  that  improper  use  is  not  made  of  such  food  material.  Local 
inspectors  should  and  usually  do  work  in  entire  harmony  with  the 
inspectors  of  the  department  of  agriculture.  In  Chicago  five  local 
inspectors  are  constantly  on  duty  at  the  Union  Stock  Yards.  Four 
inspectors  are  also  employed  to  look  out  for  dressed  meat  that  arrives 
on  the  ears.  In  order  to  avoid  the  inspectors  at  Chicago,  animals  that 
are  likely  to  be  condemned  are  retained  at  points  outside  of  Chicago 
and  slaughtered,  and  it  is  to  look  out  for  this  meat  that  inspectors 
Watch  over  railroad  traffic  in  dressed  meat.  The  following  rules  have 
been  adopted  in  Chicago  to  enable  the  local  Inspectors  to  prevenl  the 
use  of  condemned   f 1  : 

"Thai  :ill  meat  condemned  in  the  Citj  of  Chicago  by  Government  or  State  Meat 
Inspectors,  shall  be  destroyed  under  the  supervision  and  subjeel  to  the  directions  "f 
ty  Meat  i  nspectors. 

I  hat  no  owner  .,1'  a  slaughter-house  shall  slaughter  cattle,  sheep,  or  liogs  after 
tlie  hour  of  7.00  o'clock  e.  m..  or  on  Sundays,  without  lirst  notifying  the  Citj    Meat 

Inspectors. 

••.Ml  emaciated  cattle  condemned   in  the  City  of   Chicago  shall  be  destroyed  by, 

and  under  i  he  supervision  and  subject  to  the  directions  of,  the  City  Meat  [nspectors. 
v.  carcasses  of  dead  animals  shall  he  brought   within  the  precincts  "i  anj 
slaughter-house  in  the  City  of  Chicago."  ' 

'Chicago,  Ordinances  of  I  January,  1897. 


348 


FOOD    OTHER    THAN  DAIRY  PRODUCTS 


In  Buffalo  the  same  sort  of  control  is  exercised  in  order  to  secure 
the  immediate  destruction  of  food  condemned  by  federal  and  local 
inspectors. 

The  inspection  of  food  is  usually  at  slaughter-houses  or  in  markets 
and  shops.  The  inspection  of  places  where  food  is  prepared  for  imme- 
diate consumption  is  generally  neglected,  or  at  least  there  is  little 
account  of  such  in  the  reports  of  the  inspectors ;  but  in  two  cities  at 
least,  Denver  and  New  Orleans,  the  inspection  of  hotel  and  restaurant 
kitchens  is  required. 

Inspectors  of  provisions  should,  of  course,  keep  a  record  of  inspec- 
tions made,  and  particularly  of  all  goods  condemned.  An  ordinary 
blank  book  may  be  used  for  this  as  in  Providence,  one  book  for  each 
ward,  of  convenient  size  to  be  carried  in  the  pocket  and  enough  space 
given  to  each  market  to  record  the  inspections  and  condemnations  for 
the  year.     The  form  used  in  New  York  City  is  shown  below.1 

Daily,  weekly  or  monthly  reports  are  required  of  the  inspectors  in 
many  cities.  These  are  often  made  on  printed  forms,  good  examples  of 
which  may  be  seen  in  Denver,  the  District  of  Columbia,  and  New  York. 

Person*  Liable  and  Acts  Forbidden. 

In  a  great  many  of  the  laws  in  regard  to  unwholesome  and  adul 
terated  food  the  penalty  is  upon  the  person  who  "  knowingly "  sells- 
adulterates,  etc.  This  is  very  often  the  case  in  the  older  laws,  par- 
ticularly those  relating-  to  "  decayed,  diseased  and  unwholesome  provi- 
sions." It  is  also  found  in  some  of  the  adulteration  laws,  as  in  Iowa,  in 
the  oleo  law;  in  Maine,  in  the  vinegar  and  molasses  law;  in  Ohio,  in 
the  vinegar  law  :  in  the  District  of  Columbia  and  Maryland,  in  the  gen- 
eral adulteration  law ;  and  in  many  milk  laws.  Recently  the  word 
lias  been  stricken  from  the  Michigan  oleo  law  where  it  had  for  some 
time  been  a  considerable  hindrance  to  successful  prosecution.  The 
Massachusetts  law,  copied  by  many  other  states,  makes  it  an  offence  to 
"  knowingly  "  sell  veal  under  four  weeks  of  age,  but  the  word  is  omitted 
from  the  prohibition  of  slaughtering  calves  under  age,  thus  rendering 
]  >r<  isecution  af  this  latter  offence  much  the  easier.     The  addition  of  this 


Date Hour 

Street  and  Number 

Name  of  ( >wner 

Business 

From  whom  Purchased 

Condition  of  Store 

Condition  of  Ice  Box 


Condemned, 

Character.         Pounds. 

Total. 

Total. . . . 

No.  of  Inspection 

Remarks. 


FOOT)    OTHER    Til  AX  DAIRY  PRODUCTS.  349 

word  throws  directly  upon  the  plaintiff  the  burden  of  the  proof  that  the 
accused  has  knowledge  that  the  goods  in  question  were  -diseased,  cor- 
rupted or  unwholesome."  This  is,  of  course,  a  difficult  thing  to  prove. 
and  many  a  guilty  person  has  as  a  consequence  escaped. 

The  following  which  is  found  in  many  of  the  candy  laws  illustrates 
the  strictness  and  specific  character  of  much  of  this  food  legislation: 

•  No  person,  firm  or  corporation  shall,  either  directly  or  by  agent  or  employe,  or 
as  the  agent  or  employe  of  any  other  person,  firm,  or  corporation,  manufacture  for 
sale,  nr  knowingly  sell,  or  offer  for  sale.     .     .     ."1  ' 

The  making  of  the  selling  only  of  the  unwholesome  provisions  an 
offence  greatly  detracts  from  the  value  of  such  laws.  If  it  is  neces- 
sary to  prove  a  sale  of  unwholesome  provisions  before  any  action  can 
be  taken,  very  little  preventive  work  can  he  done.  Hence  thrsc  regula- 
tions often  prescribe  other  offences  than  selling.  Thus  in  Buffalo2  "  Xo 
11  or  persons  shall  bring  into  the  city.  sell,  offer,  or  have  for  sale 
for  human  food."  In  Oregon  it  is  forbidden  "  to  sell  or  exchange  or 
offer  for  sale  or  exchange."      And  in  Xew  York  City  it  is  provided 

"  That  no  person  shall  sell,  or  give  to  any  other  person,  or  permit  such  other 
person  to  get  (having  the  right  and  ability  to  prevent  the  same)  any  drink,  food  or 
dress,  when  such  first-named  person  may  have  reason  to  think  or  believe  that  such 
drink,  food  or  dress  may  cause  danger  or  detriment  to  life."  3 

In  .Milwaukee  it  is  forbidden  to  "give  away  for  food"  unwhole- 
some materials. 

Not  only  is  it  forbidden  in  Illinois  to  sell  butterine,  but  no  one 
-may  give  to  any  person"  a  substitute  for  butter.  The  same  provision 
is  found  in  Louisiana. 

The   Cleveland    ordinance  defines  still  further  what  shall  be  deemed 

evidence  of  offering  for  sale  :4 

•■  The  fact  of  any  cattle,  sheep,  hoi;  or  Lamb  being  in  any  sto«k  yard  or  slaughter- 
house pen  shall  be  considered  sufficient  evidence  that  the  same  is  being  exposed 
there  for  sale ;  and  the  fact  thai  any  carcass  of  any  cattle,  hog,  sheep  or  lamb,  01 
any  part  thereof,  is  found  in  any  slaughter-house,  or  any  public  or  private  market 
or  place,  dressed  and  prepared  as  such  meats  usually  are  for  market,  shall  be  deemed 
sutii'  ienl  evidence  that  the  same  is  for  sale  for  human  food." 

In   Iowa. 

■■  Whoever  shall  have  possession  or  control  of  any  imitation  butter  or  imitation 
cheese  or  any  substance  designed  to  be  used  as  a  substitute  for  butter  or  cheese  con- 
trary to  the  provisions  of  this  act  shall  be  construed  to  have  possession  of  property 

with  intent  to  use  it  with  the  intent  of  committing  a  public  offence." 


Nevada,  Compiled   Laws  (1900),  Sec.  5076. 

Buffalo,  Ordinances  (1802),  Chapter  25,  Sec.  84. 

City  of  \-'\\  JTork,  sanitary  Code  (1899),  Sec.  67. 
1  Cleveland  Ordinances,  Chapter  80,  s'''-.  586. 
'  Iowa,  Code,  1  L897),  Sec.  2621. 


350  FOOD    OTHER    THAN  DAIRY  PRODUCTS. 

In  Iowa  no  person  may  have  unmarked  butterine  in  his  possession 
except  for  consumption  by  himself  or  family.  In  Iowa  no  carrier  shall 
receive  butterine  not  properly  marked.  The  Michigan  law  is  as  fol- 
lows : 

"  The  presence  of  such  oleomargarine,  butterine,  or  other  substance  resembling 
butter,  in  any  such  place  before  mentioned  where  food  is  sold  or  furnished  to  per- 
sons paying  for  the  same,  shall  be  prima  facie  evidence  in  any  court  before  which 
any  person  violating  the  provisions  of  this  act  may  be  brought  for  examination  or 
trial,  that  such  person  has  sold  and  offered  for  sale  as  butter,  such  substance  re- 
sembling butter.'"  1 

As  was  shown  above,  the  Massachusetts  and  most  of  the  other  state 
laws  forbid  the  sale  of  unwholesome  provisions  only  "for  meat  or 
drink,"  and  sometimes  the  law  goes  further  as  in  Buffalo,  and  forbids 
its  sale  for  "  human  food,"  or  in  Maryland  when  "  intended  to  be  used 
for  human  food."  2  Under  such  provisions  it  would  be  possible  to  sell 
unwholesome  food  for  the  use  of  animals  or  for  a  fertilizer,  but  unless 
the  use  of  the  food  is  so  specified,  it  would  not  be  possible  to  sell  it  at 
all.  It  is  not  so  specified  in  the  Louisiana  law.  On  the  other  hand, 
the  usual  form  of  the  law  might  at  times  prevent  a  conviction,  owing 
to  the  difficulty  of  proving  that  the  goods  were  sold  for  "  meat  or 
drink  "  or  for  "  human  food." 

The  Michigan  adulteration  law  is  as  follows,  and  similar  provisions 
are  found  in  the  Massachusetts  oleo  law  and  in  other  states : 

"The  taking  of  orders  or  the  making  of  agreements  or  contracts,  by  any  person, 
firm,  or  corporation,  or  by  any  agent  or  representative  thereof,  for  the  future  deliv- 
ery of  any  of  the  articles,  products,  goods,  wares,  or  merchandise  embraced  within 
the  provisions  of  this  act,  shall  be  deemed  a  sale  within  the  meaning  of  this  act."  3 

Not  only  is  it  forbidden  to  sell  and  manufacture  adulterated  sub- 
stances, but  in  some  instances  it  is  forbidden  to  sell  food  which  con- 
tains such  articles.     Thus  the  Connecticut  oleo  law  reads : 

"No  baker  or  vender  of  food  shall  sell  or  expose  for  sale  any  article  of  food  con- 
taining imitation  butter,  unless  such  baker  or  vendor  shall  maintain  the  same  kind 
of  a  sign  as  hereinbefore  prescribed,  in  the  way  and  manner  prescribed  in  that  con- 
nection, except  that  the  word  "used  "  shall  be  substituted  for  the  word  "  sold.1'  If 
the  selling  be  done  from  a  wagon  or  other  vehicle,  such  vehicle  shall  conspicuously 
bear  such  a  sign. 

"  Xo  keeper  of  a  hotel,  boarding  house,  or  restaurant,  temporary  or  permanent, 
shall  furnish  any  guest  with  imitation  butter,  or  food  containing  it,  unless  such 
keeper  shall  maintain  in  plain  sight  of  all  guests  sitting  at  tables  where  food  is 
served  such  a  sign  or  signs  as  hereinbefore  prescribed,  except  that  the  word  "  used  " 
shall  be  substituted  for  the  word  "  sold."  * 


1  Michigan,  Compiled  Laws  (1807),  Sec.  4991. 

2  Maryland,  Chapter  604  of  1890,  Sec.  52. 

3  Michigan,  Compiled  Laws  (1897),  Sec.  5026. 

4  Connecticut,  General  Laws  (1888),  Sees.  2616-7. 


FOOD    OTHER    THAN  DAIRY  PRODUCTS.  :;:,] 

Further   information  in  regard   to  the  wording  of  food  laws  may  be 
obtained  from  the  milk  laws  which  will  be  considered  in  the  next  chap- 
ter. 
]',  nalties. 

The  penalties  attaching  to  the  violation  of  the  food  laws,  particularly 
the  adulteration  laws,  are  the  most  severe  found  in  any  of  the  so-called 
sanitary  legislation.  The  injury  to  health  is  slight  or  nil  but  the 
penalty  is  great,  while  for  the  violation  of  laws  which  may  produce 
vast  injury  to  health  the  penalty  is  often  nominal.  The  severity  of 
food  law  penalties  does  not  represent  the  feelings  of  the  public  in  regard 
to  the  importance  of  the  subject,  but  rather  the  legislative  influence  of 
the  commercial   interests  which  usually  secure   this  class  of  legislation. 

Violation  of  food  laws  are  of  course  punished  by  fine  or  imprison- 
ment. The  fines  ranere  from  a  ten  dollar  minimum  in  Tennessee  to 
a  two  thousand  dollar  maximum  in  Illinois,  and  the  imprisonment  from 
thirty  days  to  five  years.  Three  hundred  dollars  to  five  hundred  dollars 
or  one  year  are  common  maxima. 

These  aie  not  the  only  punishments  inflicted.  Unwholesome  or 
adulterated  foods  are  usually  seized  and  destroyed.  Nearly  all  the 
laws,  state  and  municipal,  contemplate  or  provide  for  the  destruction 
o|  condemned  material.  Unfortunately  the  federal  law  in  regard  to 
live  stock  inspection  cannot  constitutionally  make  use  of  this  police 
[tower,  and  this  is  the  chief  reason  why  the  federal  inspectors  at  the 
great  slaughtering  centres  need  to  be  aided  by  local  laws  and  inspectors 
to  secure  the  destruction  of  animals  which  have  failed  to  pass  the 
inspectors  of  the  depart nieiit  of  agriculture.  Hence  the  rule  in  Chicago 
page  347)  that  all  meat  condemned  by  the  federal  inspectors 
shall  lie  destroyed  under  the  supervision  of  the  city  meat  inspectors. 
Nearly  all  cities  and  a  number  of  states  provide  that  their  food  inspec- 
tors shall  seize  and  destroy  articles  offered  for  sale  in  violation  of  the 
laws.  As  regards  perishable  articles,  meat,  fruit,  vegetables,  etc.,  this 
is  the  method  usually  pursued  to  prevenl  the  sale  of  such  as  are  unlit 
for  food.  The  frequenl  routine  inspection  of  shops  permits  of  the 
seizure  of  a  large  proportion  of  such  undesirable  food  and  this  penalty 
w  of  enforcement.  It  is.  moreover,  prompt,  and  its  deterrent  effeel 
is  probabl}  almost  as  great  as  a  prosecution.     Sometimes  the  law  is  so 

worded  that  seizure  is  practically  the  only  course.  Thus  in  Massachu- 
setts where  the  law  forbids  the  sale  of  veal  only  when  the  seller  knows 
it  is  under  age,  proof  of  this  offence  becomes  almost  impossible  to 
obtain  :  but  i ther  act1  permits  inspectors  to  seize  and  destro}  all  veal 

1  Massachusetts,  Public  Statutes  (1882),  Sec.  2. 


352  FOOD    OTHER    THAN  DAIRY  PRODUCTS. 

which  they   believe  to   be  under  four  weeks   of  age.     This   power  of 
seizure  and  destruction  is  sometimes  safe-guarded.     Thus : 

"  .  .  .  If,  at  the  time  of  the  seizure,  the  owner  of  the  property  seized  notifies 
in  writing  the  inspector  seizing  the  same  of  his  desire  to  appeal  to  the  board  of 
health,  said  inspector  shall  cause  said  animals,  meat,  fish,  vegetables,  produce,  fruit, 
or  provisions  to  be  inspected  by  said  board  of  health,  or  by  a  committee  thereof  con- 
sisting of  not  less  than  two  members;  and  if  said  board  or  committee  find  the  same 
to  be  tainted,  diseased,  corrupted  or  unwholesome,  they  shall  order  the  same  to  be 
destroyed  or  disposed  of  otherwise  than  for  food.  If  said  board  or  committee  do 
not  so  find,  they  shall  order  said  animals,  meat,  fish,  vegetables,  produce,  fruit,  or 
provisions  to  be  forthwith  returned  to  the  owner  thereof."  1 

In  New  York,  Yonkers,  Memphis,  and  Cleveland  provision  is  made 
for  the  presence  of  witnesses  to  determine  whether  or  not  a  given  article 
of  food  should  be  destroyed.  The  inspector  in  Cleveland  is  to  call 
upon  "  two  reputable  persons  competent  to  judge,"  and  shall  follow 
their  decision  if  they  agree,  but  if  they  do  not  agree,  the  inspector  is  to 
refer  the  matter  to  the  health  officer.  In  making  seizures  under  this 
law  three  employees  of  the  health  department  may  make  the  inspections 
together.  In  most  legislation  no  provision  for  witnesses  is  made,  and 
the  decision  in  regard  to  the  condition  of  the  goods  is  left  to  the 
single  inspector. 

After  goods  are  condemned  they  should  be  destroyed  so  that  they 
cannot  by  any  possibility  be  sold  to  consumers.  Many  times  their 
destruction  is  left  to  the  dealer,  in  which  case  it  is  expected  that  the 
fear  of  a  subsequent  inspection  to  see  if  the  order  is  carried  out,  and 
the  threat  of  a  fine,  is  sufficient  to  secure  the  end  sought.  Thus  in 
some  cities  the  owner  is  directly  required  by  the  law  to  destroy  the 
goods,  and  failure  to  do  so  is  punished  by  a  fine  of  one  hundred  dol- 
lars in  Atlanta  2  and  of  fifty  dollars  in  Maryland.  Often  the  provision  is 
made  that  the  condemned  material  shall  be  tagged  by  the  inspector. 
This  is  required  in  Jersey  City,  Bridgeport,  Newark,  and  St.  Louis. 
The  Newark  rule  is  as  follows : 

"That  upon  any  cattle,  meat,  fish,  birds,  fowls,  fruit,  nuts  or  vegetables  being 
found  by  any  inspector  or  other  officer  of  the  board  of  health,  in  a  condition  which 
renders  the  same  unsafe  or  unwholesome  for  human  food,  it  shall  be  the  duty  of 
said  inspector  or  officer  to  affix  to  said  article  or  articles  a  label  on  which  shall  be 
written  or  printed  the  words  l  Condemned  by  direction  of  the  Board  of  Health, 
Newark,  N.  J.1  and  when  anything  included  within  the  provisions  of  this  section 
shall  be  found  in  numbers,  quantity  or  bulk,  it  shall  only  be  necessary  for  said  in- 
spector or  officer  to  affix  one  such  label  to  a  conspicuous  part  of  the  box,  tin,  basket, 
compartment  or  other  place  or  thing  containing  the  same,  and  he  shall  forthwith 
report  every  such  condemnation  at  the  office  of  the  board.  And  no  person  or  per- 
sons shall  destroy,  deface,  conceal,  interfere  with  or  remove  any  label  affixed  by  any 


1  Massachusetts,  Public  Statutes  (1882),  Chapter  58,  .Sec.  3. 
-  Atlanta,  Sanitary  Rules  and  Regulations,  Sec.  100. 


FOOD    OTHER    Til  AX  DAIRY  PRODUCTS.  353 

inspector  or  officer  of  this  board  as  aforesaid.  It  shall  be  the  duty  of  the  owner  or 
person  in  charge  of  any  matter  or  substances  that  have  been  condemned,  to  imme- 
diately remove  the  same  from  any  market,  street  or  place,  and  convey  the  same  to 
such  place  as  may  be  designated  by  the  inspector  or  officer,  and  such  articles  shall 
pot  be  sold  or  offered  for  sale,  nor  in  anyway  disposed  of,  and  in  case  the  owner 
or  person  in  charge  shall  fail  or  neglect,  or  refuse  to  remove  said  articles  within 
three  hours  after  having  been  notified  to  do  so.  the  same  may  be  removed  by  the  in- 
spector or  other  officer  of  this  board,  the  owner  or  person  in  charge  paying  all 
expenses  therefor."  : 

Sometimes  the  destruction  of  the  goods  is  secured  by  the  inspectors 
pouring  a  little  kerosene  upon  them  which,  of  course,  effectually  pre- 
vents their  sale  for  food.  This  is  the  practice  in  Providence,  Colorado 
Springs,  St.  Paul,  and  Kansas  City.  In  St.  Louis-  the  inspectors  are 
to  mark  or  to  mutilate  the  goods  as  they  deem  best  to  indicate  their 
condemnation,  and  the  owners  shall  within  forty-eight  hours  inform  the 
commissioner  in  writing  under  oath  what  disposition  they  have  made  of 
the  condemned  material.  In  Brooklyn  canned  goods  when  condemned 
are  punched  by  the  inspector  and  left  to  he  redeemed. 

In  some  of  the  larger  cities  periodic  inspections  are  made  with  a  team 
to  seize  and  carry  away  at  once  the  goods  as  fast  as  condemned.  This 
is  done  in  New  York  among  the  retail  dealers  on  the  two  favorite  mar- 
ket days  each  week,  and  also  on  Saturday  night.  In  Providence  such 
raids  are  frequently  made,  but  at  irregular  interyals.  In  Boston  all  con- 
demned meat  is  tagged  and  is  given  to  the  ••hone-man'"  who  pays  for  it 
:hc  regular  price  for  such  goods.  Usually  no  compensation  is  made  for 
the  seizure  of  unwholesome  provisions.  In  Mississippi3  the  law  pro- 
vides that  if  there  is  any  value  to  the  condemned  goods  they  shall  be 
forfeited  to  the  county  where  they  are  offered  for  sale.  In  Massa- 
chusetts the  law  provides  that  the  proceeds  of  their  sale  shall  go  to 
the  owner.  Sometimes  a  consignee  from  whom  the  goods  are  seized  is 
entirely  innocent  as  the  goods  may  have  been  shipped  or  received  in 
bad  condition.  To  enable  the  consignee  to  recover  from  the  consignor 
Dr  transportation  company  a  certificate  is  sometimes  given  stating  the 
facts  ot  the  seizure.  The  form  nscil  in  Providence  is  shown  in 
Appendix    [2. 

In  Cincinnati  '  the  person  occupying  a  stall  in  a  public  market  from 
whom  decayed  food  shall  be  seized  shall  forfeil  his  stall  and  " never 
thereafter  be  permitted  to  rent  or  occupy  one."  When  animals  are 
condemned  ;it  slaughter-houses  they  are  nol  nsinilh  seized  but  are  killed 

1  Newark,  Sanitarj  Code  i  L888),  Sec.  30. 

Louis,  Ordinances  (1893),  Chapter  14,  $ec.  358. 
Mississippi,  Annotated  Code  (1892),  Sec.  2105. 

icinnati,  .Manual  of  Health  Department,  (1898),  p.  111. 


354         FOOD    OTHER    THAN  DAIRY  PRODUCTS. 

and  utilized  by  tanking  under  the  supervision  of  the  inspectors.  In 
Brooklyn  l  considerable  trouble  was  at  one  time  occasioned  in  the  con- 
demnation of  imported  goods  owing  to  friction  between  the  local  health 
department  and  the  customs  officials,  but  it  was  afterwards  amicably 
adjusted.  In  Boston  where  much  fruit  is  imported  the  co-operation  of 
the  customs  officers,  the  transportation  companies,  and  the  health  depart- 
ment inspectors,  renders  supervision  of  this  traffic  easy. 

While  the  loss  of  property  by  seizure,  and  the  infliction  of  a  fine  in 
court,  has  a  deterrent  effect,  probably  it  has  a  much  less  effect  than  the 
fear  of  public  exposure.  Hence  the  following  provisions  of  the  Massa- 
chusetts law  : 

"The  place  where  property  condemned  under  this  chapter  is  found,  and  the 
name  of  every  person  in  whose  possession  it  is  found,  and  of  every  person  convicted 
of  an  offence  under  the  preceding  section,  shall  be  published  in  two  newspapers  pub- 
lished in  the  county  in  which  the  property  was  found  or  the  conviction  took  place.11  2 

Similar  laws  are  found  in  Connecticut  and  Tennesee,  but  in  Ten- 
nessee the  names  shall  not  be  published  till  after  conviction,  and  in  Con- 
necticut the  parties  from  whom  the  goods  were  taken  may  add  to  the 
advertisement  the  name  of  the  persons  from  whom  they  purchased.  In 
Connecticut  and  in  a  number  of  other  states  the  cost  of  the  analysis 
shall  be  paid  by  the  parties  from  whom  the  sample  was  obtained  if 
adulterated,  but  by  the  town  if  the  goods  prove  to  be  pure. 

Besides  affixing  a  penalty,  the  law  in  Michigan,  Rhode  Island, 
Nebraska,  Iowa,  Missouri,  and  Pennsylvania  provides  that  no  action 
upon  any  contract  shall  be  maintained  to  recover  upon  any  contract  for 
any  illegal  sale  of  such  goods. 

Statutes  Consulted  in  the  Prepabation  of  this  Chapter. 

Alabama.     General  adulteration,  bread,  liquor,  Code  (1897),  Sees.  5821-8. 
Arizona.     General  adulteration,  Chapter  105  of  1887. 

Meat  inspection.  Act  of  21  March,  1895. 
California.     General  adulteration,  Code  (1886),  Sec.  382,  Chapter  70  of  1895. 

Provisions,  Code  (1886),  See.  :'.s;;. 

Candy,  Code  (1886),  Sec.  401. 

Olive  oil,  Chapter  47  of  1891. 

Honey,  Chapter  104  of  1895. 
Colorado.      General  adulteration,  Annotated  Statutes   (1891),  Sees.    12-14,  Act  of 
17  April,  1893,  Sees.  61-3. 

Meat,  Annotated  Statutes,  (1891),  Sees.  18-21. 

Liquors,  Annotated  Statutes  (1891),  Sees.  27-33. 
Connecticut.      General  adulteration,  General  Statutes   (1888),  Sec.  2648,  Chapter 
235  of  1895. 

Vinegar,  Chapters  60  and  234  of  1889. 


1  Brooklyn,  Report  of  Department  of  Health,  (1896),  p.  41. 

2  Massachusetts,  Public  Statutes  (1882),  Chapter  58,  Sec.  6. 


FOOD    OTHER    Til  AX  DAIRY  PRODUCTS.  355 

Connecticut,   ContiniH  d. 

Candy,  Chapter  183  of  1895. 
Molasses,  Chapter  157  of  18!>.">. 
Sugar,  Ceneral  Statutes  (1888),  Sec.  2650. 
Hakeries,  Chapter  174  of  1807. 
Delaware.     Candy,  Chapter  200  of  1895. 
District  ok  Columbia.     Ceneral  adulteration.  Act  of  IT  February,  1898. 

Candy,  Act  of  5  May,  L898. 
FLORIDA.     Meat,  Chapter  30  of  1891,  Rules  of  State  Board  of  Health,  1  April,  1896. 
Georgia,     (reneral  adulteration.  Code  (1882),  Art.  3004. 
Bread.  Code  (1882),  Art.  4551. 
Wines,  etc.,  Laws  of  1892,  p.  130. 
Idaho.     General  adulteration,  Revised  Statutes  (1887).  Sec.  6918. 

Candy.  Art  of  16  February,  1899. 
Illinois.      Ceneral  adulteration,  bread,  candy,  canned   goods,    lard,  drugs,  liquors, 
and  vinegar,  veal,  jelly,  extracts,  Annotated  Statutes  (1896),  Chapter  38,  Sees. 
12-44,  Act  of  24  April.  1899. 
[KDIAN  \.      Provisions  and  adulterations,  various  and  general,  Statutes  (1897),  Sees. 
2183-94,  Act  of  28  February.  1899. 
Candy.  Art  of  :;  March,  1899. 
low  \.     Provisions  and  adulterations,   various  and  general,  Code  (1897),  Sees.  4502, 
4980-6,4992-7. 
Vinegar,  Art  of  '.»  March,  1899. 
Diseased  pork,  Art  of  12  April,  1898. 
K  \\-\-.     Adulterations,  general  and  various.  General  Statutes  (1896),  pp.  353-358. 
Kentucky.     General  adulteration,  provisions,  candy,  honey,   vinegar,  lard,  liquids, 
Statutes  (1894),  Sees.  1272  83,  •-'■-'no.  Chapter  52  of  1898. 
iind  goods,  Chapter  32  of  1896. 
Loi  isiana.     General  adulterations,  Act  of  5  July,  1882;   Provisions,  Act  of  3  March, 

1880. 
Maine.     Adulterations,  general  and  various,  Revised  statutes  (1883),  Chapter  128, 
Supplement    Laws  (1895),  pp.  504   »i. 
Meat.  Chapter  144  of   1895. 
MARYLAND.      Provisions,  adulterations,  general  and  various.  Chapter  604  of    1890. 
Candy,  Chapter  :;1T  of  1890. 
Bakeries,  Chapter  27:;  of  L896. 

Cakes,  Public  General  Laws  (1888),  Art.  27.  Sec.  138. 
Massachusetts.     General  adulteration,   provisions,    veal.   Public  Statutes  (1882), 
Chapters  208  and  263  of  1882;  344  of  isut:  and  27  j  of  1896. 
Lard,  Chapter  1 l'.'  of  L887. 
Poultry,  Chapter  94  of  L887. 
Pish,  Public  Statutes    1882),  Chapter  56,  Sec.  15. 
Chocolate,  Public  statutes  <  lss-_'(.  Chapter  no. 
Vinegar,  Public  statutes  ( 1882),  chapter  60;  257  of  1888;  307  of  1884,  and  150  of 

Candy,  Chapters  333  of  L891  and  279  of  1895. 

Arsenic,  Chapter  :;74  of  L891. 

Bakeries,  Chapter  US  of  1896. 

Inspectors,  Public  Statutes  (1882),  Chapter  58;  Chapters  145  and  132  of  1892. 

t  aimed  goods,   molasses  and  syrup,  Chapter  344  of  lv'.'7. 

Michigan.     Adulteration,  general  and  various,  Compiled   Laws  (1897),  Sees.  4978 
5029. 
Provisions  and  adulterations,  Compiled  Laws  (1897),  Sees.  11404  29. 
Wines  and  liquors,  Compiled  Laws  •'■-  .5408  8. 

Drugs,  Compiled  Law-  (1897),  Sec.  5818. 


356  FOOD    OTHER    THAN  DAIRY  PRODUCTS. 

Minnesota.     Various  adulterations,  Statutes  (1804),  Sees.  6625, 6985  to  7022. 

Candy,  Chapter  204  of  1895. 

Bakeries,  Chapter  199  of  1895. 

Poultry,  Chapter  201  of  1895. 

Meat,  Chapter  200  of  1895,  and  175  of  1899. 

Food  Commissioner,  Chapter  295  of  1895. 
Mississippi.     General  adulteration,  Annotated  Code  (1892),  Sees.  952,  2100-7,  2095-9, 

Chapter  29  of  1892. 
Missouri.     Various  adulterations,  Revised  Statutes  (1889),  Sees.  3876-88. 

Candy,  Act  of  1  April,  1891. 

Chemical  adulterants,  Act  of  11  May,  1899. 
Montana.     Adulterations,  provisions,  Penal  Code  (1895),  Sees.  682-3. 

Candy,  Act  of  22  February,  1899. 
Nebraska.     Food  Commission,  dairy  products   and   vinegar.      Compiled  Statutes 
(1899),  Sees.  3207-3211g. 

Liquors,  Compiled  Statutes  (1899),  Sec.  3603. 

Drugs.  Compiled  Statutes  (1899),  Sec.  3730. 
Nevada.     Provisions,  Compiled  Laws  (1900),  Sees.  826-30. 

Candy,.  Compiled  Laws  (1900),  Sees.  5076-8. 
New  Hampshire.     General  adulteration,  Chapters  39  and  200  of  1891. 

Candy,  Chapter  58  of  1899. 
New  Jersey.     General  adulteration,  Revised  Statutes  (1895),  p.  1104.  ei  seq. 

Candy,  Public  Laws  (1895),  p.  279. 

Coloring  matter,  Public  Laws  (1895),  p.  47M. 

Bread,  Public  Laws  (1896),  p.  261. 

Hakeries,  Public  Laws  (1896),  p.  266 

Horse  meat,  Public  Laws  (1899),  p.  .*>17. 
New  Mexico.     Provisions  and  adulterations,  Compiled  Laws  (1897).  Sees.  1244-57. 
New  York.     General  adulteration,    wine,   liquors,    sugar,  honey,  Revised   Statutes 
(1895),  p.  2418  (Public  Health  Law,  Sees.  40-50). 

Bakeries,  Chapter  415  of  1898,  Art.  VIII. 

Vinegar,  Revised  Statutes  (1S95),  p.  38  (Agricultural  Law,  Sees.  50-3). 

Veal,  Chapter  491  of  1898. 
North   Carolina.     General  adulteration,  Chapters  122  of   1895  and  86  and  369  of 

1  SI  M.I. 

North  Dakota.     Candy,  Act  of  12  March,  1897. 

Ohio.     Various  adulterations,  Annotated  Statutes  (1900),  Sees.  4200  (-1)  to  (-HI). 

*     Bakeries,  Annotated  Statutes  (1900),  Sees.  4364  (-71-72). 

Provisions,  veal,  Annotated  Statutes  (1900),  Sees.  0928  and  0928  (-1). 

Liquors,  Annotated  Statutes  (1900),  Sees.  6950,  7074,  8082-3. 

Canned  goods,  Annotated  Statutes  (1900),  Sees.  7072-4. 
Oklahoma.     Provisions  and  adulterations,  Compiled  Statutes  (1893),  Sees.  :;4.'!,  2204, 

•2436,  2*537,  2043. 
Oregon.     Adulterations  and  provisions,  Annotated  Laws  (1892).  Sees.  1978-80,  Act 
of  21  February,  1893. 

Candy,  Act  of  10  February,  1899. 
Pennsylvania,     (reneral  adulteration.  Acts  of  20  .Line.  1895,  and  .">  July,  1895. 

Flour,  Act  of  18  March,  1775. 

Lard,  Act  of  6  June,  1891. 

Provisions,  Act  of  7  May,  1855. 

Candy,  Act  of  23  May,  1887. 

Liquors,  Acts  of  20  March.  1800,  14  April,  1803,  :i  April,  1S72,  2  June,  1881. 

A'inegar,  Act  of  5  July,  1895. 

Bakeries,  Act  of  27  May,  1S97. 


FOOD    OTHER    THAN   DAIRY   PRODUCTS.  :;:,7 

Rhode  Island.     Provisions,  liquor,  veal,  (General  Laws  (1890),  Chapter  282. 

Saleratus,  General  Laws  (1896),  Chapter  138. 

Vinegar,  General  Laws  (1896),  Chapter  148. 

Liquors.  General  Laws  (1896),  Chapter  161. 

Candy.  Act  of  15  May.  1896. 
South  Carolina.     Provisions  ard  adulteration,  Revised  Statutes  (1893),  Sec.  266. 

Candy.  Act  of  9  March,  1896. 
Soi  in  Dakota.     General  adulteration.  Compiled  Laws  (1887),  Sees.  6654-5,  Chap- 
ter 89  of  1899. 
Texxessee.     Adulterations.  Chapter  45  of  1897. 

(  andy.  Chapter  33  of  1887. 
Utah.     Inspection,  statutes  (1898),  Sees.  2446-50. 

Drugs,  statutes  (1898),  Sec.  1726. 

Various  adulterations,  Statutes  (1898),  Sees.  4283-90. 

Vinegar.  Chapter  36  of  1899. 
Vermoxt.     Various  adulterations,  statutes  (1894),  Sees.  4332-43. 

Provisions,  veal,  drugs.  Statutes  (1S94),  Sees.  5073-0. 
Vii;o[\i  \.     Adulterations  and  provisions,  Code  (1887),  See-,.  :;sll-12. 
IFasiiixgtox.     Provisions,  Code  (1897),  See.  7275. 

General  adulteration.  Chapter  113  of  1899. 
West  Virgixi  \.     General  adulteration.  Code  (1899),  Chapter  ir>0.  See.  20. 
Wi-i  oxsix.      Provisions,  adulterations,  general  and    various,    Statutes  (1898). 
4599-4601b,  4607f-i. 

Dairy  and  Food  Commission,  statutes  (1894),  Sees.  1410-1410d. 

Bakeries,  statutes  (1894),  4608i-k. 
Wyoming,     (andy.  Revised  statutes  (1899),  See.  2223. 

Drugs,  Revised  statutes  (1899),  Sees.  2668-70. 


CHAPTER   VIII. 

DAIRY   PRODUCTS. 

THE  adulteration  of  butter  and  cheese  or  the  sale  of  imitations  very 
seriously  affects  the  pocket-books  of  the  dairymen.  As  dairymen 
form  a  large  and  influential  class  throughout  the  country,  it  might  be 
expected  that  stringent  legislation  concerning  this  class  of  adulteration 
would  be  very  common.  As  a  matter  of  fact,  laws  relating  to  butter 
and  cheese  are  found  in  all  but  six  of  the  states  and  territories.  The 
dairy  division,  bureau  of  animal  industry,  department  of  agriculture  has 
published  a  reprint  (Dairy  Bulletin  Number  21)  of  the  state  laws  relat- 
ing to  dairy  products.  These  laws,  together  with  a  summary,  are  also 
printed  in  the  fourteenth  report  of  the  bureau  of  animal  industry.  The 
facts  here  presented  are  taken  largely  from  this  compilation. 

CHEESE. 

Most  of  the  agricultural  states,  and  also  the  District  of  Columbia 
have  statutes  forbidding  the  manufacture  and  sale  of  adulterated  cheese. 
Sophisticated  cheese  is  not  so  common  as  artificial  butter  but  its  manu- 
facture and  sale  is  opposed  by  the  same  interests,  and  in  many  states  it 
is  treated  of  in  the  same  statute  with  butter.  Cheese  is  often  defined 
in  these  statutes,  usually  in  a  manner  similar  to  butter  (see  p.  364). 
There  are  three  ways  of  dealing  with  the  artificial  cheese  question. 

First. 

It  is  sometimes  made  an  offence  to  manufacture  or  sell  such  cheese 
unless  it  is  plainly  so  labeled.  This  is  the  method  pursued  in  the  Dis- 
trict of  Columbia,  Illinois,  Indiana,  Massachusetts,  Missouri,  Montana, 
Xew  Hampshire,  North  Dakota,  Ohio,  Oregon,  Tennessee,  and  West 
Virginia.     The  Massachusetts  law  is  given  below.1 


1  Massachusetts,  Chapter  352  of  1885 : 

"  Whoever,  by  himself  or  his  agents,  sells,  exposes  for  sale,  or  has  in  his  posses- 
sion with  intent  to  sell,  any  article,  substance,  or  compound  made  in  imitation  or 
semblance  of  cheese,  or  as  a  substitute  for  cheese,  and  not  made  exclusively  and 
wholly  of  milk  or  cream,  or  containing  any  fats,  oils,  or  grease  not  produced  from 
milk  or  cream,  shall  have  the  words  "  imitation  cheese,"  stamped,  labeled,  or 
marked,  in  printed  letters  of  plain,  uncondensed  Gothic  type,  not  less  than  one  inch 
in  length,  so  that  said  words  cannot  be  easily  defaced,  upon  the  side  of  every  cheese 


da  111 ) r  PR  on  zrt '  TjS.  3  5  9 

Another  act1  fixes  the  penalty  at  $100  for  first  offence,  and  1200  for 
each  subsequent  offence  for  selling  contrary  to  the  above  or  defacing  the 
iil>ed  labels. 

Secotul. 

It  may  be  forbidden  to  manufacture  or  sell  imitation  cheese  unless 

it  is  labeled  and  unless  it  is  nncolored.  The  Iowa-  oleo  law  after  elabo- 
rately stipulating  how  artificial  butter  and  cheese  must  be  sold  provides 
that  : 

■■  No  <>ne  shall  color  with  any  matter  whatever  any  substance  intended  as  a  sub- 
stitute for  butter  or  cheese  so  as  to  cause  it  to  resemble  true  dairy  products,  or  com- 
bine any  animal  fat.  vegetable  oil  or  ether  substance  with  butter  or  cheese,  or 
combine  with  any  substance  whatever  intended  as  a  substitute  for  butter  or  cheese 
anything  of  any  kind  or  nature  for  the  purpose  or  with  the  effect  of  imparting  to 
tin-  compound  the  color  of  yellow  butter  or  cheese,  the  product  of  the  milk  or  cream 
•  f  cows,  or  use,  solicit  orders  for  delivery,  keep  for  sale,  or  sell,  any  such  stibstance 
so  colored  and  disguised  as  a  substitute  for  butter  or  cheese;  but  nothing  in  this 
chapter  shall  be  construed  to  prohibit  the  use  of  salt,  rennet,  or  harmless  coloring 
matter  in  making  butter  or  cheese  from  such  milk  or  cream."' 

A  similar  method  is  pursued  in  California,  Colorado,  Maryland, 
Nebraska,  New  Jersey,  Georgia,  South  Carolina,  and  Utah. 

Third. 

The  attempt  has  been  made  to  absolutely  forbid  the  making  and  Bale 

of  artificial  cheese  and  butter.       Laws  like  the  following  have  been  passed 

in  several  states,  but  though  still  on  the  statute  books,  have  been  rendered 

void  by  decisions  of  the  United  States  Supreme  Court: 

■  So  person,  firm,  or  corporate  body  shall  manufacture  out  of  any  oleaginous 
lubstance  or  any  compound  of  the  same,  other  than  the  product  from  unadulterated 
milk  or  of  cream  from  the  same,  any  article  designed  to  take  the  place  of  butter  or 
cheese  produced  from  pure  unadulterated  milk  or  cream  from  the  same,  or  of  any 
imitation  or  adulterated  butter  or  cheese,  nor  shall  sell,  or  offer  for  sale,  or  have  in 
hi>.  her  or  then-  possession  with  intent  to  sell  the  same  as  an  article  of  food."8 

A  fuller  consideration  of  the  above  laws  will  be  found  under  butter, 
as  mosl  of  the  cheese  laws  arc  identical  with  the  butter  laws. 


cloth  or  I >a i id  arouml  the  same,  and  upon  the  top  and  side  of  everj  tub,  firkin,  i>"\.  oi 
package  containing  any  of  said  article,  substance,  or  compound.  Ami  in  case  ol  retail 
•ales  of  any  of  said  article,  substance  or  compound  not  in  the  original  pack 
the  seller  shall,  by  himseli  or  his  agents,  attach  to  each  package  so  sold  ai  retail, 
ami  shall  deliver  therewith  to  the  purchaser,  a  label  or  wrapper  bearing  in  a  con- 
ipicuous  place  upon  the  outside  c,f  the  package  the  words  ••imitation  cheese.'"  in 
printed  letters  of  plain,  un condensed  Gothic  type,  not  less  than  one-half  inch  in 
length." 

Massachusetts,  Chapter  317  of  1886,  Sec.  2. 

[owa    Code  1 1807),  Sec.  2518. 

Pennsylvania,  .Brigbtly'a  Purdon's  Digest  (1894),  p.  1621,  Sec.  1. 


360  DAIRY  PRODUCTS. 

A  different  sort  of  legislation  in  regard  to  cheese  is  found  in  Kansas, 
Nebraska,  Indiana,  Wisconsin,  Virginia,  Connecticut,  New  Jersey,  New 
York,  Illinois,  Minnesota,1  Michigan,  and  Oklahoma.  The  other  statutes 
aim  at  the  prevention  of  the  manufacture  of  artificial  cheese,  but  these 
states  attempt  to  aid  the  creameries  in  making  a  good  article,  by  insist- 
ing that  the  materials  sold  to  them  shall  be  pure. 

Quite  a  number  of  states  have  laws  regulating  the  marking  or  brand- 
ing the  different  varieties  of  legitimate  cheese.2  Most  of  these  permit 
the  manufacture  of  skimmed  milk  cheese,  and  require  that  it  shall 
be  so  marked  or  branded.  In  Colorado  cheese  must  be  so  marked  if 
less  than  thirty-five  per  cent,  of  its  total  solids  consists  of  butter  fat. 
In  Minnesota  cheese  shall  be  marked  "  skim  cheese  "  if  less  than  forty- 
five  per  cent,  of  its  total  solids  is  fats,  in  Illinois  if  less  than  forty-eight 
per  cent.  In  Ohio  the  proportion  of  fats  to  total  solids  is  under  twenty 
per  cent,  for  skimmed  cheese.  In  Pennsylvania  if  cheese  contains  less 
than  eight  per  cent,  butter  fat  it  is  skimmed  cheese.  In  Colorado  the  limit 
is  fifteen  per  cent.  fat.  In  Wisconsin  skimmed  cheese  must  be  ten 
inches  in  diameter  and  nine  inches  high.  In  California  cheese  is  to  be 
branded  "California  half  skim  cheese  "  if  it  contains  less  than  thirty 
per  cent,  and  more  than  fifteen  per  cent.  fat.  In  Pennsylvania  cheese 
is  to  be  branded  "  three-fourths  cream  "  if  it  contains  between  twenty- 
four  per  cent,  and  thirty-two  per  cent,  butter  fat,  "one-half  cream"  if  it 
contains  from  sixteen  per  cent,  to  twenty-four  per  cent.,  and  "  one-fourth 
cream'"  if  it  contains  from  eight  per  cent,  to  sixteen  per  cent,  butter 
fats.  In  Washington  half  skimmed  cheese  is  that  which  contains  from 
fifteen  per  cent,  to  thirty  per  cent,  butter  fats  or  from  which  only  half 
the  cream  has  been  extracted.  "Full  cream  cheese"  is  usually  defined 
as  that  made  wholly  from  pure  milk  from  which  none  of  the  fat  has 
been  removed,  but  the  percentage  of  fat  required  is  sometimes  specified. 
Thus  in  California  and  Washington  it  is  thirty  per  cent.,  in  Colorado, 
thirty-five  per  cent,  of  the  total  solids,  in  Minnesota,  forty-five  per  cent, 
of  the  total  solids,  in  Illinois  forty -eight  per  cent.,  and  in  Pennsylvania 
thirty-two  per  cent. 

1  Minnesota,  Chapter  295  of  1899: 

"  Sec.  14.  No  person  by  himself  or  his  agents  or  servants  shall  sell,  supply  or 
bring  to  be  manufactured,  to  any  butter  or  cheese  manufactory  any  milk  diluted 
with  water  or  any  other  substance  whatever,  or  any  unclean;  impure,  unhealthy, 
adulterated  or  unwholesome  milk,  or  milk  from  which  any  cream  has  been  taken 
(except  pure  skim  milk  to  skim  cheese  factories),  or  shall  keep  back  any  part  of  the 
milk  commonly  known  as  "  stoppings,"  or  shall  bring  or  supply  milk  which  is  sour, 
t«>  any  butter  or  cheese  manufactory  (except  pure  skim  milk  to  skim  milk  cheese 
factories.7'') 

2  California,  Colorado,  District  of  Columbia,  Iowa,  Indiana,  Maryland,  Michigan, 
Minnesota,  Missouri,  New  York,  Ohio,  Pennsylvania,  Vermont,  Virginia,  West  Vir- 
ginia, Washington,  and  Wisconsin. 


DAIRY  PRODUCTS.  361 

In  Michigan.  Minnesota,  New  York,  Ohio,  and  Washington,  and  a 
•number  of  other  states,  registered  brands  for  full  cream  cheese  may  lie 
obtained  from  the  dairy  commissioner,  for  which  a  fee  is  usually  charged. 
The  specifications  in  regard  to  size  and  character  of  marks  arc  often  as 
specific  as  they  are  in  the  corresponding  laws  for  butterine.  Fancy 
cheeses  are  usually  exempted  from  the  action  of  these  laws. 

BUTTER. 

A  few  states  have  laws  to  secure  the  delivery  of  pure  milk  or  cream 
to  creameries.  An  example  of  one  of  these  acts  was  given  on  page 
160.  There  is,  however,  a  great  mass  of  legislation  directed  against 
the  manufacture  and  use  of  butter  substitutes,  such  as  butterine  or 
oleomargarine  as  it  is  variously  called. 

It  cannot  be  maintained  that  the  use  of  butterine  is  any  more  in- 
jurious to  health  than  is  the  use  of  butter.  Opposition  to  the  use  of 
butterine  comes  from  the  manufacturers  of  butter  who  fear  that  their 
prices  will  be  lowered  and  trade  injured.  They  can  very  justly  demand 
that  butterine  shall  be  sold  under  its  true  name,  but  to  go  farther  than 
this  as  is  done  by  many  of  the  laws,  and  attempt  to  check  its  legitimate 
sale,  is  a  great  wrong.  In  any  event,  it  is  an  economic,  rather  than  a 
sanitary  question,  and  it  is  only  discussed  in  these  pages  because  sani- 
tary officials  ate  often  entrusted  with  the  execution  of  the  laws  and 
because  the  statutes  relating  to  oleomargarine  are  properly  to  be  classed 
with  the  adulteration  laws. 

As  there  can  be  DO  federal  legislation  in  regard  to  adulterations  of 
domestic  products  except  by  some  subterfuge,  and  as  the  dairy  interests 
were  strong  enough  to  successfully  demand  such  legislation,  a  law  was 
passed  by  Congress  in  1886  ostensibly  to  raise  revenue,  but  really  to 
hinder  the  sale  of  oleomargarine.  By  this  law  manufacturers  pa\  a 
tax  of  $600  per  annum,  wholesalers  $480  and  retailers  $48.  Besides 
these  taxes  the  manufacturer  is  to  pa\  two  cents  a  pound.  This  tax 
is  paid  by  stamps  which  are  affixed  to  packages.  The  manufacturer 
musl  pack  ill  woollen  packages  of  not  less  than  tell  pounds,  and  retail- 
ers must  sell  from  these,  and  all  packages  and  all  wrappers  must  be 
distinctly  marked.  The  commissioner  of  internal  revenue  enforces  the 
law.      Oleomargarine   for  export   does   nol    pay   the    tax    but   must    be 

properl}    labeled. 

All  the  states  and  territories  including  the  District  of  Columbia,  ex- 

cept  Arizona,  Kansas.  New  Mexico,  Texas  and  Wyoming,  have  butter- 
ine legislation  of  varying  stringency.  These  laws,  like  the  cheese  laws 
steal  the  subject  In  several  differenl  ways. 


362  DAIRY  PRODUCTS. 

First. 

The  attempt  is  made  simply  to  secure  the  sale  of  butterine  under  its 
true  name,  and  for  this  purpose  it  is  required  that  it  be  properly 
labeled. 

Some  of  these  laws  are  not  very  specific.     Thus  in  Maryland  r1 

"  .  .  .  no  person  shall  mix  any  .  .  .  oleomargarine,  suine,  beef  fat, 
lard,  or  any  other  foreign  substance  with  any  butter,  cheese  intended  for  human 
food  .  .  .  without  distinctly  marking,  stamping  or  labeling  the  article  or  the 
package  containing  the  same  with  the  true  and  appropriate  name  of  such  adulter- 
ant, and  the  percentage  in  which  it  is  used  for  the  purpose  of  adulteration,  or  enters 
into  the  composition  of  the  article  so  adulterated." 

The  statute  is  not  very  different  in  Louisiana,  Indiana,  Missouri, 
and  Nebraska.  In  Rhode  Island  and  West  Virginia  the  law  requires 
that  the  original  package  shall  be  marked  oleomargarine,  in  Rhode 
Island  in  letters  one-half  inch  high,  and  also  if  sold  from  the  tub  it 
must  be  delivered  in  a  wrapper  on  which  the  word  shall  be  printed  or 
stamped.  In  Rhode  Island  no  attempt  whatever  has  been  made  to  en- 
force this  law,  yet  there  is  little  doubt  that  by  far  the  larger  part  of  the 
butterine  is  sold  in  accordance  with  its  provisions.  The  writer  has 
reason  to  believe  that  if  its  enforcement  were  reasonably  followed  up, 
the  law  would  prove  amply  sufficient  to  prevent  the  sale  of  butterine 
as  butter;  but  the  promoters  of  these  laws  are  not  so  anxious  to  pre- 
vent the  fraudulent  sale  of  butterine  as  they  are  to  prevent  butter  sub 
stitutes  from  becoming  popular.  It  is  invariably  required  that  the 
original  packages  in  which  butterine  is  received  shall  be  plainly  marked 
to  indicate  the  character  of  the  contents.  Furthermore,  such  packages 
are  required  by  law  to  have  the  revenue  stamp  affixed.  To  prevent 
marking  with  letters  too  small  to  be  seen,  the  size  is  often  prescribed. 
The  Massachusetts  law  is  shown  below.2  In  Connecticut  the  marking 
must  be  "  at  all  times  in  plain  sight "  and  in  black  Roman  letters  not 
less  than  one  inch  wide  and  two  inches  long  on  a  light  ground.  In 
Michigan  the  label  is  to  be  upon  the  top  and  side  and  burned  or  painted 
in  black  permanent  paint  in  Roman  letters  one  inch  in  length.  In 
Iowa  the  letters  are  to  be  one  inch  long  by  one-half  inch  wide.  In 
Wisconsin  the  marking  must  be  in  "ordinary  bold   faced   capital  letters 


i  Maryland,  Chapter  004  of  1800.  Sec.  40. 

-  Massachusetts,  Public  Statutes  (18S2),  Chapter  56,  Sec.  IT: 

"And  in  cases  of  retail  sales  of  any  of  said  article,  substance,  or  compound  not  in 
the  original  packages,  the  seller  shall,  by  himself  or  bis  agents,  attach  to  each 
package  so  sold,  and  shall  deliver  therewith  to  the  purchaser,  a  label  or  wrapper 
bearing  in  a  conspicuous  place,  upon  the  outside  of  the  package,  the  words  "  imi- 
tation butter,"  "  oleomargarine,'"  or  "  butterine,'1  and  no  other  words,  in  printed 
letters,  in  a  straight  line  of  plain,  nncondensed  Gothic  type,  not  less  than  one-half 
inch  in  length. "" 


DAIRY  PRODUCTS.  363 

not  less  than  five  line  pica  in  size."  In  New  Jersey  the  package  must 
be  marked  with  a  black  painted  stripe  three  inches  wide  running  around 
the  package  midway  between  the  top  and  bottom,  and  must  lie  branded 
on  the  outside. of  the  cover  and  on  the  outside  of  the  package  in  two 
places  as  nearly  opposite  each  other  as  possible,  the  title  in  Roman 
letters  one-half  inch  high  and  one-quarter  inch  broad,  and  -said  name 
shall  be  ten  inches  long."  In  New  Jersey  the  package  must  also  have 
a  label  or  brand  showing  the  name  and  address  of  the  manufacturer  and 
the  location  of  the  factoiy. 

The  package  in  which  butterine  is  retailed  also  must  be  labeled. 

Similar  provisions  are  found  in  Wisconsin,  Michigan,  Connecticut, 
Iowa,  and  in  addition  to  this  in  Iowa.  Michigan  and  Illinois  the  seller 
must  distinctly  inform  the  purchaser  at  the  time  of  sale  of  the  character 
of  the  goods. 

In  North  Carolina  the  oleo  label  must  give  the  ingredients  of  which 
the  oleo  is  composed  and  also  the  proportions. 

In  addition  to  the  United  States  license  which  all  dealers  are  obliged 
to  take  out,  some  states,  as  Massachusetts  and  Connecticut,  require 
local  registration.  In  Massachusetts  dealers  are  to  register  with  the 
Inspector  of  milk  and  pay  a  fee  of  fifty  cents.  In  Connecticut  they 
register  with  the  dairy  commissioner.  In  Mississippi  dealers  must  pay 
a  license  ice  of  fifty  dollars  and  also  a  vender's  tax  of  five  dollars.  In 
Montana  dealers  must  pay  a  tax  of  ten  cents  for  each  pound  sold.  In 
Oregon  a  record  must  be  kept  of  all  sales. 

Not  only  must  butterine  packages  be  labeled,  but  in  man)  states 
si-ns  must  be  exhibited  stating  the  tact  that  butter  substitutes  are  sold 
tor  used.1  These  signs  are  to  be  furnished  at  cost  by  the  dairy  com- 
missioner. Bakers  ami  venders  of  food  and  keepers  of  hotels,  boarding- 
houses  and  restaurants,  if  furnishing  butterine  or  fond  containing  it, 
bust  display  similar  signs  substituting  the  word    used    tor  sold.     The 

Iowa  law  also  specifies  that  the  keepers  of  saloons,  lunch    counters    and 

places  of  public  entertainment  or  any  person  having  charge  thereof  or 
pmployed  thereat,  or  any  person  furnishing  board    lor   members   of  his 

nnecticut,  Chapter  11  1  ..!  1893,  Sec.  -': 
■    First,  tin-  seller  shall  maintain  in  plain  sight,  over  or  nexi   the   main  outer  en- 
trance "i  i  he  premises  where  the  selling  is  done,  a  sign  bearing  in  plain  black  Roman 
.  not  less  than  two  inches  wide  ami  four  inches  long,  on  a   white  ground,  the 
wen  U  "sold  here,"   preceded  by  t  he  name  of  t  he  imitation  art  i  ele.      [f  the  selling  is 
done  from  a  wagon  or  other  vehicle,  such  vehicle  shall  conspicuously  hear  upon   its 
outside  "ii  botli  sides  of  sail  I  wagon  or  vehicle  such  a  sign.     If  the  delivering  is  done 
from  a  wagon  or  other  vehicle,  such  vehicle  shall  conspicuously  bear  upon  its  out- 
•ide  "ii  botli  sides  ol  said  wagon  "r  vehicle  a  sign  bearing  in  plain,  Mack  l;.. man  lei 
ot  less  than  two  inches  wide  and  four  inches   long,   on  a   white  ground,  the 
"delivered  here,"  (acceded  l.\   the  name  .,f  the  imitation   article" 


364  DAIRY   PRODUCTS. 

own  family  or  for  any  employees  where  such  hoard  is  furnished  as  com- 
pensation or  part  of  compensation,  shall  keep  a  card  conspicuously  be- 
fore each  table;  the  card  to  be  ten  by  fourteen  inches,  white,  with  plain 
black  Roman  letters  one  inch  by  one-half  inch,  stating  "Substitute 
for  butter  used  here."'  In  Michigan  it  is  necessary  to  have  the  sign  on 
the  outside  door  conspicuously  hung  in  the  centre,  and  placed  on  the 
walls.  States  which  have  such  provisions  requiring  labels  and  signs 
are  Florida,  Georgia,  Indiana,  Maryland,  Massachusetts,  Michigan, 
Minnesota,  Montana,  Nebraska,  Ohio,  South  Carolina,  South  Dakota. 
Vermont,  Utah,  Virginia,  and  Wisconsin. 

It  is  in  most  states,  which  require  the  marking  of  butterine,  forbid- 
den to  destroy  the  marks.1 

As  these  acts  deal  with  pure  butter  and  butter  substitutes  and  as 
penalties  are  usually  imposed  for  selling  goods  that  are  not  pure  butter, 
these  terms  must  be  defined.  The  following  is  from  the  United  States 
Statute  :2 

1 '  That  for  the  purpose  of  this  act  the  word  -butter'1  shall  be  understood  to 
mean  the  food  product  usually  known  as  butter,  and  which  is  made  exclusively 
from  milk  or  cream,  or  both,  with  or  without  common  salt,  and  with  or  without 
coloring  matter.11 

Second. 

The  restrictions  upon  the  sale  of  butterine  that  have  been  given  not 
being  deemed  satisfactory  in  several  states,  the  sale  of  such  substances 
has  been  absolutely  forbidden.  This  is  accomplished  either  directly  or 
by  a  subterfuge.  The  subterfuge  employed  is  a  regulation  of  the 
coloring  of  the  material.  Unless  artificial  yellow  coloring  matter  is 
added  in  the  process  of  manufacture,  butterine  would  be  so  nearly  white 
as  not  to  be  attractive,  and  hence  would  find  no  sale.  Therefore  several 
states  have  forbidden  the  sale  of  butter  substitutes  containing  artificial 
yellow  coloring  matter.3 


1  Massachusetts,  Public  Statutes  (1882),  Chapter  56,  Sec.  19,  as  amended  by 
Chapter  317  of  1886: 

"Whoever,  with  intent  to  deceive,  defaces,  erases,  cancels,  or  removes  any  mark, 
stamp,  brand,  label,  or  wrapper  provided  for  in  such  sections,  or  in  any  manner 
shall  falsely  label,  stamp,  or  mark  any  box,  tub,  article,  or  package  marked,  stamped, 
or  labelled  as  aforesaid,  shall  for  every  such  offence  forfeit  to  the  city  or  town  where 
the  offence  was  committed  one  hundred  dollars,  and  for  a  second  and  each  subse- 
quent offence  two  hundred  dollars.11 

-United  States  Statutes,  49th  Congress.  Session  I.  (1886),  Chapter  840,  Sec.  1. 
Alabama,  California,  Colorado,  Connecticut,  Delaware,  District  of  Columbia, 
Georgia,  Illinois,  Iowa,  Kentucky,  Maryland,  Massachusetts,  Michigan,  Minnesota, 
Montana,  Nebraska,  New  Hampshire,  New  Jersey,  New  York,  North  Dakota,  Ohio, 
South  Carolina,  South  Dakota,  Tennessee,  Utah,  Vermont,  Virginia,  Washington, 
West  Virginia,  and  Wisconsin. 


DAIRY   PRODUCTS.  355 

It  is  worthy  of  note  that  several  of  these  laws,  like  that  of  Iowa, 
while  forbidding  the  use  of  coloring  matter  in  butterine,  permit  it  in 
butter. 

T<>  make  butterine  still  more  unattractive  and  unsaleable,  it  is  re- 
quired in  South  Dakota,  Vermont,  and  West  Virginia  that  it  be  colored 
bright  pink.  This  last  provision  has  however  been  rendered  inoperative 
by  the  decisions  of  the  federal  courts. 

Third. 

Several  states  still  have  laws  upon  their  statute  books  like  that 
shown  on  page  3o9,  which  unconditionally  forbid  the  manufacture  and 
salt-  of  oleomargarine,  but  they  have  not  been  upheld  by  the  courts  and 
cannot  therefore  be  enforced. 

In  California,  Michigan,  Ohio,  and  Wisconsin  butterine  cannot  be 
used  in  any  penal  or  charitable  state  institution. 

This  brief  summary  is  enough  to  show  that  the  drastic-  character  of 
these  laws  is  not  equalled  by  any  sanitary  legislation.  Not  only  are 
the  laws  severe,  but  special  agencies  have  been  called  into  play  to  secure 
their  enforcement.  The  state  food  and  dairy  commissions  have  been 
established  largely  for  the  purpose  of  preventing  the  sale  of  substitutes 
tor  butter,  cheese  and  lard.  It  is  very  evident  that  these  laws  aim  not 
BO  much  to  protect  the  consumer  against  fraud  as  to  protect  dairymen 
in  their  business.  It  is  interesting  to  compare  the  attitude  of  tin-  dairy 
interests  towards  these  laws  which  have  not  been  particularly  asked  for 
by  'he  public  and  which  aim  at  the  suppression  of  a  harmless  food,  with 
their  hostile  attitude  towards  milk  laws  which  are  asked  tor  by  the 
consumer  and  are  aimed  at  a  most  harmful  adulteration. 

I!,  novnted  or  PmceHH  Butter. 

It  is  possible  to  so  treat   bad  or  partly  rancid   butter  b\    rendering 

and  purifying,  and  perhaps  mixing  with  other  butter  or  cream  or  churn- 
ing with  milk,  as  to  make  a  product  which,  while  of  poor  grade,  is  yet 
saleable.  Several  states  have  laws  against  Belling  such  butter  without 
marking  it  as  such.1 

One  of  the  most  recent  acts  is  that  of  Minnesota2  given  below, 
Minnesota  :;  also  has  a  law  which  forbids  the  sale  of  butter  made  under 
the  Quinness  patent  (adulterated   with  casein)  unless  it  is  so  marked. 

California,  Illinois  Massachusetts,  Michigan,  Minnesota,  New  i'ork,  North 
Dakota,  Pennsylvania,  and  Wisconsin. 

Minnesota,  Chapter  94  of  1899: 

■  Sect  ion  1.  \(,  person,  firm,  corporation,  agent  or  employe  shall  manufact  are, 
si-ll.  1. tier  or  expose  for  sale,  in  tliis  state,  any  butter  that  is  produced  by  taking 
original  parking  stock  butter,  or  other  butter,  or  both,  and  melting  the  same  so  that 
;  Minnesota,  Chapter  1  ti  of  1887. 


366  DAIRY  PRODUCTS. 

MILK. 

Milk  is  m  far  more  urgent  need  of  protection  than  any  other  food. 
It  is  far  more  liable  to  adulteration  and  pollution  than  any  other  im- 
portant food  and  its  adulteration  and  pollution  is  attended  with  far  more 
serious  consequences.  Cows'  milk  is  the  sole  food  of  a  large  number  of 
infants,  the  chief  food  of  nearly  all  young  children  and  the  mainstay  in 
the  nourishment  of  adults  in  sickness  and  convalescence.  The  impor- 
tance of  protecting  this  food  has  long  been  recognized  and  far  greater 
efforts  have  been  made  for  this  than  for  the  control  of  any  other  food 
material ;  but  the  ease  with  which  milk  can  be  adulterated,  and  the 
great  profit  of  the  operation,  are  obstacles  which  can  be  overcome  only 
by  the  utmost  vigilance  in  the  enforcement  of  stringent  laws  ;  and  the 
labor  and  care  which  are  required  on  the  part  of  the  producer  to  secure 
a  clean  milk  are  so  great  that  little  progress  has  yet  been  made  towards 
obtaining  this  much  to  be  desired  result. 

The  temptations  for  milk  adulterations  are  so  great  that  many  yield 
among  the  producers,  and  also  among  the  middle-men  and  peddlers,  when 
such  intervene  between  the  producer  and  the  consumer.  An  important 
source  of  trouble  is  the  nature  of  the  methods  which  must  be  employed 
to  determine  adulteration.  The  principles  of  chemical  analysis  are  so 
little  understood  by  men  of  average  education  that  it  is  comparatively 
easy  for  unscrupulous  milkmen  and  their  still  more  unscrupulous  at- 
torneys to  convince  honest  producers  and  dealers  that  the  inspectors  and 
chemists  are  unjust  and  perhaps  unprincipled  in  the  methods  employed 
to  secure  convictions.  By  such  persuasions  the  adulterators  can  present 
a  powerful  and  often  very  respectable  front  to  any  effort  to  secure  the 
purity  of  the  milk  supply. 

The  subject  naturally  divides  itself  into  two  parts  :  First,  the  pre- 
vention of  the  sale  of  adulterated  or  diluted  milk,  or  milk  poor  in  nutri- 
tive ingredients,  and  secondly,  the  attempt  to  secure  clean  milk,  milk 
which  is  free  from  dirt,  and  particularly  milk  which  is  free  from  the 
micro-organisms,  either  pathogenic  germs,  or  those  which  simply  injure 
the  quality  of  the  milk.  The  first  of  these  has  received  by  far  the 
greater  attention,  and  for  thirty  years  an  active  warfare  has  been  waged 


the  butter  fat  can  be  drawn  off  or  extracted,  then  mixing  the  said  butter  fat  with 
skimmed  milk,  or  milk,  or  cream,  or  other  milk  product,  and  rechurning  or  rework- 
ing the  said  mixture,  or  that  produced  by  any  process  that  is  commonly  known  as 
boiled,  process  or  renovated  butter,  unless  the  same  is  branded  or  marked  as  pro- 
vided in  section  2  of  this  act. 

"  Sec.  2.  No  person,  firm,  corporation,  agent  or  employe  shall  sell,  offer  or 
expose  for  sale,  or  deliver  to  purchaser,  any  boiled,  process  or  renovated  butter,  as 
defined  in  section  1  of  this  act,  unless  the  words  '  Renovated  Butter1  shall  be  plainly 
branded.     ..." 


DAIRY  PRODUCTS.  367 

in  the  larger  cities  against  diluted  milk.  The  cleanliness  of  milk  has, 
however,  only  lately  received  much  attention,  and  in  fact,  it  is  only 
lately  that  the  true  importance  of  cleanliness  has  been  understood. 
Comparatively  little  has  yet  been  accomplished  in  this  direction.  The 
prevent  ion  of  the  sale  of  diluted  milk  will  be  considered  first. 

ADULTERATED  MILK. 

Legislatio)i. 

There  is  no  federal  milk  law,  but  much  has  been  done  in  the  spheres 
of  both  state  and  municipal  legislation.  As  in  all  food  legislation,  the 
Btate  laws  are  the  most  important,  though  many  valuable  municipal 
regulations  are  found,  particularly  concerning  cows  and  stables. 

Some  sort  of  milk  legislation  is  found  in  all  the  states  except  Alabama, 
Arizona.  Arkansas,  Delaware.  Florida,  Idaho.  Louisiana,  Mississippi, 
Montana.  New  Mexico,  North  Carolina,  South  Dakota,  Tenni 
Texas.  West  Virginia,  and  Wyoming.  The  fact  that  all  of  the  above 
Bxcepl  Arizona  and  New  Mexico  have  oleo  laws  directed  against  a  far 
less  serious  form  of  substitution  offers  food  for  reflection.  While  there 
is  no  general  legislation  on  this  subject  in  the  above  states,  several 
cities  situated  in  them,  either,  as  is  usually  the  case,  by  virtue  of  their 
general  sanitary  powers,  or  under  a  special  statute,  have  attempted  to 
protect  themselves  by  local  regulations.  Among  such  cities  maybe 
mentioned  Wilmington,  Del.,  New  Orleans,  Nashville,  Memphis. 

Of   course  it  is  possible  to  tight  milk  adulteration  under  the  general 
laws   againsl    food    adulteration,  which    in   excellent  form  have  been  en- 
acted in  some  of  the  states  mentioned,  as  Tennessee  and  Mississippi,  but 
always  much  more  satisfactory  to  act  under  a  special  statute. 

Milk  legislation  must  first  of  all  define  what  kind  of  milk  shall   not 
old.     The   following  are  some  of  the   laws  under  which  excellent 
work  has  been  done  : 

Massai  husetts,  Public  Statutes  i  L882),  Chapter  57: 

■•  m  <  .  5  cis  amended  by  section  2,  chapter  318,  acts  of  L886) :  Whoever,  by  him- 
lelf  or  by  his  servanl  or  agent,  or  as  the  servant  or  agenl  of  any  other  person,  sells 
■  hanges,  or  delivers,  or  lias  in  his  custody  or  possession  with  intenl  to  sell  or 
exchange,  or  exposes  or  offers  Eor  sale  or  exchange,  adulterated  milk,  or  milk  to 
which  water  <>r  any  other  foreign  substance  has  been  added,  or  milk  produced  from 
cows  ted  on  the   ref use  of  distilleries,  or  from  sick  or  diseased  cows,  or  milk  not  ol 

g I  standard  quality,  shall  for  a  tiist  offense  be  punished   by  fine  of  uot   less  than 

l  il'iy  nor  more  than  two  hundred  dollars;  for  a  second  offense  by  fine  of  nol  less  than 

'•a.-  hundred  nor  more  than  three  hundred  dollars,  or  bj  imprisonment  in  the  bouse 

irrection  for  nol   less  than  sixty  days;  and  for  a  subsequent  offense  by  fine  of 

fifty  dollars  and  bj   imprisonment  in  the  1 se  of  correction  for  nol    less  than   sixtj 

nor  more  than  ninety  daj  s. 

11  Sec.  9  (as  amended  in  section  6  of  chapter  352  of  the  acts  of  the  year  1885,  and 
tion  2  of  chapter  318  of  the  acts  ol  the  year  1886,  and  bj  section  2,  chapter  398, 


3f>8  DAIEY  PRODUCTS. 

acts  of  1890) :  In  all  prosecutions  under  this  chapter,  if  the  milk  is  shown  upon 
analysis  to  contain  less  than  thirteen  per  cent,  of  milk  solids,  or  to  contain  less  than 
nine  and  three-tenths  per  cent,  of  milk  solids  exclusive  of  far.  or  to  contain  less  than 
three  and  seven-tenths  per  cent,  of  fat,  it  shall  be  deemed  for  the  purposes  of  this 
act  to  be  not  of  good  standard  quality,  except  during  the  months  of  April,  May,  June. 
July,  August,  and  September,  when  milk  containing  less  than  twelve  per  cent,  of 
milk  solids,  or  less  than  nine  per  cent,  of  milk  solids  exclusive  of  fat.  or  less  than 
three  per  cent,  of  fat,  shall  be  deemed  to  be  not  of  good  standard  quality.1' 

New  York,  Revised  statutes  (1895),  p.  38  (Agricultural  Law): 

"  Sec.  '22.  No  person  shall  sell  or  exchange,  offer  or  expose  for  sale  or  exchange, 
any  unclean,  impure,  unhealthy,  adulterated,  or  unwholesome  milk,  or  any  cream 
from  the  same,  or  sell  or  exchange,  or  offer  or  expose  for  sale  or  exchange,  any 
article  of  food  made  from  such  milk,  or  of  or  from  cream  from  the  same,  or  manu- 
facture from  any  such  milk  or  cream  from  the  same  any  article  of  food. 

"The  term  adulterated  milk,  when  so  used,  means: 

"  1.     Milk  containing  more  than  eighty-eight  per  centum  of  water  or  fluids. 

"  2.     Milk  containing  less  than  twelve  per  centum  of  milk  solids. 
•  3.     Milk  containing  less  than  three  per  centum  of  fats. 

"  4.  Milk  drawn  from  cows  within  fifteen  days  before  and  live  days  after  parturi- 
tion. 

••  •">.  Milk  drawn  from  animals  fed  on  distillery  waste  or  any  substance  in  a  state 
of  fermentation  or  putrefaction  or  on  any  unhealthy  food. 

••  6.     Milk  drawn  from  cows  kept  in  a  crowded  or  unhealthy  condition. 

"7.     Milk  from  which  any  part  of  the  cream  has  been  removed. 

••s.  Milk  which  lias  been  diluted  with  water  or  any  other  fluid,  Or  to  which  has 
been  added  or  into  which  has  been  introduced  any  foreign  substance  whatever. 

•All  adulterated  milk  shall  be  deemed  unclean,  unhealthy,  impure,  and  unwhole- 
some. The  terms  pure  milk  or  unadulterated  milk,  when  used  singly  or  together. 
mean  sweet  milk  not  adulterated,  and  the  terms  pure  cream  or  unadulterated  cream, 
when  used  singly  or  together,  mean  cream  taken  from  pure  and  unadulterated 
milk.11 

It  is  seen  from  the  above  that  milk  which  it  is  forbidden  to  sell  is 
variously  described  and  many  definitions  other  than  those  above  men- 
tioned are  sometimes  found.  Not  only  is  adulterated,  impure,  unhealthy 
and  unwholesome  milk  forbidden,  but  it  must  not  lie  unclean  in  Georgia, 
Minnesota,  and  Iowa,  tainted  or  corrupted  in  Illinois,  unmerchantable 
in  Washington  and  Wisconsin.  Deleterious  substances  must  not  he 
added  in  Indiana,  Kansas,  Kentucky,  Maine  and  other  states,  and  in  many 
places  it  must  not  he  watered.  In  Pennsylvania  and  Colorado  ice  must 
not  be  added  to  it,  In  Virginia  milk  must  not  he  sour  and  oil  must  not 
be  mixed  with  it.  In  New  York,  Indiana,  Maine,  Michigan,  Nebraska. 
Rhode  Island.  Vermont,  and  Virginia  it  is  forbidden  to  sell  milk  from 
which  any  [>art  of  the  cream  has  been  removed  ( except  as  provided 
for  skimmed  milk).  In  Georgia,  Illinois,  Indiana,  Iowa,  Michigan, 
Nebraska,  Vermont,  and  Virginia  milk  must  not  be  sold  from  which  has 
been  taken  what  is  known  as  strippings. 

The  use  of  coloring  matter  has  been  forbidden  in  Oklahoma  and  in 
Omaha  and  Denver,  and  such  a  provision  would  be  frequently  found  it 


DAIRY  PRODUCTS.  369 

it  were  not  that  it  is  forbidden  by  the  general  adulteration  laws  of  quite 
a  number  of  states. 

The  use  of  preservatives  is  forbidden  in  Michigan,  Minnesota,  New 
Jersey,  Pennsylvania.  Washington,  and  "Wisconsin.  The  increasing  use 
of  antiseptics  will  probably  call  for  more  of  such  legislation  in  the  near 
future.      The  Pennsylvania  law  is  given  below.1 

As  it  is  properly  assumed  that  milk  from  sick  or  poorly  nourished 
cows  will  be  dilute  even  if  not  diluted,  and  will  be  deficient  in  valuable 
nutritive  qualities,  milk  of  this  character  is  frequently  proscribed,  as  in 
the  Massachusetts  and  New  York  statutes  above  given.  Most  milk 
laws  forbid  the  sale  of  milk  from  sick  or  diseased  cows,  in  Indiana  from 
injured  cows,  and  in  Bridgeport  from  disabled  cows.  Various  forms  of 
sickness  an-  sometimes  specifically  named,  as  ulcers,  abscesses,  and  run- 
ning soies  in  Georgia  and  Iowa.  Tuberculosis  is  especially  named  in 
New  Hampshire,  Milwaukee,  Portland,  Lynn,  and  a  number  of  other 
cities.  Besides  New  York,  California.  Georgia,  Iowa.  Minnesota, 
<>n,  Washington  and  Chicago.  Atlanta,  and  New  Haven  forbid  the 
sale  of  milk  drawn  from  cows  fifteen  days  before  or  five  days  after 
calving.  In  Wisconsin  and  Minnesota  it  is  fifteen  days  before  ami  four 
days  after,  in  Indianapolis  sixty  days  before  and  twelve  days  after,  in 
Denver  fifteen  days  before  and  after,  and  in  Bradford,  Pa.,  it  is  merely 
forbidden  for  four  days  before  calving.  In  Colorado  it  is  forbidden  to 
sell  colostrum. 

The  Stabling  of  COWS  has  a  marked  effect  upon  the  milk,  hence  the 
provision  of  the  New  York  law  that  milk  shall  be  considered  "adulter- 
ated when  drawn  from  cows  kept  in  a  crowded  or  unhealthy  condition." 
A.  similar  provision  is  found  in  New  Hampshire,  California,  Ohio,  Wash- 
ington and  Atlanta,  the  City  of  New  York.- Chicago.  Buffalo,  Cleve- 
land, Louisville,  Denver,  Rochester,  and  a  number  of  other  cities. 

By  "swill   milk,"  is    usually  meant  the  milk  from  cows  \\-<\  on  "  dis- 

Pennsylvania,  Chapter  118  of  1897: 
ec.   I.     That  the  sale  or  offering  for  sale  of  milk  '>r  cream  for  human  consump- 
tion in  i  Jii>.  commons ealt  li  to  which  has  Kern  added  boracic  acid  salt,  boracic  acid, 
■alicylic  acid,  salicylate  of  soda,  or  an]  other  injurious  compound  or  substanci 
artificially  coloring  the  same  shall  I  ■  *  -  a  misdemeanoi  and  punishable  by  a  line  of 
not  less  than  fifty  nor  more  than  one  hundred  dollars,  or  imprisonment  no!  exceed- 
ing sixty  days,  or  both,  or  either,  at  the  discretion  oi  the  court." 
k  Sfork,  Sanitarj  Code  (1899),  Sec.  59: 

n"i    shall   any    preson   bring  or  send    to  said   citj   any    unwholesome, 

skimmed,  watered   or  adulterated    milk.  ..r  milk    known  as  "swill   milk,"  or  milk 

hoi ws  ■•!  other  animals  that  for  the  most  part  have  been  kepi  in  stables,  or  that 

iiav.-  been  fed  in  whole  or  in  part  on  swill,  or  milk  from  sick  or  diseased  cows  oi 
ftther  animals,  or  anj  butter  or  cheese  made  from  any  such  milk,  '.r  an]  unwhole- 
some hut  ter  or  cheese.'1 


370  DAIRY  PRODUCTS. 

tillery  slops,"  or  refuse  from  distilleries  and  the  sale  of  this  sort  of  milk 
is  forbidden  by  the  majority  of  milk  laws  and  the  feeding  of  refuse 
from  vinegar  factories  is  forbidden  in  Chicago,  Omaha,  and  Milwaukee. 
The  use  of  "  brewers  grains"  is  not  so  universally  condemned  as  that  of 
distillery  refuse,  but  it  is  forbidden  in  Indiana,  Kentucky,  Maine,  Mich- 
igan, Minnesota,  New  Hampshire,  Utah,  Denver,  Omaha,  Scranton,  and 
other  places.  They  may  be  used  in  Rochester  if  not  over  three  clays 
old.  While  there  is  some  dispute  as  to  the  use  of  brewers'  grains,  there 
is  none  as  to  the  use  of  garbage,  and  the  provision  of  the  New  York 
law  which  is  also  found  in  several  other  states  that  milk  shall  not  be 
drawn  from  "  cows  fed  on  any  substance  in  a  state  of  fermentation  or 
putrefaction,"  is  intended  to  cover  garbage  and  also  distillery  refuse  and 
brewers'  grains  as  usually  fed.  Lest  this  provision  be  too  sweeping,  it 
is  provided  in  New  York  and  Minnesota :  1  "  This  section  shall  not 
prevent  the  feeding  of  ensilage  from  silos." 

Massachusetts,2  New  Jersey,  and  Colorado  specifically  forbid  the 
feeding  of  garbage  to  milch  cows,  and  so  do  the  City  of  New  York, 
District  of  Columbia,  Rochester,  and  many  other  cities. 

A  very  excellent  provision  is  found  in  New  Orleans  3  which  could 
be  well  adopted  in  many  other  cities.  The  practice  of  selling  spring 
water  in  cities  has  furnished  an  excuse  to  milkmen  for  carrying  cans  of 
water  in  their  wagons.  By  so  doing  they  can  readily  evade  the  inspec- 
tor by  adulterating  the  milk  as  it  is  delivered,  thus  having  no  watered 
milk  on  hand  from  which  the  inspector  can  take  samples. 

The  primary  object  of  most  of  our  milk  legislation  was  the  preven- 
tion of  the  sale  of  watered  or  skimmed  milk  as  pure  full  milk.  The 
watering  and  skimming  of  milk  are  by  far  the  most  common  forms  of 
tampering  with  this  food,  though  the  addition  of  coloring  matter,  as 
annatto,  and  preservatives,  as  borax,  salicylic  acid,  and  formalin,  is  not 
very  uncommon  in  the  cities.  All  of  these  adulterations  may  be  readily 
detected  by  chemical  tests. 


1  Minnesota,  Chapter  295  of  1899,  Sec.  5. 

2  Massachusetts,  Chapter  326  of  1889: 

*'  Whoever  knowingly  feeds  or  has  in  his  possession  with  intent  to  feed  to  any 
milch  cow,  any  garbage,  refuse  or  offal  collected  by  any  city  or  town,  or  by  any 
person  having  authority  from  any  city  or  town,  by  contract  or  otherwise,  shall  be 
punished  by  imprisonment  in  the  jail  or  house  of  correction  not  exceeding  sixty  days 
or  by  a  tine  not  exceeding  one  hundred  dollars." 

3  "  New  Orleans,  Ordinance  No.  7583,  16  May,  1893: 

"  .  .  .  That  no  vendor  of  milk  in  the  public  streets  and  places  shall  place 
within,  or  carry,  or  have,  in  or  about  the  vehicle  in  which  the  milk  shall  be  carried 
or  kept  for  sale,  or  from  which  it  is  sold,  or  have  in  any  can  or  vessel  carried  by 
hand  at  the  same  time  as  milk  is  similarly  carried  for  sale,  any  water  or  liquid  of 
any  description  other  than  milk  or  cream." 


I) AIR  Y  PR  01)  UCTS. 


371 


It  will  be  seen  at  once  that  while  it  is  easy  to  forbid  the  sale  of  milk 
which  is  of  poor  quality,  from  any  one  of  the  numerous  causes  above 
given,  it  is  no  easy  matter  to  prove  to  a  jury  that  a  given  sample  of 
milk  is  watered,  adulterated,  impure,  drawn  from  cows  diseased,  fed  on 
distillery  slops,  etc.  Normal  milk,  that  is  milk  drawn  from  approxi- 
mately healthy  animals  in  fair  condition,  has  such  a  variable  composi- 
tion that  it  would  be  an  almost  hopeless  task  to  prove  beyond  a  reason- 
aide  doubt  in  the  minds  of  twelve  men  that  a  certain  lot  was  "not  of 
good  standard  quality."  Heme  it  has  been  found  necessary  to  fix  a 
legal  standard  and  provide  that  milk  which  is  below  that  standard  shall 
be  considered  adulterated. 

The  following  are  the  state  and  municipal  standards  adopted: 

Milk  .Standards. 


STATES. 


Dist.  of  Columbia 

Georgia 

Iowa 

Maine 

Massachusetts 

April-Sept 

Michigan 


Total 

solids. 


Percent. 


Minnesota 

New  | [ampshire.  . 

H  ■   '■   Jersey 

New   Ymk 

Ohio 

May  and  .June. 

n 


Pennsylvania 

cities  _■  I  and  3d  class.) 

Rhode  Island 

•s"uth  Carolina  .    .  . 
Vermont 

Ma\   and  -I  line  . 

Washington 

Wisconsin 


12.5 
12 
13 
12 
12.5 
Sp.grav. 
1.029-33 
13 
13 
12 
12 
12 

11.5 
12 


12.5 
Sp.grav. 
L.029-33 

12 


Solids 
not  fat 


Perct 

9 
8.5 


12.5 
12 


9.3 


8.5 
9.25 


Perct 
3.5 

3.5 

3 

3 

3.7 

3 

3 


3.5 


3 
3 

3 

12  p.  c. 
cream 

by  \ol. 


2.5 
3 


CITIES. 


Atlanta.  . . 
Baltimore. 


Bridgeport 

Chicago 

Colorado  Springs. 

Denver 

New  Haven 


New  Orleans. 


Omaha 

St.   Louis. .  . . 
San  Antonio. 


San  Francisco. 


Total 
solids. 


Percent, 

12 

12 
Sp.grav. 
1.029+ 

12 


1? 
12 
11.5 
Sp.grai . 
1.029+ 

13 

Sp.grav. 

1.029+ 

12 

12 

12 

Sp.grav. 

1.029+ 

12 


Solids 
not  fat. 


Perct. 


Fat. 


Perct 
3 
3 


3.5 


3.5 


3 

2.8 
3 


Thai  these  standards  are  In-low  the  average  of  the  milk  sold  in  the 
emu  in  unities  to  which  the}  apply,  is  shown  by  tests  in  manj  cities.  Thus 
in  1898,  in  .Milwaukee,1  of  6,328  samples,  including  those  which  were 
idulterated,  the  average  percentage  of  fal  was  3.76.  In  Cleveland  the 
average  of  (3,002  samples  was,  fats,   :>>.s   per  cent,  and   solids  L2.S1  per 


Milwaukee,  Report  of  Commissi ir  of  Health  for  year  ending   \pni.  1899,  p.  9. 


372  DAIRY  PRODUCTS. 

cent.  This  included  647  samples  which  were  below  the  standard.1  In 
the  District  of  Columbia2  in  1897  the  average  of  193  samples  of  pine 
milk  taken  during  the  year  was  3.84  per  cent,  fats,  the  lowest  being 
11.85  per  cent,  solids  and  3  per  cent.  fats.  The  New  York3,  inspectors 
find  that  "  for  the  greater  part  of  the  year  the  majority  of  the  herds 
supplying  the  city  yield  milk  containing  four  per  cent,  and  over  of 
fat."'  In  Newport,  R.  I.,  in  1896,  the  average  of  38  samples  (all  that 
were  taken)  was  3.75  per  cent,  fat,  or  50  per  cent,  above  the  state 
standard. 

It  is  also  to  be  remembered  that  prosecutions  are  rarely  undertaken 
unless  the  samples  fall  one-half  of  one  per  cent,  below  standard,  as  it  is 
unwise  usually  to  go  before  a  jury  on  a  less  margin. 

The  only  real  objection  to  fixing  a  milk  standard  is  that  it  is  mani- 
festly unfair  and  unreasonable  to  fix  a  very  high  standard  or  a  standard 
which  shall  be  above  the  average  of  milk  produced.  As  a  matter  of 
fact  nearly  all  existing  standards  are  much  below  the  average.  The 
result  is,,  that  unscrupulous  producers  and  dealers,  and  their  number  is 
legion,  soon  learn  to  test  their  milk  and  water  it  down  to  the  legal 
standard.  This  is  a  serious  evil,  but  a  far  less  evil  than  indiscriminate 
watering  that  would  take  place  without  regulation  by  means  of  a  legal- 
ized standard. 

The  groundless  objections  that  are  urged  against  a  legal  standard 
are  that  it  is  unjust,  unless  fixed  so  low  as  to  pass  the  poorest  milk 
which  any  cow  can  produce.  Such  a  low  standard  would  of  course  be 
useless,  for  very  poor  milk  can  be  obtained  from  poor  cows  poorly  fed. 
Reasonably  good  cows,  reasonably  fed,  will  always  yield  a  milk  fully  up 
to  even  a  high  standard  as  standards  go. 

It  is  objected  that  the  state  has  no  right  to  attempt  to  improve  or 
regulate  the  breed  of  cows  or  quality  of  milk  by  legislation.  It  is  the 
opinion  of  the  writer  that  this  is  a  perfectly  proper  governmental 
function  and  similar  supervision  has  long  been  exerted  in  other  direc- 
tions. The  state  establishes  the  weight  of  a  bushel  of  oats  and  by  so 
doing  it  requires  that  a  certain  minimum  of  nutriment  shall  be  con- 
tained. The  state  can  as  well  establish  a  minimum  for  the  nutritive 
qualities  of  milk. 

Skimmed  Milk. 

The  temptation  to  sell  as  pure  milk,  milk  from  which  a  part  of  the 
cream  has  been  removed,  is  almost  as  great  as  is  the  temptation  to  sell 
watered  milk.     The  sale  of  such  milk,  even  as  skimmed  milk,  is  there- 

1  Cleveland,  Report  of  Public  Health  Division  (1890),  p.  40. 

2  District  of  Columbia,  Report  of  Health  Officer  (1897),  p.  36. 

s  City  of  New  York,  Report  of  Department  of  Health  (1896),  p.  170. 


I>MliY   PRODUCTS. 


6  i  6 


fore  prohibited  in  many  states  along  with  milk  that  is  "  impure,  adulter- 
ated, or  unwholesome.''  The  sale  of  such  milk  is  absolutely  prohibited 
in  Georgia,  Indiana,  Kansas,  Kentucky,  Nebraska,  Vermont,  Virginia, 
and  Washington.  In  Michigan  it  is  forbidden  to  sell  it  to  creameries, 
and  in  New  York  it  must  not  be  sold  except  to  skim  cheese  factories. 
except  when  it  is  properly  designated,  and  its  sale  is  absolutely  prohib- 
ited in  the  City  of  Xew  York.  In  Xew  Jersey  the  absolute  prohibi- 
tion «»nly  applies  to  cities  of  the  first  class.  In  the  District  of  Columbia 
and  Massachusetts  skimmed  milk  must  not  be  sold  if  it  contains  less 
than  9.3  per  cent,  of  milk  solids  exclusive  of  fat.  In  Milwaukee  it  is 
forbidden  to  sell  skimmed  milk  containing  less  than  !»  per  cent,  of  milk 
solids  exclusive  of  butter  fat.  In  Buffalo1  "skimmed  milk  must  not 
contain  a  less  percentage  of  casein  and  salts  than  that  contained  in 
unskimmed  milk."  In  Pennsylvania  skimmed  milk  must  not  contain 
less  than  -.'•>  per  cent,  fat  and  must  have  a  sp.  gr.  of  1.032  to  1.037. 
In  Rhode  Island,  if  milk  contains  less  than  2.5  per  cent,  of  milk  fats 
it  shall  be  labeled  ''skimmed."  Usually  the  provisions  in  regard  to 
skimmed  milk  define  the  article  as  milk  from  which  "cream  has  been 
removed "  or  "from  which  the  cream  or  any  part  thereof  has  been 
remoA  ed." 

The  following  is  the  New    York  law:2 

'JExcept  in  the  counties  of  New  York  and  Kings,  the  prohibitions  contained  in 

this  article  against  the  sale  of  adulterated  milk  shall  not  apply  to  skim  milk,  which 
i>  clean,  pure,  healthy,  wholesome  and  unadulterated,  except  by  skimming,  sold  for 
use  in  the  county  in  which  it  is  produced  i>r  an  adjoining  county,  if  it  is  sold  for 
and  as  skimmed  milk." 

Several  of  the  above  mentioned  states  are  engaged  very  extensively 
in  the  manufacturing  of  cheese  and  butter,  and  it  is  to  protect  the 
creameries  chiefly  that  these  provisions  are  made.  In  fact,  the  prohibi- 
tion is  in  a  number  of  the  states.  Indiana,  Kansas,  .Michigan,  Nebraska. 
and  New    York,  contained  in  aids  referring  principally  to  creameries. 

Some  other  states,  as  .Maine,  .Massachusetts.  Nevada,  Ohio,  Penn- 
sylvania, South  Carolina,  and  the  cities  of  Balti re  ami  Denver,  forbid 

the  sale  of  skimmed  milk  only  when  il  is  sold  as  the  pure  article. 
-Maine.  Nevada,  and  South  Carolina  arc  the  only  ones  of  these  states 
that  do  not  go  further,  and  specify  how  its  character  shall  be  indicated 
when   sold. 

Very  great  objection  is  in  some  quarters  made  to  the  sale  of 
'•separator""  milk  under  the  name  "skimmed  milk,"  as  the  former  con- 
tains less  than   0.5  per  cent.  fat.      'This  is  forbidden  by  the  Pennsylvania 


Buffalo,  Ordinances,  chapter  25,  Sec.  92. 
- 'New  York.  Revised  Statutes  (1806),  p.  38  (Agricultural  Law,  Sec.  81). 


374  I>4  IRY  PR  OJJ  UC  T8. 

law,  but  an  unfavorable  decision  was  recently  given  by  the  court.1  It 
would  certainly  seem  that  separator  milk  ought  not  to  be  sold  except 
under  its  true  name. 

Express  directions  are  given  as  to  how  the  skimmed  milk  shall  be 
labeled  in  many  states  and  cities.2  The  following  is  the  Massachusetts 
law: 

"  No  person,  by  himself  or  his  agents,  shall  sell,  exchange,  or  deliver,  or  have  in 
his  custody  or  possession  with  intent  to  sell,  exchange,  or  deliver,  milk  from  which 
the  cream  or  any  part  thereof  has  been  removed,  unless  in  a  conspicuous  place  upon 
every  vessel,  can,  or  package  of  more  than  two  quarts  capacity  from  or  in  which  such 
milk  is  sold,  exchanged,  or  delivered  the  words  'Skimmed  milk'  are  distinctly 
marked  in  plain,  uncondensed  Gothic  letters  not  less  than  one  inch  in  length,  said 
marking  to  be  in  dark  letters  on  a  light  ground,  and  to  be  on  the  vessel,  can,  or 
package  itself  and  not  upon  a  detachable  label  or  tag;  and  unless  in  a  conspicuous 
place  upon  every  vessel,  can,  or  package  of  two  quarts  or  less  capacity  from  or  in 
which  such  milk  is  sold,  exchanged,  or  delivered  the  words  'Skimmed  milk'  are 
distinctly  marked  in  plain,  uncondensed  Gothic  letters,  said  marking  to  be  in  dark 
letters  on  a  light  ground,  and  to  be  either  on  the  vessel,  can,  or  package  itself,  or 
upon  a  detachable  label  or  tag.  Whoever  violates  the  provisions  of  this  section  shall 
,be  punished  by  the  penalties  provided  in  section  five.'"  3 

In  Connecticut  the  label  must  not  be  over  six  inches  below  the  top 
of  the  can.  The  New  Jersey  law  is  like  the  Connecticut,  except  that  it 
requires  the  label  to  be  soldered  to  the  can,  as  do  the  regulations  of 
Rochester  4  and  Yonkers,  when  the  milk  is  sold  from  a  can.  In  those 
cities  when  sold  from  any  other  vessel  the  letters  are  to  be  fastened 
thereto  as  the  board  of  health  or  milk  inspector  may  direct.  In  Chicago  5 
and  Milwaukee  there  is  to  be 

"  Conspicuously  attached  thereto  a  steel  or  metal  plate  tab  on  which  shall  be 
engrossed  the  words  '  Skimmed  Milk,'  in  large,  plain,  distinct  letters;  said  steel  or 
metal  plate  tab  shall  not  be  less  than  three  (3)  inches  by  five  (5)  inches  in  size." 

In  Scranton  there  is  to  be  attached  a  printed  tag.  In  Rhode  Island, 
Ohio,  and  District  of  Columbia  the  label  is  to  be  attached  above  the 
centre  of  the  can,  and  in  Minnesota  it  is  to  be  on  top  or  where  it  can 
be  plainly  seen.  The  size  of  the  letters  is  often  specified.  Usually  it 
is  1  inch  high,  sometimes  1  by  1-2  inch,  but  in  Omaha  it  is  2  inches. 
In  New  Haven  the  letters  must  be  black.     In  Baltimore  the  words 


1  Commonwealth  vs.  Ilufnal,  Supreme  Court,  7  January,  1898. 

-Connecticut,  District  of  Columbia,  Illinois,  Massachusetts,  Minnesota,  New 
Hampshire,  New  Jersey,  Ohio,  Pennsylvania,  Rhode  Island,  and  outside  of  these 
states  in  Atlanta,  Buffalo,  Chicago,  Milwaukee,  Minneapolis,  New  Orleans,  Omaha, 
Rochester,  and  Yonkers. 

:*  Massachusetts,  Public  Statutes  (1882),  Chapter  57,  Sec.  7,  as  amended  by  Chap- 
ter 352  of  1885,  and  398  of  1896. 

4  Rochester,  Ordinances  of  Board  of  Health  No.  1G,  Sec.  4. 

5  Chicago,  Ordinances  of  21  November,  1892,  Sec.  19. 


DAIRY  PRODUCTS.  875 

skimmed  milk  must  be  visible  across  the  street.  While  most  of  the 
laws  merely  require  the  marking  of  the  cans,  Buffalo  and  Fitchburg 
require  that  the  wagon  shall  be  marked  also,  and  in  Fitchburg  a  special 
license  must  be  obtained. 

<  'ondensed  Milk. 

Massachusets,  New  York,  and  Ohio  are  the  only  states  which  have 
regulations  concerning  condensed  milk.  The  Massachusetts  statute 
merely  requires  that  every  package  of  condensed  milk  shall  be  marked 
with  the  name  of  the  maker,  the  brand  and  the  contents, 

The  New  York  and  Ohio  laws  are  alike;1 

••  N'ii  person  shall  manufacture,  sell,  exchange,  expose,  or  offer  for  sale  or  ex- 
change, any  condensed  milk,  unless  the  package,  tan,  or  vessel  containing  the  same 
shall  hi;  distinctly  labeled,  stamped,  or  marked  with  its  true  name,  brand,  by  whom 
and  under  what  name  made,  and  no  condensed  milk  shall  he  made,  exchanged,  ex- 
posed, or  offered  for  sale  or  exchange,  unless  the  same  be  made  from  pure,  clean, 
healthy,  fresh,  unadulterated,  and  wholesome  milk,  from  which  theYream  has  not 
been  removed,  or  unless  the  proportion  of  milk  solids  contained  in  the  condensed 
milk  shall  be  in  amount  the  equivalent  of  twelve  per  centum  of  milk  snlids  in  crude 
milk,  and  of  such  solids  twenty-live  per  centum  shall  be  fat.11 

A  similar  rule  is  found  in  Chicago.2  In  the  City  of  New  York  it  is 
forbidden  to  sell  adulterated  condensed  milk. 

•■  The  term  "adulterated,"  when  used  in  this  section,  refers  to  condensed  milk  in 
which  the  amount  of  fat  is  less  than  twenty-five  per  cent.  <>f  the  milk  solids  con- 
tained therein,  or  to  which  any  foreign  substance  whatever  lias  been  added,  except- 
ing sugars,  as  in  preserved  milks.''  ; 

In  St.  Louis  it  is  provided  that  condensed  milk,  cream  and  butter- 
milk are  exempt  from  the  provisions  of  the  milk  law.  In  Omaha  it  is 
permitted  to  sell  sour  milk  and  buttermilk.1 

Each  of  the  inspectors  in  the  City  of  New  York  are  instructed  to 
obtain  three  samples  of  condensed  milk  each  week. 

<  'ream. 

A  number  of  the  milk  laws  include  the  word  cream  in  the  provision 

Which    forbids    the    sale  of  adulterated,  diseased  and   unwholes e  milk, 

though  in  St.  bonis  it  is  expressly  exempted  from  the  action  of  the 
ordinance.     Chicago  has  a  special  section  Eor  cream  6  which,  after  for- 

»Ohio,  A.nnatated  Statutes  (1900),  Sees.  12004  42). 
'Chicago,  Ordinance  of  21  November,  1892,  See.  26. 

\eU  y,,ik.  Sanitarj  Code  i  L899),  See.  65, 
'  <  imaha,  M  ilk  <  Ordinance,  Sec.  10: 

••  Nothing  in  this  ordinance  shall  i>e  so  construed  as  in  prohibit  the  sale  .a  sour 
milk  or  what  is  known  as  buttermilk,  provided  the  same  is  produced  from  pure, 
wholesome  milk  ami  is  sold  as  such." 

icago,  Ordinance  of  21  November,  1892,  Sec.  20. 


376  DAIRY  PRODUCTS. 

bidding  the  sale  of  cream  taken  from  milk  the  sale  of  which  is  pro- 
hibited, fixes  a  standard  of  15  per  cent.  fat.  In  Denver  the  standard 
is  25  per  cent,  solids,  of  which  16.25  per  cent,  must  be  fat.  In  San 
Francisco  the  percentage  of  fat  must  be  9.5  per  cent,  in  January,  Feb- 
ruary, April,  May,  and  June ;  9  per  cent,  in  March,  July,  August,  Sep- 
tember; 10.5  per  cent,  in  October,  November,  and  December.  In  Min- 
nesota the  statute  fixes  the  standard  of  cream  at  20  per  cent.  fat.  In 
St.  Louis  it  is   22  per  cent,  solids,  of  which   12  per  cent,  shall  be  fat. 

In  milk  laws,  as  in  all  adulteration  laws,  it  is  necessary  to  describe 
the  material  which  is  proscribed,  the  act  which  is  forbidden,  and  the 
persons  liable.  The  provisions  in  regard  to  the  character  of  the  milk 
have  been  considered.  Among  the  many  provisions  of  the  different 
state  laws  defining  the  forbidden  act  may  be  mentioned  the  following : 
No  person  shall  sell,  exchange,  furnish,  supply,  distribute,  deliver,  expose 
for  sale,  etc.,  have  in  possession  or  custody  with  intent  to  sell,  etc., 
cause  to  be  sold,  etc.,  deliver  for  domestic  use,  sell  for  human  food, 
bring  to  another  for  domestic  or  potable  use,  or  to  be  connected  with 
any  product  of  human  food,  transport  or  carry  for  the  purpose  of  sale. 
The  word  knowingly  is  added  in  Georgia,  Indiana,  Kansas,  Kentucky, 
Maine,  Nebraska,  Nevada,  Pennsylvania,  Virginia ;  and  willfully  in 
Maine.  The  act  of  adulteration  is  forbidden  in  California,  Michigan, 
New  Hampshire,  and  Pennsylvania. 

Many  laws  simply  provide  that  "no  person  shall  sell,"  and  in 
Georgia  and  South  Carolina  the  words  "  corporation  "  and  "  agent "  are 
added.  In  Illinois,  Indiana,  Kansas,  Kentucky,  Nebraska,  and  Virginia 
"  whoever  "  sells  adulterated  milk  is  liable  to  suffer  the  penalty.  In  a 
few  states  more  specific  terms  are  employed ;  in  the  Connecticut  law 
"  No  person  by  himself  or  his  agents  or  his  servants ;  "  in  Rhode  Island 
"  Every  person  .  .  .  for  himself,  or  as  the  employee  of  any  other 
person  ;  "  in  New  Hampshire  "  every  person  acting  as  the  employee  of 
another."  The  laws  of  Massachusetts,  Michigan,  and  Ohio  make  use 
of  the  expression  "  whoever  by  himself  or  by  his  servant  or  agent  or  as 
the  servant  or  agent  of  any  other  person." 

The  penalties  prescribed  for  the  violation  of  milk  laws  are  often 
quite  severe,  though  on  the  whole  not  so  severe  as  for  the  violation  of 
the  butterine  laws.  Penalties  may  be  of  various  kinds,  as  fines,  im- 
prisonment, advertising,  revocation  of  license,  and  destruction  of  the 
milk. 

The  lowest  minimum  fine  is  $5  in  the  District  of  Columbia,  the 
highest  minimum  is  §50  in  Ohio  and  Vermont.  The  smallest  maximum 
is  |50  in  Minnesota,  the  highest  -^500  in  Indiana  and  St.  Louis.  The 
average  fine  is  perhaps  from  $25  to  $100.     Imprisonment  is  an  alter- 


DAIRY  PRODUCTS.  377 

native  in  the  District  of  Columbia,  Idaho,  Illinois,  Massachusetts,  Min- 
nesota. Nevada,  New  Hampshire,  Ohio,  Oklahoma,  and  Washington: 
the  maximum  is  six  months  in  Washington.  The  District  of  Columbia, 
Maine.  Massachusetts,  Ohio,  New  Jersey,  and  Rhode  Island  have  more 
severe  punishment  for  the  second  and  subsequent  offence  than  for  the 
first.  In  Massachusetts  and  Rhode  Island  the  first  offence  is  punished 
by  fine,  but  in  Rhode  Island  the  second  offence  and  in  Massachusetts 
the  third  offence  must  be  punished  by  imprisonment.  It  is  sometimes 
provided,  as  in  Vermont,  that  the  person  injured  by  the  sale  of  bad 
milk  may  recover  damages  from  the  seller. 

The  Massachusetts,  New  Hampshire,  and  Rhode  Island1  laws  pro- 
vide that  the  names  of  convicted  dealers  shall  be  published,  and  this  is 
the  practice  in  Chicago  and  some  other  cities.  In  Philadelphia  the 
names  of  dealers  against  whom  legal  action  is  taken  are  published  in 
the  newspapers.  In  Nashville  and  in  Warren,  O.,  all  the  milk  analyses 
are  published. 

In  most  cities  a  person  may  not  sell  milk  without  a  license,  and  in 
such  cases  the  revocation  of  the  license  after  violation  of  the  milk  laws 
is  a  most  severe  and  effectual  means  of  punishment.  It  does  not 
appear  that  any  of  the  statutes  which  provide  for  the  licensing  of 
dealers,  except  that  of  New  Hampshire,  provide  for  the  revocation  of 
the  license:  but  such  is  the  practice  in  Buffalo,  Chicago,  Cleveland,  the 
District  of  Columbia,  Milwaukee.  Minneapolis,  New  Haven,  Rochester, 
and  other  cities.  In  Minneapolis,  however,  it  is  done  under  the 
charter,2  and  perhaps  the  same  is  true  of  other  cities.  In  \e\\  Jersey 
a  person  twice  convicted  of  violating  the  state  law  is  not  allowed  to 
sell  milk  for  two  years.  In  Yoiingstou  n.  <  >.,  the  dealer  also  forfeits 
his  bond  of  #300. 

It  is  very  often  possible  for  inspectors  acting  under  the  general  food 
laws  t<»  seize  and  destio\  adulterated  milk;  but  special  provision  is 
made  for  this  in  New  York,3  and  in  the  regulations  of  Milwaukee.'  San 
Francisco,  Fitchburg,  Chicago,6  and  other  cities:  and  the  reports  show- 
that  it  is  the  practice  in  Allegheny,  Baltimore,  Bradford,  Pa.,  Denver, 
and    the  C it}   of    New  York.      In    Milwaukee  the    inspectors   must    take 

1  Rhode  Island,  General  Laws  (1896),  Chapter  146: 

"Sec.  12.  Every  inspector  of  milk  shall  cause  the  name  and  place  of  business 
<>f  all  persons  convicted  under  this  chapter  to  be  published  in  i\\"  newspapers 
published  in  the  town  or  countj  where  the  offense  shall  have  been  committed'.11 

Minnesota,  Chapter  it::.  Special  Laws  1 1889),  Sub-Chapter  I.  Sec.  16. 
\eu  STork,  Revised  Statutes  (1806),  p.  2418  (Public  Health  Law,  Sec.  45). 
'  Milwaukee,  Ordinance,  19  October,  1891,  Sec.  12. 
Chicago,  Ordinance,  21  November,  1892,  Sec.  30. 


378  DAIRY  PRODUCTS. 

duplicate  samples  from  all  milk  destroyed,  and  give  one  sample  to  the 
dealer  together  with  a  certificate  of  the  amount  destroyed.  If  the 
analysis  shall  show  that  the  milk  is  not  adulterated,  it  must  be  paid  for 
by  the  city. 

Licenses. 

One  of  the  most  valuable  means  of  controlling  the  milk  supply  is 
by  licensing  the  dealers  in  that  commodity.  This  is  a  very  general 
practice  in  American  cities.  The  licensing  of  dealers  is  required  in  the 
District  of  Columbia,  Iowa,  Massachusetts,  Minnesota,  New  Hampshire, 
North  Dakota,  and  Rhode  Island,  and  is  permitted  by  the  laws  of  New 
Jersey.  In  Massachusetts,  New  Hampshire,  and  Rhode  Island  it  is 
restricted  to  those  cities  and  towns  in  which  milk  inspectors  are  ap- 
pointed, in  Minnesota  to  cities  and  towns  of  over  1,000  inhabitants,  and 
in  Iowa  to  cities  of  10,000  inhabitants  and  over.  Sometimes,  as  in  the 
District  of  Columbia,  only  those  who  bring  milk  into  the  city  are 
licensed.  In  other  places,  as  Rhode  Island  and  Buffalo,  peddlers  only 
are  licensed,  but  in  most  cases  all  dealers  in  milk,  whether  peddlers  or 
storekeepers,  are  licensed,  though  in  many  instances,  as  in  Massachu- 
setts, Minnesota,  New  Hampshire,  and  the  City  of  New  York,  the  two 
classes  are  treated  somewhat  differently.  The  Massachusetts  law  is 
given  below.1 


1  Massachusetts,  Public  Statutes  (1882),  Chapter  o7,  Sees.  .°>  and  4: 
"In  all  cities,  and  in  all  towns  in  which  there  is  an  inspector  of  milk,  every 
person  who  conveys  milk  in  carriages  or  otherwise  for  the  purpose  of  selling-  the 
same  in  such  city  or  town  shall  annually,  on  the  first  day  of  May,  or  within  thirty 
days  thereafter,  be  licensed  by  the  inspector  or  inspectors  of  milk  of  such  city  or 
town  to  sell  milk  within  the  limits  thereof,  and  shall  pay  to  such  inspector  or  in- 
spectors fifty  cents  each  to  the  use  of  the  city  or  town.  The  inspector  or  inspectors 
shall  pay  over  monthly  to  the  treasurer  of  such  city  or  town  all  sums  collected  by 
him  or  them.  Licenses  shall  be  issued  only  in  the  names  of  the  owners  of  carriages 
or  other  vehicles,  and  shall  for  the  purposes  of  this  chapter  be  conclusive  evidence 
of  ownership.  No  license  shall  be  sold,  assigned,  or  transferred.  Each  license  shall 
record  the  name,  residence,  place  of  business,  number  of  carriages  or  other  vehicles 
used,  name  and  residence  of  every  driver  or  other  person  engaged  in  carrying  or 
selling  said  milk,  and  the  number  of  the  license.  Each  licensee  shall  before  engag- 
ing in  the  sale  of  milk  cause  his  name,  the  number  of  his  license,  and  his  place  of 
business  to  be  legibly  placed  on  each  outer  side  of  all  carriages  or  vehicles  used  by 
him  in  the  conveyance  and  sale  of  milk,  and  he  shall  report  to  the  inspector  or  in- 
spectors any  change  of  driver  or  other  person  employed  by  him  which  may  occur 
during  the  term  of  his  license.  Whoever,  without  being  first  licensed  under  the 
provisions  of  this  section,  sells  milk  or  exposes  it  for  sale  from  carriages  or  other 
vehicles,  or  has  it  in  his  custody  or  possession  with  intent  so  to  sell,  and  whoever 
violates  any  of  the  provisions  of  this  section,  shall  for  a  first  offence  be  punished  by 
fine  of  not  less  than  thirty  nor  more  than  one  hundred  dollars;  for  a  second  offense 
by  fine  of  not  less  than  fifty  nor  more  than  three  hundred  dollars;  and  for  a  subse- 


DAIRY  PRODUCTS.  379 

Besides  the  general  laws  providing  for  the  licensing  of  milk  dealers, 
a  number  of  cities  have  such  provisions  in  their  charters,  or  are  author- 
ized to  do  it  by  special  acts,  as  Baltimore1  and  Xc\v  Haven.  Again 
many  cities  control  their  milk  supply  by  virtue  of  their  grant  of  general 
sanitary  authority,  even  if  milk  is  not  specifically  mentioned  in  the 
enabling  act.  Among  such  cities  are  Buffalo,  Cincinnati,  Cleveland, 
Nashville,  New  York,  and  Rochester. 

The  authority  which  grants  the  license  varies  in  different  localties. 
In  Iowa  the  whole  matter  of  milk  control,  including  the  issuing  of 
licenses,  is  in  the  hands  of  the  state  dairy  commissioner.  The  New 
Jersey  laws  permit  the  common  council  or  other  governing  body  of 
cities  and  towns  to  provide  for  licensing  as  they  may  decide  best.  In 
Massachusetts,  New  Hampshire  and  Rhode  Island,  where  milk  inspect- 
ors are  in  most  cities  independent  officers,  elected  by  the  city  council, 
the  licensing  of  dealers  is  left  to  the  inspectors.  In  most  cases  it  is  the 
sanitary  authority  which  issues  milk  licenses.  Sometimes  it  is  the 
board  of  health  or  department  of  health,  as  in  Allegheny,  Atlanta, 
Detroit,  Louisville,  New  Haven,  New  York,  Pittsburgh,  and  Rochester. 
In  the  District  of  Columbia,  Chicago,  Denver  and  Omaha,  it  is  the 
health  commissioner.  In  Cleveland  it  is  the  director  of  police  of  which 
department  the  health  bureau  is  a  part;  in  Buffalo,  the  mayor,  in 
Minneapolis,  the  city  council,  in  Scranton,  it  is  the  secretary  of  the 
board  of  health,  and  in  Cincinnati  and  other  Ohio  cities,  the  health 
officer. 

The  recent  movement  of  health  officers  to  secure  good  milk  requi res 
the  control,  or  at  least  inspection  of  the  conditions  under  which  the 
milk  is  produced  and  hence  a  knowledge  of  the  producers  is  required. 
'I'he  tracing  of  adulteration  and  the  following  up  of  outbreaks  of  disease 
presupposes  a  knowledge  of  the  location  of  the  producer  of  every  can  of 

milk.     d'<»  se<  are  the  informati scessary   tor  a   proper  control   ot  a 

milk  supply  many  cities  require  the  applicant    for  a    license    to    furnish 

the  data  required  for  such    control.      An g  the   cities   which   do   this 

ma\    be  mentioned    Buffalo,   Chicago,  Cleveland,    Denver,    District   oJ 

Columbia,     Minneapolis.     New     Orleans,    and    the    City    of     New     York, 


(|iicin  offense  by  fine  of  titty  dollars  and  by  imprisonment  in  the  bouse  of  correction 
fur  ma  less  than  thirty  aor  more  than  sixty  days. 

••  Every  person  before  selling  mili  or  offering  it  for  sale  in  a  store,  booth,  stand. 
or  market  place  in  a  city  or  in  a  town  in  which  an  inspector  or  inspectors  of  milk 
;m  appointed  shall  register  in  the  books  of  such  inspector  or  inspectors,  and  shall 
pay  to  liim  or  them  fifty  cents  to  the  use  of  such  city  or  town;  ami  whoever  oeg- 
o  to  register  shall  be  punished  for  each  offense  by  fine  no!  exceeding  twentj 
dollars/1 

1  Maryland,  Chapter  58  of  1894. 


380  DAIRY  PRODUCTS. 

and  some  smaller  cities,  as  Asbiuy  Park,  X.  J.,  Nashua,  X.  H.,  Lynn, 
Warren,  ( )..  and  Yonkers.  A  committee  appointed  by  the  Massachu- 
setts Association  of  Boards  of  Health  which  gave  the  question  of  milk 
supply  most  careful  study  reported  this  as  the  first  step  necessaiy  for  a 
proper  control.1  Most  of  the  cities  mentioned  require  a  written  ap- 
plication usually  on  blanks  furnished  by  the  city.  Forms  of  application 
are  shown  in  Appendices  43-45. 

In  the  District  of  Columbia  the  application  must  be  •' accompanied 
by  such  detailed  description  of  the  dairy  farm  where  said  milk  is  pro- 
duced as  said  health  officer  ma}"  require  and  by  a  sworn  statement  as  to 
the  physical  condition  of  the  cattle  supplying  the  milk.'"  In  Cleveland 
and  Denver  the  information  derived  in  this  way  is  to  be  recorded  in  a 
•book  which  is  to  be  open  to  the  inspection  of  the  public.  In  Cleveland2 
and  Louisville  the  license  is  granted  only  on  condition  "  that  no  milk 
shall  be  sold  contrary  to  the  provisions  of  the  preceding  section."  viz. : 
the  rules  against  adulteration,  etc.  In  Baltimore,  Colorado  Springs,  and 
Lynn,  a  license  is  not  issued  until  the  premises  of  the  producer  have 
been  inspected. 

In  Minnesota  all  peddlers  or  venders  of  milk  in  cities  must  make 
quarterly  reports  to  the  state  dairy  commissioner  on  blanks  furnished 
by  him  of  the  amount  of  business  transacted.  In  Iowa  there  is  a  sim- 
ilar law.  In  Asbury  Park3  milk  dealers  are  required  to  furnish  to  the 
board  of  health  when  requested  a  list  of  persons  from  whom  they  buy, 
and  also  of  their  customers. 

In  most  state  and  city  regulations  it  is  provided  that  licenses  shall 
be  issued  annually,  though  in  the  City  of  New  York  and  a  few  small 
places  this  does  not  appear  to  be  the  case.  It  is  certain  that  licenses  to 
be  of  much  value  to  the  city  must  be  renewed  annually,  or  else,  as  in 
New  York,  the  licensee  must  be  required  to  give  notice  at  once  of  any 
change  in  the  information  given  on  the  blank  :  and  the  licensees  must 
be  held  strictly  to  this. 

In  regard  to  fees  for  the  licenses,  three  methods  may  be  pursued : 
no  fee  mav  be  charged :  the  fee  may  be  nominal,  or  it  may  be  made  a 
source  of  revenue.  In  Atlanta,  Baltimore,  Cincinnati.  District  of  Col- 
umbia, Minnesota,  Providence,  Rochester,  Yonkers,  and  a  few  other 
places  no  fee  is  charged.  In  Hartford  it  is  twenty-five  cents.  In  Massa- 
chusetts. Xew  Hampshire,  and  Xew  Haven  it  is  fifty  cents.  In  Cleve- 
land, Denver,  Iowa,  and  Minnesota  it  is  one  dollar.     In  Buffalo  it  is  two 


Journal  of  Massachusetts  Association  of  Boards  of  Health.  December.  1897.  Vol. 
VII.,  p.  119. 

2  Cleveland.  Ordinances,  Chapter  30,  Sec.  551. 

3  Asbury  Park,  X.  J.,  Sanitary  Code(189T),  Sees.  7  and  8. 


DAIRY  PRODUCTS.  381 

dollars  for  each  vehicle  and  three  dollars  for  each  dealer  who  brings 
milk  into  the  city.  In  Yoimgstown,  O.,  the  fee  is  one  dollar  and  twenty- 
five  cents  (twenty-five  cents  for  the  clerk).  In  Chicago  and  Omaha 
the  fee  is  ten  dollars  :  and  in  Fort  Wayne.  Ind.,  twenty-five  dollars,  but 
in  Omaha: 

•Any  person  owning  less  than  ten  (10)  cows  and  delivering  milk  by  hand,  or  from 
his  or  her  residence,  shall  pay  a  license  fee  of  one  dollar  ($1.00)  for  each  cow,  and 
any  person  selling  milk  from  any  store  or  other  place  of  business,  and  selling  less 
than  ten  gallons  per  day.  shall  pay  a  license  fee  of  live  dollars  (15.00). 

In  Chicago  the  amount  received  for  milk  licenses  goes  to  the  labor- 
atory fund.      In  that  city  the  rule  about  licensing  provides: 

••  That  tliis  section  shall  not  apply  to  private  persons  who  own  one  or  more  cows 
and  who  sell  milk  therefrom  to  their  neighbors  or  customers  by  peddling  the  same 
by  hand."' 

Iowa.    Buffalo,  Chicago,  Denver,  and   Omaha  require  that  a  license 

shall  be  taken  out  for  each  wagon.  Examples  of  licenses  are  shown  in 
Appendix  40. 

For  tin-  purpose  of  the  easy  identification  of  licensees  it  is  usually 
provided  that  the  wagons  used  by  them  shall  be  marked  in  some  con- 
spicuous and  distinctive  manner.  Such  a  requirement  is  found  in  the 
laws  of  California,  Illinois.  Massachusetts,  Minnesota.  New  Hampshire. 
Rhode  Island,  and  in  Pennsylvania  in  boroughs  of  over  1,000,  hut  is 
usualh  dealt  with  in  the  local  regulations  of  cities.  Almost  all  of 
these  regulations  require  that  the  name  of  the  licensee  he  placed  on  the 
Jragon,  though  in  one  instance  " City  .Milk  License  "  with  the  date  is 
all  that  is  required1  and  in  Chicago  the  name  is  not  required.  Massa- 
chusetts, New  Hampshire,  Buffalo,  Chicago,  Denver,  District  of  Colum- 
bia, Kite  hburg,  Minneapolis,  and  some  other  cities  require  the  number 
of  tin-  license.  California,  .Massachusetts.  Minnesota,  and  New  Hamp- 
shire require  that  the  place  of  business  as  well  as  the  name  shall  appear, 
while  Illinois.  Atlanta,  District  of  Columbia,  New  Orleans,  and  Penn- 
sylvania cities  of  the  second  class  require  the  name  of  the  daily  or  the 
place  from  which  the  milk   is  obtained. 

Most  of  the  rules  require  that  the   lettering  shall   be  "legible"  or 

f  Conspicuous,"  or  "  plain,"  and  some,  as  Denver  that  it  shall  be  kept 
|0.      When  milk    is  uol   -old    from  a    wagon,  but    from  a   can  carried    b\ 

hand,  or  is  sold  in  a  store,  it  is  sometimes  required  thai  the  can  shall  be 

marked.      The    Rochester    rule    is    given    below.-      In    other    cities    than 

1  Little  Falls,  N.  V. 

1  Rochester,  Ordinances  of  Board  of  Health,  No.  16,  Sec.  i 
"  Sucli  license  number  shall  lie  painted  on  such  wagon  or  vehicle  m  numbers  not 
less  than  three  indies  in  height,  in  what  is  known  as  Gothic  characters,  ami  shall  be 


382  DAIRY  PRODUCTS. 

Rochester  the  size  of  letters  or  figures  is  specified.  Sometimes,  as  in 
New  Orleans,  like  Rochester  it  is  three  inches.  In  Atlanta  it  is  four 
inches,  Cincinnati  two  inches,  Colorado  Springs  and  Denver  one  and 
one-half  inches.  In  Fitchburg  the  number  "  must  be  painted  on  both 
sides  of  the  wagon  in  letters  two  inches  in  length  and  one  and  one-half 
inches  in  width,  and  in  some  color  contrasting  with  that  of  the  wagon."  x 
Plain,  satisfactory,  and  uniform  lettering  is  secured  in  Chicago,  Mil- 
waukee,2 and  Omaha3  by  requiring  that  the  licensee  shall  exhibit  on 
both  sides  of  his  wagon  a  tin  sign  furnished  by  the  city  free  of  charge. 

Besides  lettering  the  wagons  several  cities  provide  that  the  license 
shall  be  kept  posted  in  the  wagon  at  all  times.  This  is  the  rule  in 
Denver,  Colorado  Springs,  Fitchburg,  and  Scranton,  and  in  Fitchburg 
the  licenses  for  stores  which  in  Massachusetts  is  different  from  that  for 
wagons,  must  be  kept  posted  in  the  stores,  and  a  similar  rule  is  in  force 
in  Minneapolis  and  Milwaukee,  in  which  city  the  notice  is  furnished  by 
the  inspector. 

It  is  a  great  help  to  the  inspector  to  have  a  sign  of  some  sort  ex- 
hibited in  stores  showing  from  what  dealer  or  dairy  the  milk  was  obtained ; 
hence  such  a  regulation  is  found  in  a  number  of  cities,  as  Buffalo,  the 
District  of  Columbia,  Cincinnati,  Cleveland,  and  Louisville.  In  the 
District  of  Columbia  it  must  be  posted  in  bakeries  as  well. 

Each  of  the  inspectors  in  the  City  of  New  York  is  instructed  to 
procure  three  samples  of  cream  each  week,  but  as  there  is  no  legal 
standard  for  cream,  the  samples  are  tested  for  coloring  matter  and  pre- 
servatives only.     They  vary  much  in  their  fat  contents.4 

Inspection. 

Milk  laws  are  of  little  value  unless  active  measures  are  taken  to 
enforce  them.  There  must  be  a  constant  supervision  of  the  dealers  and 
inspection  of  the  milk.  This  is  so  important  that  a  number  of  states  in 
their  food,  milk  or  dairy  legislation  have  provided  for  it.     Sometimes 

placed  on  such  wagon  or  vehicle  under  the  direction  of  the  board  of  health  or  its 
milk  inspector;  and  in  case  milk  is  sold  from  cans  or  vessels,  where  no  wagon  or 
other  vehicle  is  used,  then  the  license  number  of  the  person,  persons,  or  corporation 
selling,  or  offering  for  sale  such  milk,  shall  be  placed  in  a  conspicuous  place  on  such 
can  or  vessel,  in  such  manner  as  to  style  of  number  and  method  of  fastening  the 
same  on  such  can  or  vessel  as  to  meet  the  approval  of  the  board  of  health  or  its 
milk  inspector,  or,  if  such  milk  is  sold,  or  exposed  for  sale  within  a  store  or  house, 
then  such  license  number  shall  be  exposed  in  some  conspicuous  place  in  said  store 
or  house.11 

1  Fitchburg,  Rules  and  Regulations,  Board  of  Health  (1S97),  p.  32,  rule  7. 

2  Milwaukee,  Ordinance  of  23  October,  1891. 

3  Omaha,  Milk  Ordinance,  Sec.  4. 

4  New  York,  Report  of  Board  of  Health  (1896),  p.  172. 


DAIRY  PRODUCTS.  383 

this  control  is  exercised  wholly  or  partially  through  state  agencies.  In 
some  states,  as  in  Massachusetts  and  Maryland,  the  state  board  of  health 
through  its  agents  looks  after  the  milk  as  well  as  other  foods.  Usually 
the  work  of  the  state  inspectors  is  confined  to  the  smaller  cities  and 
villages,  as  most  of  the  larger  communities  are  provided  with  their  own 
local  inspectors.  Other  states  have  dairy  or  dairy  and  food  commis- 
sioners who  perform  similar  functions.  In  Iowa,  Washington,  and  Wis- 
consin the  commissioner  apparently  has  full  control  of  the  milk  supply, 
there  being  no  local  inspectors  except  in  Milwaukee.  In  Iowa  the 
dairy  commissioner  is  authorized  by  statute  to  appoint  an  agent  in  each 
city  of  over  10,000  inhabitants,  to  collect  from  each  dealer  not  more 
than  four  times  a  month,  samples  of  milk  offered  for  sale.  The  com- 
pensation is  three  dollars  for  each  day  actually  employed.  There  are 
thirteen  such  cities  in  Iowa  where  500  dealers  supply  milk  to  40,000 
families.  There  is  one  agent  in  each  city  appointed  by  the  state  dairy 
commissioner.1  In  Pennsylvania,  Ohio,  and  Michigan  the  daily  com- 
missioner, and  in  Pennsylvania  the  state  board  of  agriculture  look  after 
the  local  milk  supply  to  some  extent. 

The  chief  need  for  milk  inspection  is  in  the  cities,  and  usually  the 
cities  appoint  their  own  inspectors.  Doubtless  it  is  possible  under  a 
grant  of  general  sanitary  legislative  power  for  municipalities  to  provide 
for  milk  inspection,  even  though  no  direct  authority  is  given  in  the 
general  statutes  or  in  their  charters.  There  is  no  legislation  providing 
for  the  appointment  of  milk  inspectors  in  Ohio,  Illinois,  Nebraska,  Xew 
York.  Missouri,  Tennessee,  and  Kentucky,  yet  many  of  the  important 
cities  in  those  states  have  appointed  milk  inspectors  and  adopted  rules 
for  the  control  of  the  milk  supply,  though  there  is  no  specific  authority 
in  their  charters  for  them  to  do  so. 

The  importance  of  milk  inspection  has  induced  several  states  to 
Legislate  concerning  it.'- 

The  Maine,  Massachusetts,  New   Hampshire,  and  Rhode  Island  laws 

an-  milch  alike.      The  following  is  that  of  .Massachusetts: :; 

••  Tin-  mayor  and  aldermen  of  cities  shall,  and   the  selectmen  of  towns  may. 

annually  appoint  oi r  more  persons  to  be  inspectors  of  milk  for  their  respective 

places,  who  shall  he  sworn  before  entering  upon  tin-  duties  of  their  office.  Bach 
inspector  shall  publish  a  notice  of  his  appointment  Eor  two  weeks  in  a  newspaper 
published  in  his  citj  or  town,  or,  if  no  newspaper  is  published  therein,  In-  shall  post 
up  such  notice  in  two  <>v  more  public  places  in  such  city  or  town. 

-  mIi  inspectors  shall  keep  an  office  ami  shall  record  in  ln.oks  kept  for  tin-  pur- 

lIowa,  Report  of  Dairy  Commissioner  (1897),  p.  186. 

•Among  these  an-  Colorado,   Mainr.   Massachusetts.  Michigan,  Minnesota,  NTe^ 
Hampshire,  \'-u  Jersey,  Pennsylvania,  ami  Rhode  Islam). 

Massachusetts,  Public  Statutes  1882),  Chapter  57,  s«-rs.  l  •_'.  as  amended  bj 
Chapter  318  ol  1886. 


384  DAIRY  PRODUCTS. 

pose  the  names  and  places  of  business  of  all  persons  engaged  in  the  sale  of  milk  in 
their  city  or  town.  Said  inspectors  may,  with  the  approval  of  the  mayor  or  the 
selectmen,  employ  suitable  persons  to  act  as  collectors  of  samples,  who  shall  be 
sworn  before  entering  upon  their  duties.  Said  inspectors,  or  the  collectors  em- 
ployed and  qualified  as  aforesaid,  may  enter  all  places  where  milk  is  stored  or  kept 
for  sale,  and  all  carriages  used  for  the  conveyance  of  milk,  and  the  said  inspectors 
or  the  collectors  may  take  samples  for  analysis  from  all  such  places  or  carriages,  and 
at  the  same  time  a  portion  of  each  sample  so  taken,  shall,  if  the  person  taking  the 
same  be  requested  so  to  do,  be  sealed  and  delivered  to  the  owner  or  person  from 
whose  possession  the  same  is  taken  and  a  receipt  given  therefor  to  the  person  taking 
the  same. 

"  The  inspectors  shall  cause  the  samples  of  milk  so  taken  to  be  analyzed  or  other- 
wise satisfactorily  tested,  the  results  of  which  analysis  or  test  they  shall  record  and 
preserve  as  evidence.  The  inspectors  shall  receive  such  compensation  as  the  mayor 
and  aldermen  or  selectmen  may  determine." 

As  in  Massachusetts,  so  in  Maine,  the  law  is  mandatory,  but  only 
for  towns  of  over  3,000  inhabitants.  The  other  state  laws  are  only  per- 
missive. The  Minnesota  statute  which  was  enacted  in  1895  gives  au- 
thority to  appoint  inspectors  of  milk,  dairies,  and  dairy  herds. 

With  the  exception  of  Colorado  and  New  Jersey  all  of  the  laws 
above  referred  to  place  the  appointment  of  milk  inspectors  in  the  hands 
of  the  city  council  or  similar  body  rather  than  in  the  hands  of  the  board 
of  health.  In  Colorado  the  statute  gives  the  power  to  the  board  of 
health,  and  in  New  Jersey  the  cities  may  so  provide  if  they  so  desire. 
It  is  an  important  question  whether  the  control  of"  the  milk  supply 
should  be  under  the  jurisdiction  of  the  board  of  health  or  confined  to  an 
independent  officer.  The  state  legislators  have  evidently  thought  best 
to  make  the  milk  inspector  an  independent  officer  appointed  by  the  city 
council.  The  cities  have  thought  otherwise,  for  by  special  acts  the 
cities  of  Boston  and  Lynn  have,  within  a  few  years,  succeeded  in  placing 
their  milk  supply  under  the  control  of  the  board  of  health,  and  in  those 
states  in  which  the  statutes  do  not  provide  how  the  inspectors  shall  be 
appointed  they  are  usually  in  the  board  of  health.  This  is  true  of  Bal- 
timore, Buffalo,  Chicago,  Cincinnati,  Cleveland,  District  of  Columbia, 
Minneapolis,  Nashville,  New  York,  Omaha,  Philadelphia,  Pittsburgh, 
Rochester,  and  San  Francisco.  The  efficiency  of  some  of  these  cities 
in  looking  after  their  milk  supply  would  indicate  that  such  an  arrange- 
ment is  satisfactory.  If  the  sanitary  condition  of v  the  cows,  dairies, 
wagons,  vessels,  etc.,  is  to  be  controlled  at  all,  it  would  seem  that  the 
health  department  would  have  better  facilities  for  doing  it  than  an  inde- 
pendent officer.  A  recent  discussion  by  health  officers  in  Massachu- 
setts 1  brought  out  the  fact  that  while  milk  inspectors  were  appointed 
by  the  councils,  rules  for  the  control  of  dairies  must  be  made  by  boards 


1  Journal  of  the  Massachusetts  Association  of  Boards  of  Health,  Vol.  VII,  p.  116. 


DAIRY  PRODUCTS.  335 

of  health,  and  it  appeared  that  unless  the  milk  inspector  was  also  ap- 
pointed by  the  board  of  health  there  might  easily  be  an  unfortunate 
conflict.  Effort  is  made  in  some  .Massachusetts  cities,  as  Lowell  and 
Fitehburg,  to  secure  co-operation  between  the  milk  inspectors  and  the 
board  of  health,  but  such  efforts  may  not  always  he  successful. 

Several  of  the  inspection  laws,  as  those  of  Massachusetts,  Xew 
Hampshire,  Rhode  Island,  and  Wisconsin,  give  the  inspectors  the  right 
t<»  enter  premises  and  vehicles  for  the  purpose  of  taking  samples,  and 
similar  provisions  arc  found  in  municipal  ordinances. 

I'm  successful  milk  inspection  three  things  are  to  he  done  ;  first  the 
milk  must  be  inspected  in  the  hands  of  producers  and  dealers:  second. 
the  samples  must  he  tested  and  analyzed:  third,  the  offenders  must  he 
prosecuted.  In  many  cities  all  these  things  may  he  done  by  one  and 
the  same  person,  usually  the  milk  inspector,  hut  perhaps  by  the  food 
inspector,  the  chemist  or  the  health  officer.  Other  cities,  particularly 
the  larger  cities,  have  found  it  advisable  to  separate  these  functions 
among  different  officers.  To  consider  the  last  first,  it  may  he  said  that 
in  the  majority  of  places  the  police  or  law  officers  actually  see  to  the 
preparation  of  the  evidence  and  the  presentation  of  the  cases  for  prose- 
cution, or  else  this  work  is  done  under  their  immediate  supervision. 
The  milk  acts  do  not  usually  refer  to  this  matter  as  it  is  covered  by 
other  laws,  lait  in  Rhode  Island  the  inspector  is  empowered  by  the 
act  10  prosecute,  and  in  the  District  of  Columbia  and  Hartford  it  is 
made  the  duty  of  the  city  attorney,  and  in  Detroit  of  the  chief  of 
police. 

The  successful  prosecution  of  milk  adulterators  presupposes  the 
chemical  analysis  of  the  suspected  milk.  Hence  milk  inspectors  are 
usually  chemists  or  else  have  a  chemist  under  them,  or  refer  directly  to 
the  municipal  chemist.  Thus  in  Baltimore,  Brooklyn,  Buffalo,  Chicago, 
Cleveland,  Milwaukee,  the  City  of  New  York,  and  San  Francisco,  the 
inspection  of  milk  is  made  a  part  of  the  general  food  inspection,  and  in 
nearl\  even  instance  thai  division  or  bureau  is  presided  over  by  a 
chemist,  and  in  ever)  instance  has  a  chemist  in  its  employ.  In  New 
Orleans  the  city  chemist  looks  after  the  milk  supply.  In  other  cities. 
;is  Atlanta,  Newark.  Pittsburgh,  and  doubtless  many  smaller  places,  the 
milk  inspector  is  simph  an  inspector  and  collector  of  samples,  and 
hands  over  the  samples  to  the  < - i  1  \  chemist  for  analysis.  When  the 
milk    inspection    is  not    merged    in  a  division  ,,\'   food    inspection,  by  far 

the  st    common  way  is  to   require  the  milk    inspector  to   he  a  chemist 

skilled  in  milk  analysis. 

W  Idle  milk  inspectors  who  are  trained  chemists  do  often  make  all 
their  own    inspections  and    collect    their  samples,  yet    ii    hardly  seems 


386  DAIRY  PRODUCTS. 

wise  to  employ  a  skilled  person  for  such  service,  and  in  large  cities 
it  is  necessary  for  the  chemist  to  have  assistants  to  collect  samples. 

The  appointment  of  collectors  by  the  inspectors  is  provided  for  in 
the  Massachusetts  and  Rhode  Island  laws,  and  such  officers  have  been 
appointed  elsewhere,  as  in  Chicago,  Milwaukee,  New  Orleans,  New 
York,  Philadelphia,  and  San  Francisco.  In  Detroit  the  police,  in  Cleve- 
land the  sanitary  police,  and  in  Milwaukee  sanitary  inspectors  are  some- 
times detailed  to  collect  samples.  In  Chicago  the  inspectors  wear  the 
badge  and  insignia  of  the  police  (furnished  at  their  own  expense). 
It  might  be  expected  that  this  would  identify  them  too  readily  to  the 
milk  dealers,  thus  giving  one  with  poor  milk  a  chance  to  get  out  of  the 
way. 

Sometimes,  as  has  been  said,  the  milk  inspection  in  the  larger  cities 
is  made  a  part  of  the  general  food  inspection.  In  other  cities  the  milk 
inspector  is  sometimes  a  food,  meat  or  vegetable  inspector  as  well.  This 
is  true  of  a  number  of  the  Massachusetts  cities,  and  Allegheny,  Atlanta, 
Columbus,  Evansville,  Newark,  Salt  Lake  City,  Scranton,  and  Youngs- 
town,  O.  In  San  Antonio  and  Hartford  the  sealer  of  weights  and  meas- 
ures is  the  milk  inspector.  In  Lancaster,  Penn.,  and  Memphis  the  health 
officer  makes  the  tests  of  the  milk  and  is  practically  the  inspector.  In 
Terre  Haute,  Ind.,  the  sanitary  inspector  must  be  a  skilled  milk  in- 
spector, and  in  Warren,  (..).,  the  sanitary  policeman  is  the  milk  inspec- 
tor. In  Brookline  and  Pittsfield,  Mass.,  the  milk  inspector  is  also  the 
veterinarian. 

The  following  is  a  list  of  cities  with  the  officials  controlling  the  milk 
supply  and  their  salaries  : 

Number  of  Annual 

City.  Inspectors.  Salary. 

Baltimore 2  milk  inspectors 1,000 

Boston 1  chemist 3,000 

1  chemist 2,400 

3  collectors per  day  3 

Buffalo 2  milk  inspectors 1 ,000 

Chicago 1  milk  inspector 1,500 

6  milk  inspectors 900 

Cincinnati 1  chemist 1,200 

Denver 1   chemist 900 

Hartford '. 1  chemist 1.0001 

Milwaukee 1  chemist 1,200 

1  milk  inspector 800 

Minneapolis 1  bread  and  milk  inspector 900 

1  veterinarian 1,000 

2  dairy  inspectors 1,000 

Newark 1  milk  inspector 1,000 

New  Orleans 1  milk  inspector 1,300 


1  Is  also  sealer  of  weights  and  measures. 


DAIRY  PBODUCTS  387 

Number  of  Annual 

City.  [nspectors.  Salary. 

New  York  (Borough  of  Manhattan) . .    1  milk  inspector 1,500 

i>  milk  inspectors 1,200 

Philadelphia 1  chief  milk  inspector 1,900 

4  assistant  milk  inspectors 1,020 

5  collectors 720 

Pittsburgh 1  chemist 1,500 

1  collector 1,200 

Providence 1   chemist 2,000 

1   chemist 800 

_'  collectors per  week  15 

Rochester 1  chemist 1,200 

1  collector 2,100 

1  collector 600 

St.    Louis 1   milk   inspector 1,500 

2  dairy  inspectors 2,100 

St.    Paul 4  milk   inspectors 900 

s>  ra<  use 1   milk  inspector 1,200 

For  salaries  of  food  and  milk  inspectors  see  also  p.  :'.44. 

The  methods  employed  in  supervising  the  milk  supply  vary  in  dif- 
ferent cities,  owing  to  the  differences  in  the  source  of  supply  and  man- 
ner of  distribution.  In  cities  containing  up  to  100,000  inhabitants,  and 
Sometimes  in  larger  cities  surrounded  by  an  easily  accessible  agricultural 
feountry,  the  milk  is  chiefly  distributed  directly  to  the  customers  by  the 
producer.  The  farmer  keeps  his  own  cows  and  sells  the  milk  to  the 
consumer,  delivering  it  from  his  wagon  which  is  driven  to  the  city  in 
the  earl}  hours  of  the  morning.  Sometimes  he  may  buy  some  milk 
from  his  neighbors,  and  occasionally  a  country  dealer  may  buy  all  the 
milk  which  In-  delivers  to  his  customers.  In  Providence  about  four- 
fifths  of  the  milk  is  thus  brought  in  on  wagons  from  a  distance  of  a 
dozen  miles  or  less.  In  the  larger  cities  the  milk  supply  must  neces- 
sarily coine  chiefly  from  a  longer  distance,  and  this  has  necessitated  its 
transportation    by    railroad    and   the    development    of   the   middleman. 

Boston1  and  New  York-  are  excellent  examples  of  this  class  of  city.  In 
Boston  about  three-fourths  of  the  milk  is  railroad  milk  and  in  New 
JTork  a  much  larger  proportion.  In  Boston  some  of  the  milk  comes  a 
distance  of  1  |<i  miles,  and  in  New  Fork  300  miles.  The  transportation 
companies  use  ice  freely  in  specially  constructed  ears  :  the  milk  nsnalh 
arrives  in  the  city  in  good  condition,  that  is,  it  is  not  sour.  This  milk 
is  purchased  of  the  fanners  by  middlemen  who  have  depots  in  the  <it\ 
;it  which  it  is  received.      In  some  cities  the  business  has  been  much  con- 


Milk  supply  of  Boston  and  other  Ne^  England  cities.     Bulletin  20.     Bureau  "' 

Animal  Industry.  I.  S.  Department  "i  Agriculture,  1808. 

tf<  \  Fork,  Report  of  Depari at  of  Health  (1800),  pp.  90-04. 


388  DAIRY  PRODUCTS. 

solidated  and  is  in  the  hands  of  a  few  persons  who  distribute  the  milk 
from  very  extensive  establishments.  These  middlemen  sell  to  the 
retail  dealers  who  distribute  it  to  their  customers  each  morning.  The 
milk  is  usually  at  least  thirty-six  hours  old  before  it  reaches  the  con- 
sumer. Milk  is  also  sold  from  stores,  the  amount  sold  in  this  way  dif- 
fering greatly  in  different  cities.  Usually  the  amount  is  greater  in 
larger  than  in  smaller  places.  Generally  some  milk  is  produced  in  the 
city  itself.  Usually  the  amount  is  not  large.  In  New  York  it  is  about 
five  per  cent,  of  the  total  supply ;  in  Baltimore  ten  per  cent. ;  more  than 
is  brought  in  on  wagons. 

In  those  towns  and  cities  where  milk  is  distributed  from  wagons  by 
the  producer  directly  to  the  consumer,  with  perhaps  the  intervention  of 
a  few  stores,  the  problem  of  the  inspector  or  collector,  for  usually  there 
is  only  one  for  such  a  town,  is  comparatively  simple.  He  has  to  be  on 
hand  early  in  the  morning  to  intercept  the  milkmen  on  their  way  from 
the  country  to  the  city,  and  later  to  visit  the  stores.  In  the  larger  cities 
it  is  necessary  not  only  to  inspect  the  milk  on  the  wagons  and  in  the 
stores,  but  also  to  look  after  it  while  it  is  in  the  depots  of  the  middle- 
men and  as  it  is  received  from  the  railroads.  The  relative  attention 
given  to  these  different  parts  of  the  business  varies,  as  the  experience 
in  different  cities  has  shown,  that  one  part  or  another  is  the  greatest 
seat  of  danger.  In  Boston.  Chicago,  New  York,  and  Philadelphia  com- 
paratively little  attention  is  given  to  the  receiving  depots,  while  the 
reverse  is  true  in  Baltimore,  Cleveland,  and  San  Francisco.  In  San 
Francisco  the  milk  comes  into  the  city  through  four  stations  and  every 
can  is  tested.  The  inspectors  claim  that  subsequent  tests  from  the 
Avagons  in  the  city  show  that  the  milk  is  not  adulterated  by  the  dealers 
after  it  leaves  the  station.  In  Baltimore  the  incoming  milk  is  tested  at 
six  stations.  In  New  York,  Chicago,  and  Denver  most  attention  is 
given  to  stores;  in  the  first  named  city  seven  out  of  eight  inspectors  are 
occupied  mostly  in  this  work,  and  only  occasionally  visit  receiving- 
depots,  and  one  only  is  detailed  to  look  after  the  milk  as  it  is  delivered 
from  wagons.  In  the  large  cities  of  Brooklyn,  Chicago,  New  York,  and 
Philadelphia,  where  there  are  several  inspectors,  each  inspector  is  usu- 
ally assigned  to  a  certain  district  of  the  city,  and  in  Brooklyn  and 
Chicago  the  assignment  is  frequently  changed.  Usually  inspectors 
make  their  rounds  on  foot,  but  in  Providence,  owing  to  the  speed  with 
which  certain  milkmen  drove  out  of  sight  at  the  collector's  approach, 
the  latter  was  furnished  a  horse  and  buggy,  which  he  uses  in  his  work. 
In  Providence  and  Newark  the  inspectors  direct  their  attention  chiefly 
to  the  wagons  of  the  peddlers. 

The   inspectors"  and   collectors'  outfit  and  duties  vary  according  as 


DAIRY  PRODUCTS.  389 

different  methods  of  testing  are  relied  upon.  There  are  two  main 
methods  of  testing  milk:  one  is  by  the  use  of  the  lactometer  to  deter- 
mine its  specific  gravity,  and  the  other  is  by  chemical  analysis  which 
determines  the  percentage  of  solids  and  of  fat. 

A  practical  difficulty  in  the  use  of  the  lactometer  is  that  it  is  only 
reliable  at  the  temperature  for  which  it  is  graduated.  If  the  milk  is 
above  or  below  that  temperature  the  readings  will  not  be  correct. 
Hence  this  instrument  should  always  be  used  in  conjunction  with  a 
thermometer,  and  the  best  lactometers  have  a  thermometer  blown  in  the 
glass  with  the  graduation  above  that  of  the  lactometer.  Lactometers 
are  usually  intended  to  be  used  at  a  temperature  of  60  ,  and  if  the  milk 
is  above  or  below  that,  a  correction  must  be  made  by  means  of  a  table 
which  has  been  prepared  for  that  purpose,  or  for  ordinary  usage  one 
degree  of  the  board  of  health  lactometer,  so-called,  must  be  subtracted 
from  every  three  degrees  which  falls  below  60c  or  added  for  every  three 
degrees  above.  Even  this  correction  is  not  reliable  for  over  10°  of  tem- 
perature either  way.  and  it  is  more  satisfactory  if  the  milk  is  within  5 
of  il<»  .  (Mm-  greal  objection  to  the  use  of  the  lactometer  is  that  while 
the  removal  of  cream  raises  the  specific  gravity  the  addition  of  water 
towers  it  so  that  the  skillful  milkman  by  employing  both  processes  can 
produce  with  much  profit  to  himself  a  fluid  with  the  specific  gravity  of 
pnaltered  milk.  The  watery  blue  appearance  of  this  watered  ami 
skimmed  milk  would  betray  its  character  to  the  skilled  inspector. 
Special  instruments  have  been  devised  to  supplement  the  skill  of  the 
observer  in  detecting  the  removal  of  cream.  A.mong  such  that  have 
been  to  some  extent  used  by  milk  inspectors  are  the  pioscope  and  lacto- 
scope. 

The  former  of  these  consists  of  a  disc  of  hard  rubber  with  a  depres- 
sion in  the  centre  and  the  rim  surrounding  this  painted  in  segments  to 
pepresenl  cream  and  milks  of  various  degrees  of  richness.  A  drop  of  milk 
is  placed  in  the  centre  and  covered  with  a  glass  to  give  a  uniform  thick- 
ness. The  color  of  the  milk  is  then  compared  with  standard  colors  on 
the  rim.  The  pioscope  is  used  some  m  San  Francisco.  The  lactoscope 
is  used  somewhat  in  Philadelphia  and  a  \\'\v  other  cities.  Neither  of 
the  two  instruments  is  used  nearly  as  much  as  the  lactometer. 

Formerly  the  lactometer  was  much  relied   upon  in  milk  inspections 

and  was  used  exclusively  in  inan\  large  cities,  and  conviction  OH  its 
evidence  was    secured    in    New     York    in    1878    in    the    celebrated    "milk 

cases"1  and  more  recently  in  Baltimore.2     The  difficulties  in  the  m 

the  lactometer  have  been   referred   to.  the   must    important   being   that 

except    in    the    hands   of   a  skilled    and    careful    observer,  much    watered 

1  The  People  vs.  Daniel  Schrumpf,  Supreme  <  lourt,  A.pri]  term,  1878. 
-.lelin  W.  Deems  vs.  Mayor  and  Citj  I  ouncil  of  Baltimore,  1894. 


390  DAIR  Y  PR  OB  J  7 '  7'.s. 

milk  will  l>e  passed  as  pure:  but  the  skill  of  an  inspector  is  very  uncer- 
tain ground  to  rest  a  case  on  before  a  jury.  The  fact  that  few  states  or 
cities  have  fixed  the  standard  for  milk  in  terms  of  specific  gravity  still 
further  limits  the  use  of  this  instrument,  for  it  can  only  be  used  suc- 
cessfully for  prosecutions  when  the  standard  is  fixed  in  specific  gravity 
degrees.  A  specific  gravity  standard  is  established  in  Michigan,  Oregon, 
Pennsylvania  cities  of  the  second  class.  Baltimore,  New  Haven.  New 
Orleans,  San  Francisco,  and  San  Antonio.  Its  showings  may,  however, 
be  used  as  a  basis  for  destroying  milk  as  is  done  in  New  York  and  Bal- 
timore, and  in  Baltimore  it  is  the  sole  reliance  in  such  cases.  But  the 
chief  use  of  the  lactometer  is  to  furnish  a  rough  test  to  guide  the 
inspector.  If  he  finds  that  the  readings  indicate  a  quality  below  the 
standard,  he  takes  a  sample  for  chemical  analysis  ;  if  otherwise  he  passes 
on  to  another  inspection.  In  this  way  it  is  claimed  much  labor  is  saved 
the  chemist  and  a  much  larger  amount  of  milk  can  come  under  the  cog- 
nizance of  the  inspector.  In  the  majority  of  cities  the  inspectors  are 
provided  with  means  for  using  the  lactometer,  and  also  for  taking  samples 
of  suspected  milk. 

The  following  instructions  for  the  use  of  the   lactometer  are   given 
by  the  board  of  health  in  New  York  City  : x 

"To  test  for  water  the  lactometer  can  be  used  as  follows:  Stir  the  milk  to  be 
tested  so  that  a  fair  sample  can  be  taken.  Warm  or  cool  enough  milk  to  60°  Fahren- 
heit to  fill  the  testing  cylinder.  Insert  the  lactometer  in  the  milk  in  the  testing 
cylinder,  being  careful  not  to  wet  that  part  of  the  stem  above  the  milk,  and  observe 
where  it  floats.  Pure  niilk  will  not  fall  below  the  100°  mark  on  the  lactometer 
at  60°  temperature.  It  must  be  remembered  that  skimming  the  milk  will  make 
the  lactometer  float  higher,  and  the  addition  of  water  or  cream  may  make  it  sink 
lower  than  100°,  but  if  the  appearance  of  the  milk  upon  the  lactometer  is  noted,  no 
one  can  mistake  watered  milk  for  milk  to  which  cream  has  been  added,  nor  pure 
milk  for  milk  from  which  the  cream  has  been  removed,  as  in  skimmed  milk.  In 
other  words,  if  the  lactometer  floats  below  100°  and  the  milk  looks  thin,  water  has 
been  added.  If  it  floats  above  100°  and  the  milk  looks  thin,  it  may  be  skimmed,  or 
skimmed  and  watered.  But  if  it  floats  above  100°  and  looks  creamy  and  yellow 
and  sticks  to  the  glass,  you  can  be  reasonably  sure  that  it  is  pure.  Good  average 
milk  will  indicate  about  109°  on  the  lactometer  at  a  temperature  of  60°  Fahrenheit, 
and  show  about  fourteen  per  cent,  of  cream  by  the  cream  test." 

The   method  of  milk  inspection  is  perhaps  as  complete  as  anywhere 

in  New  York  City  :  2 

11  Each  inspector  is  provided  with  a  suitable  bag  containing  a  lactometer  and 
thermometer,  both  of  which  have  a  distinguishing  number,  they  having  been  tested 
as  to  their  accuracy  by  the  chemists,  and  the  record  of  such  tests  kept  for  reference; 
the  number  of  the  instrument,  the  date  tested,  the  results  and  the  name  of  the 
chemist  who  performed  the  test  are  tabulated,  so  that  should  any  dispute  arise  as 
to  the  accuracy  of  any  instrument  used  this  record  can  be  referred  to. 


iCity  of  New  York.  Report  of  the  Department  of  Health  (1896),  p.  110. 
2  City  of  New  York,  Report  of  Department  of  Health  (1896),  p.  97,  et  seq. 


DAIRY   PRODUCTS. 


391 


••  Hi-  is  also  provided  with  an  inspection  book,  which  is  numbered  with  consecu- 
tive numbers  (see  diagram),  indicating  the  proper  number  of  the  inspection: 

26 

Date Hour 

Street  and  Number 

Name  of  <  >wner 

Business 

From  whom  purchased 

Number  of  Quarts  sold  Daily 


Ian    \m. 

Amount  of  Contents. 

Temper-     Lactometer     Appear- 
Lactometer.       :ltnri.         at  godeg.         ance.          Odor-         ' 

1 

•2 

3 

4 

Xo.  of  inspection,  N  1626. 
Marks  on  <  'ans. 

REMARKS. 

—  also  a  stub-hook  numbered  with  consecutive  numbers  of  milk  samples  taken,  as 

follows  : 

Health  Department,  City  of  New  York. 
division  of  tood  inspection    \m>  offensive  trades. 

Date 


Xo.  of   Inspection . 
Inspector 

Witness 

Name  of  <  >\vner 

Address     

(Quarts  Destroyed 
Adulteration 


Sample  No , 


Health  Department,  City  of  New  Vokk. 
division  of  food  inspection   and  0ffensiv]    trades 


■tote 

No.  of  Inspection 
Inspector 


Wit  ness    

Name  of  <  >wner 
Address      


Quarts  Destroyed 

Ad u It e rat  ion 

Sample  No 

as  required  l>>  Chapter  338,  Laws  of  L898. 

Six-ounce  bottles  for  samples  to  be  delivered  to  render,  both  sides  of  this  bot- 
tle perforated  wit  li  a  small  hole  to  permii  sealing  with  wire  and  lead  seal ;  w  ire  and 
•eals  and  brad-awl  and  sealing  iron,  this  latter  having  '  Health   Department,  V  'i 
on  reverse  of  die,  and  the  distinguishing  letter  of  the  inspector,  as  A,  K.  ('.  •• 
the  nbverse  side. 

"  Four-ounce  wide-mouth  bottles  for  milk  samples  to  be  delivered  to  Department 
Chemist. 


392  DAIRY  PRODUCTS. 

"A  testing  cylinder  to  hold  the  milk  under  examination,  towels,  labels,  etc.     Each 
inspector  is  required  to  wear  his  official  badge  at  all  times  when  on  duty. 

^— i -  "  The  cylinder  used  to   contain  the  milk  under  examination  is 

y  ^         made  in  the  following  shape : 

"  The  tin  cup  at  the  bottom  holding  a  little  alcohol,  this  enables 
the  inspector  to  readily  warm  the  milk  to  sixty  degrees  Fahrenheit 
by  pouring  a  little  alcohol  in  this  cup,  igniting  the  same  and  stirring 
contents,  while  burning,  with  the  thermometer,  until  the  desired 
temperature  is  attained. 

"  Chapter  338  of  the  Laws  of  1893  requires  every  inspector  tak- 
ing a  sample  of  milk  for  analysis  to  deliver  to  the  vender  or  his 
representative  a  sealed  sample  and  in  the  presence  of  a  witness. 

"  In  order  to  comply  with  this  law,  it  has  been  found  convenient 
to  have  an  officer  detailed  from   the  sanitary  police,  to  accompany 
the  inspector  and  so  act  as  the  witness  and  generally  assist." 

Other  states  and  cities  besides  New  York  have  regulations  in  regard 
to  sampling  milk.  In  Massachusetts,  Vermont,  and  Washington  dupli- 
cate samples  must  be  furnished  the  dealer  if  asked  for,  but  in  Massa- 
chusetts 1  if  such  a  duplicate  sample  is  not  given,  the  evidence  derived 
from  the  sample  taken  shall  be  received  in  court.  In  Vermont2  the 
sample  must  be  taken  in  the  presence  of  the  dealer  and  a  disinterested 
witness,  and  must  be  labeled  and  the  label  signed  by  the  witness.  A 
witness  is  also  required  in  Milwaukee,  and  in  the  District  of  Columbia 
two  witnesses.  In  Massachusetts 3  a  recent  law  requires  that  the 
analysis  must  within  ten  days  be  sent  to  the  person  from  whom  the 
sample  was  obtained. 

In  Chicago  the  inspector  on  taking  a  sample  makes  out  two  slips, 
one  of  which  is  kept  in  the  office,  and  the  other  is  given  to  the  dealer. 
The  latter  slip  is  shown  in  Appendix  47.  If  the  dealer  brings  this  to 
the  office,  which  he  usually  does,  he  can  have  noted  upon  it  the  results 
of  the  analysis. 

In  Chicago  each  inspector  carries  a  case  of  twenty-four  half  pint 
bottles.  In  Detroit  seven  ounce  square  bottles  are  used.  In  Massa- 
chusetts the  counterfeiting  of  the  inspector's  seal  is  forbidden.4 

In  New  York  City  "  The  inspector,  before  the  examination  of  the 
milk,  either  in  a  store  or  upon  a  cart,  as  in  the  course  of  delivery  to 


1  Massachusetts,  Chapter  318  of  1886,  Sec.  3. 
-Vermont,  Statutes  (1894),  Sees.  4329-30. 

3  Massachusetts,  Chapter  109  of  1S99. 

4  Massachusetts,  Chapter  398  of  1896,  Sec.  3 : 

"  Whoever  makes,  causes  to  be  made,  uses,  or  has  in  his  possession  any  imita- 
tion or  counterfeit  of  any  seal  used  by  any  inspector  of  milk,  collector  of  samples, 
or  other  official  engaged  in  the  inspection  of  milk,  and  whoever  changes  or  in 
any  way  tampers  with  any  sample  taken  or  sealed  as  provided  in  section  two, 
shall  be  punished  by  a  fine  of  not  less  than  one  hundred  dollars  and  by  imprison- 
ment in  the  house  of  correction  not  less  than  three  nor  more  than  six  months." 


DAIRY  PRODUCTS. 


393 


customers,  ascertains,  first,  if  the  owner  has  a  permit  to  sell  milk,  and 
such  facts  as  are  necessary  to  fill  in  the  blanks  on  his  inspection  books, 
and  also  such  information  as  might  become  necessary  should  subse- 
quent legal  steps  be  taken.  Having  recorded  such  information  on  his 
inspection  book,  he  next  proceeds  to  obtain  the  lactometric  standing  as 
follows :  "  In  order  to  take  a  fair  sample,  the  milk  in  the  vessel  from 
which  the  sample  is  taken  must  be  thoroughly  mixed.'"  This  is  doubt- 
less the  usual  practice  with  inspectors,  but  it  rarely  receives  legislative 
notice  as  it  does  in  the  District  of  Columbia,  where  it  is  provided1  that 
-such  sampling  shall  be  made  according  to  the  Babcock  method,  to  wit: 
dumping  tin-  milk  from  one  can  to  another  not  less  than  twice  before 
sampling."  In  New  York-  the  inspector  after  taking  his  sample  makes 
the  lactometer  test. 

"  If  from  this  examination  he  believes  the  milk  to  be  adulterated  by  the  addition 
<>f  water  or  by  the  removal  of  part  of  the  cream,  or  should  the  taste,  odor,  etc., 
indicate  some  other  form  of  adulteration,  the  six-ounce  bottle,  having  holes  through 
the  neck,  is  filled  from  the  testing  cyclinder,  the  cork  inserted,  a  wire  passed 
through  the  holes  in  the  neck  of  the  bottle  and  the  cork,  then  twisted  around  the 
bottle,  the  blank  lead  seal  slipped  over  the  ends  of  wire  and  sealed  with  sealing 
iron,  as  in  diagram. 


■•  Upon  tin-  bottle  he  fastens  the  label  required  by  chapter  338  bj  means  of  gum 
which  is  on  the  label   pari  of  stub-boob   leaf;  this  label,  filled  out  as  required  by 

law.  and  in  the  presence  of  the  officer,  delivers  this  sealed  and  labeled  sample  to  the 

render  or  his  representative. 

••  The  four-ounce  wide-mouthed  bottle  is  now  tilled  with  the  milk  from  i  lie  cylin- 
der, a  label  pasted  upon  it  on  which  the  number  of  the  inspection  ami  sample 
number  is  written,  this  latter  sample  being  the  one  taken  for  deliver;  to  the 
department  chemist.     Should   more  than  one  sample  he  taken,  each  bottle  delivered 

to  the  \iiii!er  is  marked   with  I  he  sa  m  pie  mi  in  her  on  its  la  he  I  hy  means  of  a  marking 

'lia i no ni I.     This  prevents  the  soaking  off  of  a  label  frpm  one  sample  bottle  and  t  rans- 


A.-t  of  2  March,  1805,  Sec.  18. 
City  of  New    York.   Report  of  Kcparlinent  of  Health  (1896),   p 


394 


JtAIBY  PRODUCTS. 


f erring  it  to  one  of  the  others,  which  might  not  be  adulterated,  so  that  on  the  trial, 
if  one  took  place,  there  would  be  a  discrepancy  between  the  results  of  the  analysis 
of  the  sample  of  milk  made  by  the  department  chemist  and  those  obtained  by  some 
chemist  employed  by  the  vender. 

"  If  the  milk  is  found  to  be  apparently  pure,  only  the  record  of  the  result  of  the 
inspection  is  made,  and  the  inspector  proceeds  to  the  next  place  where  he  intends 
to  inspect  the  milk. 

"The  condensed  milk  is  obtained  for  the  same  reason,  and  also  to  determine 
whether  it  was  made  from  skimmed  or  partly  skimmed  milk. 

"After  obtaining  a  sample,  the  inspector  returns  to  headquarters  and  delivers 
it  to  the  chemist  for  analysis,  the  method  of  delivery  being  as  follows : 

"Upon  arrival  at  the  office,  he  (ills  out  a  card,  prepared  for  subsequent  card  in- 
dexing, as  in  the  diagram. 


Form  G  23-1897.     C.  R.  Xo.  31S8. 

Page  No.  336.  Health  Department  City  of  New  York.  Permit  No.  8096. 

3d  Division  (Food  Inspection,  Offensive  Trades  and  Mercantile  Establishments). 

Inspection  No.  R565.         Sample  No.  55.        Date,  Jan.  31,  1897.        Time,  10  a.  m. 

Name,  Doe,  John,  s         Business,  Grocer.         Years  in  Business,  10  years. 

Address,  1200  East  16th  st.  Who  in  charge,  Doe,  John. 

From  whom  purchased,  D.  Water,  186  Rock  st.         Qts.  sold  daily,  40. 


Can 

No 


Con- 
tents. 


Lat-t. 


Temp. 


Lc't  at   60' 


:  I21 ' 


Can  Marks. 


1 
P.  II 

4 


01° 


Appear-  :   Can  Con-  L      t 
ance,etc.  |  NoJtents. 


Thin 
taste, 
flat. 


Lact.  No.  583. 
Ther.  No.  601. 


Temp.    Lc't   at   60° 


Appear- 
ance, etc. 


Witness,  Officer  Roe. 
Dipper  in  Can  ?     Yes. 


Citizen's  Complaint  No.  1230. 
Held  on  Bail  1st  Dist.  Court,-!  100.  2/4/97. 
Result  of  Trial,  2/10/97.     Fined  $150  at 
\_)      Court  of  Special  Sessions. 

Was  Can  Wired  ?     No. 
Location  of  Can?     In  ice-box  at  rear  of 
store. 


Date  Received To  Inspector 

Time Q  Offense. 

Inspector 1st 

2d 

3d 

Analysis,  '  'an  No.  4th 

Water ~)  Results. 

Fat I    

Total  Solids [  

Solids  not  fat J    

Approved : 


Assistant  Chemist. 


Sanitary  Superintendent. 


Chief  Inspector. 


DAIR  V    PBODUCTS. 


:;<»5 


^-except  he  does  not  at  that  time  fill  in  the  vender's  name.  (The  s  at  name  of 
vender  or  representative  indicates  that  proof  of  ownership  was  obtained.)  lie  then 
delivers  the  sample,  labeled  with  sample  number  and  inspection  number  (only)  to 
the  chemist,  who  signs  and  dates  the  card.  This  is  returned  to  the  clerk  for  entry 
in  the  record  book  and  indexed,  a  sample  page  of  which  is  given  below: 


No 

Inspector 

Analyst 

<  obtained  fn  >m 


Date  obtained. . 
Date  delivered. 
Date  reported. 


Reason  for  obtaining  sample. 


Analysis. 


Lactometer  at  60°  Fahr. . . . 
Equiv.  to  Specific  Gravity . 
Reaction  to  Litmus  Paper. 

Odor 

Remarks 


Water 

Fat 

Sugar 

Casein  and    Albumin. 
Salts 


Total  Solids 

Solids  not  Fat 

Fat  by  Lactoscope 


••  The  data  obtained  from  the  card  being  copied  in  it,  together  with  the  name  of 
tin- vender,  this  being  taken  from  the  stub  of  the  "bottle  label  book,"  which  stub 
i-  delivered  with  this  card. 

••At  the  end  of  forty-eight  hours  after  reception  of  sample  the  card  is  delivered 
to  the  chemist,  who  indorses  upon  it  the  results  of  the  analysis  and  returns  it  to  the 
chief  inspector,  who.  after  careful  examination,  stamps  on  it  "Arrest,11  or  "Do  Nbl 

Arrest.'1     The  results  of  the  analysis,  etc.,  are  entered   in  the  milk  1 k,  also  this 

iecisioo  of  t  he  chief  inspector. 


,  Date  Received,  Jan.  :Jlst,  1897 
Time.  12  \i. 


To  inspector,  Feb.  4th,  1897,  10.00  \.  m. 
Q  Offense. 

lsi 

2d 

Inspector  Brown.  3d 

.  1  inlh/sis.    <  ilu    \n.    I.  4tll 

Water,  89.31  percent ]  Results. 

Fa  i.  3.59  per  cent I  Solids  10  per  cent.  low. 

Total  Solids,  10.69  per  cent Borax  and  Formalin.     Negative. 

Solids  no!  fat,  7.10  per  cent J   

Read  ion.     Normal.  A  pproved  : 

I  II  \i:i.i:s  F.   ROBERTS,    M.  D. 
Sanitary  Superinti 
EDMUND  CLARK, 

.  Issistant  <  'hemist. 
Feb.  2d,  L897.  i:i>\\  \i;i>   W.  MARTIN, 

Feb.  2d,  1897.  ( 'hief  Inspector. 


196 


DAIll  Y  PR  OB  UC  Ts. 


"He  stamps  'Arrest1  if  the  total  solids  are  five  per  cent,  or  more  below  the 
legal  standard  of  twelve  per  cent. ;  or  if  the  amount  of  fat  contained  is  ten  per  cent, 
or  more  below  the  legal  standard  of  three  per  cent.,  or,  as  in  condensed  milk,  if  the 
arm  Hint  of  fat  contained  is  ten  percent,  or  more  below  the  legal  standard  of  fat 
(condensed  milk  must  contain  fat  equivalent  to  twenty-five  per  cent,  of  the  total 
milk  solids  found) ;  or  if  the  cream,  milk  or  condensed  milk  contains  any  antiseptic 
or  foreign  substance. 

"Should  the  adulteration  be  less,  however,  than  in  the  cases  cited,  '  Do  Not 
Arrest'  is  stamped  upon  the  card.  This  card  is  now  forwarded  to  the  sanitary 
superintendent,  who  approves  or  disapproves  the  decision  of  the  chief  inspector  and 
returns  the  same. 

"  The  inspector  is  then  notified  to  appear  at  the  office,  and  the  card  delivered  to 
him,  with  instructions  for  further  procedure. 

"Although  this  may  appear  complicated,  yet  usually  only  a  few  hours  over  the 
forty-eight  required  elapse  between  the  delivery  of  the  sample  for  analysis  and  the 
obtaining  of  the  warrant,  should  sufficient  adulteration  be  detected  for  this  course 
to  lie  pursued. 

"At  the  end  of  each  day  the  inspector  writes  on  a  suitable  blank,  headed  as 
below: 


No. 


Date. 


Name. 


Location. 


Permit 

No. 


Lac. 


—  the  result  of  his  day's  work.  This  is  forwarded  by  mail,  reaches  the  office  in  the 
morning  and  is  from  time  to  time  verified  by  a  reinspection  of  the  places  recorded, 
by  another  inspector  who  has  been  selected  to  act  as  "  Roundsman  "  to  check  and 
verify  the  work. 

'•At  the  end   of  the  week,  a  report  —  summary  of  the  week — is  made  out  and 
delivered  in  person  at  Headquarters  at  9  A.  m.  Mondays,  as  in  sample  given: 


Health  Department  of  the  City  of  New  York,    \ 

Sanitary  B treat-,  v. 

New  York 189      ) 


To  the  Chief  Inspector  of  the  Division  of  Food  Inspection  and  Ofl'ryisice  Trades: 

"  Sir  —  I  have  the  honor  to  submit  the  following  report  of  the  work  performed 

by  me  in  the  Inspection  of  Milk  for  the  week  ending  Saturday 189 

Sunday 

Monday 

Tuesday : 

Wednesday 

Thursday 

Friday 

.Saturday 


I) AIR  Y  PR  01)  U<  ■  TS. 


Sow. 

Mox. 

Ties. 

Wed. 

Tucks. 

FBI. 

S  \  r. 

Total. 

"        Citizens'      Complaints     Re- 



"        citizens'     Complaints     held 

Original   Complaints  by   In- 

Citizens'      Complaints      Re- 

"        Citizens'      Complaints      Re- 

Citizens'    Complaints   under 

"          Quarts  Adulterated  Milk  De- 

Days  in  Country  or  at  Labora- 

:::::::: 

II, -hi  on  Bail 

Trials  at  Special  or  General 



Respectfully  submitted, 


Milk  Inspector. 

The  duty  of  the  collector  is  to  collect  and  deliver  to  the  chemist 
samples  of  milk,  secure  all  evidence  that  it  may  be  necessary  to  use  in 
case  'it'  trial,  and  to  keep  a  careful  record  of  all  his  proceedings.  The 
chemist  on  his  part  must  analyze  with  great  care  the  samples  given 
him,  preserving  with  certainty  their  identity  all  the  time,  and  he  too 
must  carefully  record  his  work  and  be  prepared  to  explain  and  justify 
it  on  the  witness  stand.  In  all  but  the  largest  cities  all  this  frequently 
has  to  be  dmie  by  one  man.  Occasionally,  as  in  Philadelphia,1  St. 
Louis,2  and   Atlanta,''  specific  rules  are  provided   for  the  inspectors. 

As  most  of  the  milk  laws  prescribe  a  standard  in  terms  of  total 
milk  solids  and  milk  fats,  it  is  these  elements  which  it  is  the  business 
•  if  the  chemist  to  determine.  The  methods  employed  do  not  tall  within 
the  scope  of  this  work.  The  technology  of  milk  analysis  may  be  studied 
in  Leffman  and  Imam's  Analysis  of  Milk  and  Milk  Products,  and  Par- 
tington and  Wall's  Trstiny  Milk  and  its  Products,  h  is  sufficient  to 
lay  that  the  fiaboock  and  Adams  methods  are  usually  adopted  for  the 
estimation  of  the  tats.  There  is  very  little  legislation  in  regard  to  milk 
analyses  other  than  such  as  specifies  whal   chemists  may    be  employed 

id    that    the  analyses  made    by  them: shall    be    accepted    :is    prima   facie 

L  Philadelphia,  Rules  of  Board  of  Health  (1895),  til   150. 
St.  Louis.  Ordinances  (1893),  Chapter  14,  Sec.  864. 
Atlanta,  <  Ordinance  of  22  Maj  .  1898. 


ai 


398  DAIRY  PRODUCTS. 

evidence  ;  but  in  Maine1  and  Vermont2  it  is  prescribed  that  all  meas- 
uring instruments  used  in  milk  analyses  shall  be  first  tested  (in  Maine 
this  is  done  by  the  director  of  the  State  College  Experiment  Station),  that 
sulphuric  acid  used  in  the  Babcock  test  shall  have  a  sp.  gr.  of  1.82  and 
that  no  person  shall  test  milk  unless  he  or  she  has  a  certificate  of  com- 
petency from  the  Dairy  School. 

Not  only  are  samples  collected  by  city  officials  tested  in  municipal 
Laboratories,  but  usually  the  offer  is  made  to  test  samples  brought  in  by 
citizens.  A  certain  number  avail  themselves  of  this  offer.  Thus  in 
Boston  in  1896  there  were  277  citizens'  samples,  in  "Cleveland  in  1897 
sixty-two  samples. 

Generally  it  is  considered  unwise  to  prosecute  on  citizens"  samples, 
but  if  they  are  found  to  be  below  the  standard  the  dealer  is  followed 
up  by  the  city  inspector:  but  in  Chicago  the  ordinance  provides  that  if 
such  samples  are  below  the  standard  "  steps  shall  be  taken  for  a  prose- 
cution." 

In  Chicago,  and  doubtless  in  many  other  cities,  it  is  customary  to 
have  an  analysis  made  by  two  chemists  when  a  case  is  likely  to  go  to 
court. 

When  milk  is  found  to  be  below  the  standard  the  authorities  may 
proceed  at  once  to  the  prosecution  of  the  offender,  or  if  the  offence  is 
the  first  one,  or  if  it  is  believed  that  the  dealer  in  whose  possession  it 
was  found  is  innocent  of  adulteration  and  the  victim  of  another,  a 
warning  notice  may  be  sent.  The  form  used  in  Minneapolis  is  shown 
in  Appendix  48. 

It  frequently  happens  that  a  dealer  will  so  deliver  milk  that  the  last 
half  of  the  can  will  be  much  below  the  standard.  If  that  is  probably 
the  case  a  notice  is  sent.     The  Indianapolis  form  is  shown  below.3 


1  Maine,  Chapter  169  of  1895. 
-  Vermont,  Chapter  81  of  1899. 

3  City  of  Indiaxapolis. 


BUREAU    OF    MILK   INSPECTION. 


Lt  You  are  hereby  informed  that  a  sample  of  milk  recently  obtained  from  you  proved 

not  to  conform  to  the  requirements  of  the  Ordinances.  Your  attention  is  called  to  the 
fact  that  tli<'  sale  of  such  mill,'  or  its  possession  with  intent  to  sell  renders  you  liable  to 
the  penalties  provided  by  law.  The  sample  was  from  a  part  of  a  can,  and  its  poor 
quality  was  owing  to  a  deficiency  i)i  cream,  which,  by  careless  handling,  may  Jtave 
been  poured  off  witli  the  first  part  sold. 


City  Sanitarian. 
To  


J) AIRY  PRODUCTS.  WWW 

In  Chicago,  Philadelphia,  and  other  cities,  dealers  are  encouraged  to 
bring  to  the  city  inspector  samples  of  milk  to  he  tested  when  the}'  sus- 
pect that  the  producer  may  he  furnishing  milk  below  the  standard.  In 
Brookline,  Mass.,  one  day  in  the  week  is  set  apart  for  this.  In  Phila- 
delphia the  dealers  are  also  encouraged  to  use  the  lactometer,  and  a 
circular  is  sent  to  them  from  the  hoard  of  health  advising  them  to  pur- 
chase a  lactometer  and  thermometer  and  test  all  milk  purchased.  The 
dealers  are  also  invited  to  visit  the  milk  inspector's  office  and  receive 
instruction  in  the  use  of  the  instrument. 

Unclean   .Milk. 

Within  the  last  few  years  there  has  grown  up  a  very  strong  desire 
on  the  part  of  sanitary  officials  and  progressive  medical  men  for  clean 
milk.  At  present  this  desire  only  affects  a  small  part  of  the  consumers. 
ilic  greal  body  of  whom  are  content  to  use  the  dirty  milk  which  is  gen- 
erally furnished  by  dairymen.  It  is  possible  at  a  few  places,  for 
persons  who  are  willing  to  pay  a  considerable  advance  for  it.  to  obtain 
clean  milk,  hut  the  demand  is  not  great,  and  the  supply  is  scarcely 
equal  to  the  demand.  The  great  majority  of  milk  consumers  in  cities 
at  Least,  do  not  care  whether  their  milk  is  clean  or  dirty,  nor  do  they 
care  very  much  about  the  amount  of  fat  it  contains,  provided  it  is  cheap, 
that  is  provided  the  price  per  quart  is  low-.  At  present  the  price  of 
dean  milk  appears  to  he  necessarily  higher  than  that  ^\'  dirty  milk,  hut 
it  does  not  follow  that  it  will  always  he  so.  The  history  of  improve- 
ments in  other  forms  of  business  leads  us  to  suppose  that  it  will  he 
possible  tor  producers  to  markedly  improve  their  product  without 
increasing  the  cost,  provided  they  are  forced  to  it  by  competition  or 
otherwise. 

If  the  mass  of  consumers  continue  to  consider  merelj  the  number 
of  cents  per  quarl  which  the)  are  obliged  to  pay,  without  regard  to 
quality,  ami  there  is  every  reason  to  believe  that  they  will  so  continue 
there  is  little  chance  of  improvement  through  competition,  h  there- 
fore seenis  to  be  Likely  thai  the  milk  supply  so  far  as  cleanliness  is  con- 
cerned can  onl\  he  improved  by  official  control.  Such  control  is  being 
\er\  general!)  urged  by  sanitary  officials,  ami  also  by  dairy  commis- 
sioners, department  of  agriculture  ami  experimenl  station  officials,  and 
other  educated  ami  experienced  men  who  have  at  heart  the  interests  oi 
both  producer  and  consumer. 

I'»\  clean    milk  is  meant    milk   free,  mil     only    from  dirt,  as  il    is    prop- 

erl\  undersl I.  but   free  IV disease  producing  organisms,  and  as  free 

as    possible    from    organisms  which    injure    the    qualit)    and    "keeping" 

power  of  the  milk.     There  are  several   reasons  wh)    it  is  desirable  that 

milk  shonld    he    dean.      The    least   iinporlant  of    these  is  that     milk  con- 


400  DAIRY  PRODUCTS., 

taming  cow  dung  and  similar  substances,  offends  the  aesthetic  sense : 
but  this  however,  has  little  weight  with  the  majority.  Secondly,  the 
presence  of  manure,  hair,  dirt,  etc.,  and  certain  kinds  of  bacteria,  as  well 
as  the  use  of  improper  food,  and  the  improper  use  of  certain  foods, 
gives  a  peculiar  "  cowey  "  or  "  turnipy  "  taste  to  milk  which  is  positively 
disagreeable  to  a  great  many  consumers  and  leads  them  to  seek  another 
dealer  or  give  up  the  use  of  raw  milk.  Third,  the  more  bacteria  there 
are  in  milk  the  sooner  it  sours  or  undergoes  putrefactive  changes  and 
the  greater  the  loss  to  the  producer  and  consumer.  This  fact  is  one  of 
the  most  powerful  levers  to  be  employed  in  the  effort  to  improve  the 
supply,  for  it  is  an  argument  which  affects  the  pocket.  Fourth,  the 
danger  of  producing  contagious  disease  by  dirty  milk.  The  danger  of 
spreading  scarlet  fever,  diphtheria,  and  typhoid  fever  will  be  alluded  to 
when  considering  those  diseases.  The  danger  of  transmitting  tubercu- 
losis through  the  medium  of  milk  has  received  a  vast  amount  of  con- 
sideration of  late,  and  though  this  danger  is  a  real  one,  the  relative 
importance  of  this  cause  of  human  tuberculosis  has  not  been  definitely 
determined.  Lastly,  there  is  a  very  great  danger  of  gastro-intestinal 
disturbances  in  infants  and  young  children  from  the  ingestion  of  milk 
containing  large  numbers  of  bacteria.  The  harm  may  come  from 
changes  produced  by  the  bacteria  in  the  milk  before  ingestion,  or  it  may 
come  from  the  activity  of  the  organisms  in  the  gastro-intestinal  tract. 
The  exact  aetiology  of  gastro-intestinal  troubles  is  as  yet  little  known. 
and  accurate  statistics  in  regard  to  infant  mortality  due  to  infected  milk 
are  as  yet  lacking,  yet  there  is  little  doubt  in  the  minds  of  the  best 
observers  that  the  most  of  the  gastro-intestinal  diseases  of  infants  are 
due  to  defects  in  the  milk  supply. 

In  order  to  obtain  clean  milk  for  the  public,  it  is  necessary  to  con- 
trol the  methods  of  producing  milk  and  handling  it  on  the  way  from 
the  producer  to  the  customer. 

Control  of  Herds  and  Dairies. 

There  has  within  recent  years  been  some  legislation  providing  for 
the  inspection  or  licensing  of  milch  cows.  Thus  in  Wisconsin1  the 
dairy  commissioner  may  appoint  an  agent  for  the  inspection  of  dairies. 
In  California2  the  state  dairy  commissioner  is  required  to  inspect  dairies. 
Maryland3  requires  dairymen  to  register  their  herds  and  provides  for 
their  inspection.- 

1  Wisconsin,  Statutes  (1898),  Sec.  1410. 

2  California,  Chapter  136  of  1899. 

3  Maryland,  Chapter  300  of  1898,  Sees.  19-20: 

"It  shall  be  the  duty  of  all  dairymen  or  herdsmen  or  private  individuals  sup- 
plying milk  to  cities,  towns,  or  villages,  to   register  their  herds  of  cattle  with   the 


DAIRY  PRODUCTS.  401 

The  first  public  act  authorizing  cities  to  protect  their  milk  supply 
by  control  of  the  dairies  was  passed  in  Minnesota1  in  1895.  This  law 
lias  been  sustained  by  the  courts2  as  has  also  the  Maryland  law.  A 
recent  act  in  New  Jersey3  while  not  specifically  providing  for  the 
licensing  and  inspection  of  dairies  apparently  authorizes  it.  Special  acts 
authorizing  such  inspection  have  been  passed  for  the  District  of  Col- 
umbia4 and  Pennsylvania  cities  of  the  second  class.5 

Notwithstanding  the  dearth  of  specific  legislative  authority,  a  con- 
siderable number  of  cities  have  taken  more  or  less  energetic  action 
looking  to  the  supervision  of  the  sources  of  their  milk  supply.  In 
many  instances  the  action  taken  is  merely  one  of  inspection,  advice 
and  publicity,  no  control  being  exercised.  In  others  control  is  exer- 
cised over  the  dairies  within  the  jurisdiction  of  the  municipality,  and 
in  others  still  the  attempt  is  made  to  control  all  the  sources  of  the  milk 
supply  of  the  city.  In  most  instances  what  is  accomplished  is  done 
nnd<r  the  grant  of  general  sanitary  power. 

A  number  of  cities  have  merely  made  inspections  of  the  dairies  and 
usually  only  those  within  the  city  limits.  Sometimes  such  inspections 
have  been  made  but  once,  to  call  to  the  public   notice  the  condition  of 


Live  Stock  Sanitary  Board;  in  violation  of  which  the  parties  offending  shall  he  lined 
rmt  less  than  "in-  dollar  nor  more  than  twenty  for  each  offense. 

••  It  shall  he  the  duly  of  the  hive  Stuck  Sanitary  Hoard  to  have  inspected  at  least 
annually,  without  notice  to  the  owner  or  those  in  charge  of  any  dairy  or  the  parties 
supplying  milk  as  named  in  section  l!t  of  this  article,  the  premises  wherein  cows  are 
kept,  and  if  such  premises  are  found  in  an  unsanitary  condition  the  said  board  may 
prohibit  the  sale  and  shipment  of  milk  from  such  premises  until  such  time  as  such 
premises  shall  conform  to  the  following  sanitary  rules.'1 

(These  rules  as  well  as  the  complete  law  may  be  found  in  the  seventh  report  of 
the  state  \  eterinarian.) 

1  Minnesota,  Chapter  203  of  1895: 

"Sec.  I.  The  city  council  of  any  city  may  by  ordinance  provide  for  the  inspec- 
tion of  milk  and  of  dairies  and  of  dairy  herds  kept  for  the  production  of  milk  "Within 

its  limits,  and  issue  licenses,  for  which  no  fee  shall  be  charged,  for  the  sale  of   milk 

within  its  limits  and  regulate  the  same,  and  may  authorize  and  empower  the  hoard 
of  health  to  enforce  all  laws  and  ordinances  relating  to  the  production  and  sale  of 
milk  and  the  inspection  of  dairies  and  dairy  herds  producing  milk  for  sale  or  con- 
sumption within  such  city,  and  to  appoint  such  inspectors,  experts,  ami  chemists 
necessary  for  the  proper  enforcement  of  such  laws  and  ordinances,  their  com- 
pensation to  he  lixed  bj  the  citj  council ;  and  sin- h  inspectors,  experts,  and  chemists 
shall  he  possessed  of  such  necessary  power  within  the  limits  of  such  citj  as  shall  be 
nhed  l.\  ordinance,  but  no  such  ordinance  shall  conflict  with  any  law  of  this 
Stat. 

siatc  of  Minnesota  oa.  Mans  < '.  Nelson.  October  term  of  Supreme  Court.  1896. 
Neu  Jersey,  Act  of  28  April,  1897. 
'  Act  of  Congress,  -J  March,  1896. 
Pennsylvania.  U-1  of  26  June,  1895,  Sec.  11. 


402  DAIRY  PRODUCTS. 

the  dairies  in  the  hope  of  inducing  some  municipal  action  to  bring 
about  their  improvement.  Again  such  inspections  are  made  annually 
or  oftener.  Often  when  decided  nuisances  are  found  they  are  abated 
under  the  nuisance  laws.  The  results  of  all  such  investigations  are 
usually  published  in  reports  which  do  some  good  in  calling  the  atten- 
tion of  the  public  tp  the  carelessness  with  which  the  milk  supply  is  pro- 
duced and  handled. 

The  first  step  in  the  control  of  the  sources  of  the  milk  supply  is  to 
know  where  these  sources  are.  This  can  only  be  done  through  the 
licensing  of  milk  dealers  in  the  city  and  making  it  a'  requirement  that 
the  dealer  shall  keep  the  milk  inspector  informed  as  to  where  the  milk 
which  lie  sells  is  produced.  The  obtaining  of  such  information  is  pro- 
vided for  in  the  New  Jersey,  District  of  Columbia  and  Minneapolis  acts 
referred  to  on  page  400,  and  this  method,  though  without  special  legis- 
lative sanction,  is  adopted  in  Boston,  Buffalo,  Lynn,  Meadville,  Pa., 
Milwaukee,  Nashua,  New  York,  Omaha,  and  many  other  cities. 

The  blank  form  used  for  giving  the  information  required  before  a 
license  is  issued  varies  somewhat  in  different  cities.  Those  used  in 
Boston  and  Minneapolis  are  given  in  Appendices  43  to  45.  Not  very 
much  information  is  here  required  beyond  a  bare  statement  of  where 
the  milk  is  obtained. 

For  the  purpose  of  facilitating  the  tracing  to  the  producer  of  all 
milk  sold  in  New  York, 

"The  information  obtained  from  the  application  blanks  of  wholesalers  is  entered 
upon  cards  and  arranged  as  follows  (example  of  card  given)  "  : 


N.  Y.,  Sus.  & 
W.  R.  R. 

s  Hrs. 

Stillwell,  James,  Milford,  Pike  Co.,  Perm. 

B.  < ).  B.  13. 
100  Qts. 

Durham. 

20. 

Well. 

Port  Jervis,  Orange  Co.,  N.  Y.     A.  m.  and  p.  m. 
7.00  P.  M.     John  Doe,  830  W.  42d  St..    N.  Y.   C. 

O 

The  cards  are  first  sorted  as  to  railroads,  then  as  to  stations,  then  alphabetically, 
so  that  the  names  and  addresses,  amount  of  milk  produced,  etc.,  for  all  localities 
can  be  ascertained  at  a  glance. 

For  instance,  a  milk  dealer  named  John  .Smith  obtains  his  supply  from  the  Erie 
Railroad  from  Goshen.  Looking  at  Erie  Railroad  cards  we  find  Goshen,  and  the 
farmers  supplying  John  Smith  are  A.,  B.,  etc.,  and  we  find  on  the  appropriate  cards 
the  number  of  cows,  quarts  of  milk  given,  character  of  water-supply,  time  of  ship- 
ment, delivery,  etc.11 

In  New  York  also  a  map  is  prepared  on  which  is  marked  the  loca- 
tion of  all  dairy  farms  under  the  observation  of  the  department. 

A  second  step  is  to  provide  for  an  inspection  of  the  herds  and  dairies 
from  which  the  milk  is  derived.  AYithout  such  inspection  it  is  of 
course  impossible  to  secure  any  efficient  control  over  most  of  the  con- 
ditions which  determine  the  cleanliness  and  wholesomeness  of  the  milk. 


DA  IE  Y  PR  OJD  UC  TS. 


403 


An  inspection  for  purposes  of  control  may  be  confined  to  the  producers 
within  the  city  limits,  as  in  the  City  of  New  York,  Baltimore,  Boston, 
Brookline,  Mass..  Cincinnati,  Cleveland,  District  of  Columbia,  Grand 
Rapids,  Newton,  Pittsburg,  Newark,  and  Waltham,  or  it  may  extend 
to  all  the  producers  supplying  the  city  wherever  they  may  be  located 
even  if  in  an  adjoining  state,  as  in  Asbury  Park,  X.  J..  Atlanta, 
Buffalo,  Denver,  Detroit.  Los  Angeles,  Lynn,  Meadville,  Penn..  Mil- 
waukee. Minneapolis,  Nashua,  X.  II.,  Oakland,  CaL,  Omaha.  Pittsfield, 
Mass.,  Portland,  Me.,  Rochester,  St.  Louis,  St.  Paul,  Syracuse,  War- 
ren, ')..  and  Westbrook,  Mi-.  While  the  latter  method  of  inspection 
of  the  whole  supply  is  the  goal  to  be  desired,  the  control  of  the 
city  dairies  is  easier  to  start  with  and  may  perhaps  be  extended  to 
the  others.  Certainly  the  work  done  by  some  cities,  as  Boston,  New 
York,  and  the  District  of  Columbia,  in. controlling  their  local  supply,  is 
most  commendable  and  may  serve  as  a  model  for  more  extended  efforts 
on  their  part,  as  well  as  for  other  cities.  This  dairy  inspection  where- 
ever  it  has  been  carried  out  has  been  under  the  direction  of  the  local 
health  department,  though  state  officials  have  sometimes  been  called 
npon  to  assist.  As  the  health  of  the  animals  is  an  important  considera- 
tion ""  all  dairy  farms,  it  is  advisable  that  a  veterinarian  should  make 
the  inspection,  or  at  least  be  called  upon  to  examine  the  cows.  This  is 
done  in  Baltimore.  Brookline,  Denver,  District  of  Columbia,  Lynn. 
Minneapolis,  New  York,  St.  Louis.  St.  Paul,  and  ether  cities.  In  Asbury 
Park  ;in  agent  of  the  state  dairy  commissioner  inspects  the  herds. 
In  Denver  the  inspection  is  made  in  conjunction  with  state  cattle  com- 
Brissioners  and  the  tuberculin  used  is  furnished  by  the  United  States 
department  of  agriculture.  In  Portland,  Me.,  and  Westbrook.  Me., 
the  animals  are  examined  by  the  state  board  of  cattle  commissioners. 

The  result  of  tin*  dairy  farm  inspection  is  usually  reported  to  the 
board  of  health  on  blanks  furnished  for  that  purpose.  The  blank  used 
in  the  District  of  Columbia  may  be  found  in  Appendix  50.  Besides 
the  filing  of  this  report  in  New  York,  a  card  index  is  prepared  giving 
ii] in-  side  of  the  card  the  more  general  results  of  the  sanitary  in- 
spection, ami  upon  the  other  the  outline  plan  of  the  stable. 


B496 
1246 

7/30/95 
7/30/95 

Map  No.  1000. 
line.  Richard,  1200  W.  81st  >t. 

V..  >.i  <  low  > 

Wat., 

Milk 

in 
12760 
a981 

Stable,  l>ri<U.  •_'::•  10>  20.                   Water  for  Cows,  Croton. 
Ventilation,  good.                              Water  foi    washing,!  roton. 
No.  Of  CU.  It.  air  \n-v  COW,   1840.        Disposal  of  Milk.  Sold. 

Drainage,  Citj  se\\ er. 
Manure.  Removed  1  >ailj  . 

1  an-  i,     COWS,  Good. 

i  londil  ion  "f  <  '"\\  s   <  rood.       ^-^ 
Pood,  bran,  meal.  Iiaj .            \_J 

404 


J)  A  IB  Y  PR  OJD  TIL '  IS. 


Something  besides  inspection  is  in  a  few  cities  undertaken  in  order 
to  1  tetter  control  the  condition  of  the  animals  kept  by  the  milk  pro- 
ducers. In  New  York  City  at  the  time  of  inspection,  a  steel  tag  is 
fastened  in  the  right  ear  of  the  cow  at  a  point  where  it  is  least  liable  to 
be  rubbed  off.  Each  tag  has  a  different  number.  The  day  after  the 
inspection  and  tagging,  the  cow  is  tested  with  tuberculin.1  If  any 
animal  is  found  to  be  tuberculous, 

tl  The  healthy  cows  are  then  separated  from  those  found  to  he  tuberculous,  and 
a  chain  made  of  steel,  with  welded  links,  is  fastened  around  the  neck  of  the  con- 
demned animal  by  means  of  a  padlock  numbered  and  marked  "  Health  Department.'" 
This  lock  is  sent  to  the  inspector  unlocked.  He  locks  the  chain  with  it,  and  this 
chain  cannot  be  removed  until  the  time  of  killing  as  the  key  is  kept  at  headquarters 
and  is  not  at  any  time  in  the  possession  of  any  one  except  the  chief  inspector. 


"These  latter  are  taken  to  a  convenient  place  and  slaughtered,  with  the  consent 
of  tlie  owner,  and  an  autopsy  made  in  each  case.  The  carcass  is  taken  to  the  <  "tt'ai 
Dock  or  destroyed  in  offal  tank;  the  killing  bed  is  then  washed  and  disinfected,  and 
the  healthy  cows  are  allowed  to  return  to  the  stable." 

A  record  of  all  this  work  is  kept  as  follows: 

"A  card  is  prepared  giving  tag  number  of  each  cow.  date  tagged  and  date  and 
result  of  tuberculin  test  (see  diagram  below): 


8496 

7,30/95 

Wagon  1".  1246 

7,30,95 

730 

9/4/96 

•  9/5/96 

731 

9/4/90 

9/5/96 

732 

9/4/90 

9/5/96 

t:;:; 

9/4/96 

9/5/96 

7:H 

9/4/96 

9/5/96 

7:;:. 

9/4/90 

9/5/96 

730 

9/4/90 

9/5/90  ' 

Roe,  Richard,  1200  W.  01st  st. 


No.  of  Cows,  10 

.Map  No.  loi  ii. 


o.  K. 

O.  K. 

O.  K. 
Positive. 

().  K. 

().  K. 
Positive. 


O 


— and  is  indexed  under  location. 


1  The  details  of  this  test  are  given  on  pp.  117-119  of  the  Report  of  the  Department 
of  Health  of  the  City  of  New  York  (1896). 


DAIRY  PRODUCTS. 


405 


"  The  tag  number  of   all   cows  examined   and   killed    is  entered   upon  cards  as 
follows: 

"No.   1.     A   plain  card,  as   in  diagram   below,  where  the  cow    is  examined   and 
passed  as  being  healthy. 


Tag  No. 

Date  Examined. 

Smith;  John.  1.3  Kossuth  St. 

26 

12/12/96 

Red  cow.  white  star,  dehorned. 

f~\                    Inspector. 

■■  No.  2.  A  card  with  the  upper  projection  at  the  left,  as  in  diagram,  when  the 
ow  has  been  condemned  and  slaughtered:  the  result  of  the  autopsy  being  entered 
tpon  the  reverse,  as  in  diagram  below: 


Tag  No.  ii.". 
5/12/96. 


J. dm  Doe,  1000  14th  ave. 
Red  Cow. 


O 


Inspi  ctor. 


Result  <>f  Autopsy. 
Liver. 
Lungs. 
K  idneys, 
Mammary  Glands, 


O 


Tag  No.  25. 


Inspector. 


■■  No.  3.     A  card  with  the  projection  in  the  middle,  where  the  cow    is  examined, 
classed  as  suspicious  and  held  for  examination,  as  in  diagram  below: 


Reinspecl  Tag,  No.  5. 

Tagged  Ll/12/96. 

Richard  Hoc.  in  Boulder  st 


Black  Cow,  white  star,  while  spot  on  righl  shoulder. 


O 


Inapt  ctor. 


■•No.   i.     And  a  card   with  tin-  projection  at   the  righl  end,  when  the  cow  lias 

been  examined,   passed    a-~  healthy  and    subsequent  |y  killed  where  we  could  examine 

its  condition.     The  entries  being  the  same  us  in  No.  2. 

"These  tag-numbered  cards  are  then  kept  on  file  in  consecutive  numbers,  chang- 
ing them  as  the  results  require. 


406 


DA  III  Y  PR  OJJ  UC  TS. 


"A  temperature  book  is  kept  in  which  all  of  the  temperatures  in  each  test  are 
recorded  (see  example  below): 


1896. 
Date. 

6 

53 

-.i- 

-. 
H 

r.ii 

Temperature  (Beforki. 

6 

r- 

Z 
> 
< 

.5  at 

=  = 

-  s 
3>  ■_ 
■2  » 

■■j 

CO 

cS 

?■! 

z. 

S  p.  111. 

11  11.  111. 

Amount, 
Carb. 

Aug.  11 

103.6 

104.9 

104.5 

105.2    105"    1(14.(1 

104.6+ 

105.2 

Neck  K 

30  c.c.  E. 

T  I :  MPERATUB  E  I  A  FTER). 

it 

o 
3 

105.3 

Interval       be- 
tween  injec- 
tion and   rise 
of    tempera- 
ture     above 
in  a  \  i  in  u  in 
normal. 

Duration  of 

rise. 

< 

2 

Z 

189G. 
Date. 

33 

/- 

^ 

a 

CI 

IO 

s 

V- 

3 

Name,  etc. 

Aug.ll. 

103. 

104.8    104.8 

105.3 

11)4.5- 

Hrs. 

19 

Hrs. 

1" 

Negative 

Pat.  11.  Dunn. 
530-42  E.  68th  st. 

In  this  way  a  full  and  compete  record  is  kept,  and  one  that  is  easily  referred  to. 


It  is  the  opinion  of  the  department  officials  in  New  York  that  the 
freeing  from  tuberculosis  of  the  cows  kept  in  the  city,  will,  through 
competition,  result  in  a  similar  but  voluntary  purging  of  the  country 
herds. 

Among  other  cities  which  require  the  tuberculin  test  are  Brookline, 
Mass.,  Denver,  Lynn,  Minneapolis,  Portland,  Me.,  St.  Paul,  and  West- 
brook,  Me.  In  San  Francisco  it  was  attempted,  but  owing  to  violent 
opposition,  had  to  be  given  up.  Legislation  could  not  be  obtained 
empowering  the  board  of  health  to  apply  the  test  to  all  cows  supplying 
the  city,  and  the  dairymen  in  the  city  represented  that  it  would  be  a 
hardship  to  eradicate  the  disease  from  their  herds,  and  let  outside 
dairymen  go  free.1  Examples  are  given  below  of  a  local  ordinance 
under  which  the  tuberculin  test  is  required.2 


1  San  Francisco,  Report  of  Health  Department  (1897-8),  p.  182. 

2  Westbrook,  Me.,  Rules  and  Regulations,  Board  of  Health,  10  June,  1897: 

"  Sec.  1.  No  person  shall  at  any  time  by  himself,  his  clerk,  his  servant  or  agent, 
directly  or  indirectly,  sell  or  offer  for  sale  any  milk  or  cream  within  the  City  of 
Westbrook,  except  sterilized  milk  or  cream,  unless  the  cow  from  which  such  milk 
or  cream  was  taken  shall  have  first  been  examined  by  the  board  of  cattle  commis- 
sioners, or  by  some  veterinarian  appointed  by  them  or  approved  by  the  board  of 
mayor  and  aldermen  of  Westbrook  and  a  certificate  filed  by  such  examiner  with  the 
secretary  of  the  board  of  health,  showing  that  such  cow  is  healthy  and  free  from 
disease,  and  such  certificate  shall  remain  in  force  one  year.'' 

Lynn,  Regulations  of  Board  of  Health,  2  March,  1896: 

"On  and  after  May  1,  1896,  for  all  milk  brought  into  or  offered  for  sale  in  the 
City  of  Lynn,  satisfactory  evidence  will  be  required  of  the  producer  and  dealer  by 


DAIRY  PRODUCTS.  407 

In  New  ( )rleans  and  St.  Paul  free  inspection  of  dairy  farms  was 
offered,  but  not  required  by  the  health  department.  It  was  intended 
that  a  certificate  should  he  given  all  herds  free  from  diseases,  and  that 
this  certificate  would  be  valuable  enough  to  induce  the  dairymen  to 
apply  for  inspection.  The  board  of  health  in  Xew  Orleans1  reports 
this  a  failure,  and  the  health  commissioner  of  St.  Paul'-  says  it  was  only 
a  partial  success.  In  the  latter  city  it  lias  now  been  succeeded  by  com- 
pulsory examination.  In  Indianapolis,  on  the  other  hand,  the  volun- 
tary method  seems  to  have  been  successful.3  The  following  is  from  a 
letter  by  Dr.  Hurty  of  the  Indiana  state  hoard  of  health  to  Dr.  Knopf  in 
regard  to  what  lias  been  done  in  that  city: 

•■  The  city  board  of  health  induced  one  of  the  prominent  dairymen  to  write  a  let- 
ter, requesting  that  his  herd  be  tested  with  tuberculin,  and  also  that  a  sanitary  sur- 
vey he  made  of  his  dairy  and  suggestions  be  made  for  sanitary  improvements,  he 
promising  to  destroy  all  cattle  which  reacted  to  the  tubeculin  test,  and  to  make  all 
sanitary  improvements  suggested.  For  tin's  he  was  to  receive  a  certificate  from  the 
board  of  health  simply  stating  the  facts  of  t lie  case.  This,  you  see.  was  a  true  com- 
mercial method.  The  work  was  done,  as  above  indicated,  and  immediately  the 
popular  demand  arose  for  the  milk  supplied  from  tuberculin-tested  animals.  Every 
dairy  supplying  milk  in  this  city  has  now  been  tested  and  sanitary  surveys  made  as 
above.  About  six  per  cent,  of  the  dairy  cattle  have  been  killed,  and  in  every  instance 
it  was  discovered  that  the  tuberculin  test  was  accurate  and  absolute,  This  method 
seems  better  than  the  legal  method." 

Besides  the  City  of  New  York.  Minneapolis,  .Milwaukee,  and  Lynn. 
Mass.,  tag  the  animals  which  successfully  pass  the  tuberculin  test. 

To  insure  the  city  against  the  importation  of  infected  animals  the 
rule  given  below  has  recently  been  adopted  in  the  Citj  of   New  York.4 


the  board  of  health  that  the  milk  has  been  drawn  from  healthy  cows.  The  condi- 
tion of  health  is  to  be  based  upon  results  of  tuberculin  test  by  a  veterinarian  that  is 
satisfactory  to  the  state  cattle  commission  and  to  the  inspector  of  milk  tor  the  Citj 
of  I. vnn.  After  test  each  animal  to  have  ear  tag  and  certificate  of  health.  Also  that 
tlie  animals  used  are  properly  fed  and  the  premises  occupied  by  them  are  iii  a 

condition  of  sanitation." 

1  Louisiana.  Mate  Board  of  Health  Report  (1892  3),  p.  118. 
St.  Paul,  Report  of  Health  Commissioner  (1896),  p.  4. 

Proplylaxis  and  Treatment  of  Puh arj  Tuberculosis,  Knopf,  p.  77. 

M  ity  of  New  York,  Sanitary  (ode  (1899),  as  amended  15  February,  1899: 

■  M  '  .   135.      Thai  no  diseased  or  sickly  cat!  le,  swine  or  sheep,  nor  any  horse,  dog 

or  cat,  which  is  suffering  from,  or  lias  been  exposed  to  any  disease  which  is  con 
is  anion";  such  animals  shall  he  broughl  into  the  Citj  of  New  N  ork.  All  per- 
sons, corporations,  or  companies  bringing  milch  cows  into  the  Citj  of  New  Fork 
shall  furnish  a  certificate  signed  l>>  a  veterinarian  who  is  a  graduate  of  a  recognized 
Veterinarj  College,  with  the  date  of  gradual  ion  and  the  name  of  college  from  which 
the  degree  was  received,  to  the  effect  that  said  cows  are  free  from  tuberculosis  as 
far  as  may  he  determined  by  physical  examination  and  the  ttiberculin  test,  said 
certificate  shall  ^i\e  a  number  which  has  been  permanently  attached  to  each  cow, 
ami  a  description  sufficiently  accurate  for  identification,   stating  the  date  (which 


408  DAIRY  PRODUCTS. 

In  most  states  the  cattle  laws  would  provide  for  the  disposal  of  the 
animals  condemned  in  dairy  inspections  and  such  would  be  killed ;  but 
local  regulations  appear  to  be  necessary  in  most  cities  to  prevent  the 
sale  of  milk  from  animals  that  have  been  condemned,  before  they  are 
finally  disposed  of.     The  St.  Louis  regulation  is  given  below.1 

While  an  annual  inspection  is  excellent  and  is  maintained  by  most 
of  the  cities  referred  to  in  the  last  few  pages,  yet  a  more  frequent 
inspection  is  desirable  and  is  sometimes  carried  out.  Thus  in  Warren, 
O.,  the  dairies  are  inspected  two  or  three  times  each  year ;  in  Syracuse, 
twice  a  year;  in  Omaha  they  are  inspected  every  two  months  ;  in  Brook- 
line,  Mass.,  twice  each  year,  and  also  several  times  in  the  District  of 
Columbia.  In  Minneapolis,  Newton,  Mass.,  and  Richmond,  Ind.,  the 
dairies  are  inspected  monthly. 

In  order  to  obtain  prompt  information  in  regard  to  disease  among 
cows,  it  is  provided  in  the  rules  of  the  District  of  Columbia  as  follows: 

ltIt  shall  be  the  duty  of  any  person  having  charge  or  control  of  any  prem- 
ises upon  which  cows  are  kept  to  notify  the  health  officer,  in  writing,  of  the 
existence  of  any  contagious  or  infectious  disease  among  such  cows,  within  twenty- 
four  hours  of  the  discovery  thereof,  and  to  thoroughly  isolate  any  cow  or  cows 
affected  or  which  may  reasonably  be  believed  to  be  infected,  and  to  exercise  such 
other  precautions  as  may  be  directed,  in  writing,  by  the  health  officer." 


must  be  not  more  than  sixty  days  prior  to  the  time  they  are  brought  into  the  city), 
the  place  of  examination,  the  temperature  of  the  cow  or  cows  at  intervals  of  three 
hours  for  twelve  hours  before  the  subcutaneous  injection  of  the  tuberculin,  the  pre- 
paration of  tuberculin  used,  the  location  of  the  injection,  the  quantity  injected,  the 
temperature  at  the  tenth  hour  after  the  injection  of  the  tuberculin  and  every  three 
hours  after  the  aforesaid  tenth  hour  for  twelve  hours,  or  until  the  reaction  is  com- 
pleted. No  cow  with  a  certificate  which  states  that  said  cow  gave  a  reaction  of  two 
degrees  F.  after  the  injection  with  0.  5  c.  c  of  the  tuberculin  prepared  by  the  depart- 
ment of  health  of  the  City  of  New  York  (or  its  equivalent),  diluted  with  ten  times 
its  volume  of  a  0.5  per  cent,  watery  solution  of  carbolic  acid,  shall  be  brought  into 
the  City  of  New  York." 

1  St.  Louis,  Ordinance  of  6  April,  1896  : 

"  Sec.  16.  When  said  veterinary  surgeon  or  surgeons  shall  find  any  cow  or  cows 
in  a  dairy,  from  which  dairy  milk  is  brought  into  this  city  for  sale,  to  be  diseased, 
they  shall  immediately  make  a  repqrt  of  the  facts  in  duplicate;  one  of  said  reports 
to  be  delivered  to  the  health  commissioner,  and  the  other  to  the  person,  firm  or  cor- 
poration receiving  and  disposing  of  the  milk  from  such  cows.  On  receipt  of  a  report 
that  milk  from  the  diseased  cows  is  being  brought  into  this  city  the  health  commis- 
sioner shall  issue  an  order  forbidding  its  sale  in  the  City  of  St.  Louis  until  such  time 
as  the  health  commissioner  is  satisfied  by  approved  veterinary  certificate  that  such 
diseased  cows  have  been  separated  from  the  balance  of  the  herd;  and  if  the  parties 
who  shall  have  been  served  with  such  order  fail  to  obey  the  same  the  health  com- 
missioner is  hereby  empowered  to  give  notice  to  the  citizens  of  St.  Louis  through 
the  newspapers  doing  the  city  printing,  stating  all  the  facts  in  the  case,  and  to  warn 
them  against  the  use  of  such  milk.  And  said  parties  may  be  proceeded  against  in 
the  manner  prescribed  by  the  provisions  of  this  ordinance." 


DAIRY  PRODUCTS.  401) 

The  results  of  dairy  inspection  show  that  if  it  is  desired  to  have 
clean  milk  from  healthy  cows,  the  average  dairy  is  not  at  the  present 
time  in  any  condition  to  supply  it.  Thus  in  New  York  in  1896 1  out 
of  1,123  cows  tested  with  tuberculin  l(.'i)  were  condemned.  In  Denver2 
four  per  cent,  of  the  cows  tested  with  tuberculin  were  condemed,  in 
Lynn3  of  3,471  cows  tested  562  were  condemned,  in  Minneapolis4  of 
4. <»:;»;  cows  tested  172  wen-  condemned,  In  Omaha"'  of  3,977  cows,  140 
were  condemned.  Of  1,356  cows  in  the  District  of  Columbia6  ")-  were 
condemned,  in  Syracuse7  of  3,843  cows  300  were  tuberculous.  In 
Philadelphia8  101  out  of  382,  and  in  St.  Paul9  154  out  of  2,084  cows 
were  infected.  In  this  connection  it  is  well  to  remember  that  not  only 
is  there  danger  of  the  spread  of  tuberculosis  through  the  milk  of  tuber- 
culous cows  but  this  milk  is  usually  deficient  in  fat. 

Of  ninety-seven  dairies  inspected  in  Baltimore  in  1894 10  eighteen 
were  reported  in  bad  condition.  In  Concord,  .Mass..11  on  a  second  inspec- 
tion twenty-one  per  cent,  of  the  farms  were  in  fair  condition,  and 
twenty-three  percent,  in  bad  condition.  In  Somerville,  Mass.,12  of  thirty- 
seven  applications  to  keep  cows,  seven  were  refused  on  account  of  the 
condition  of  the  stables,  etc.  In  Rochester13  many  of  the  stables  were 
in  bad  condition,  the  pails,  strainers,  and  cans  were  not  clean,  there  was 
insufficient  water  and  no  way  of  heating  it  for  washing,  and  the  stables 
and  milk  rooms  wen-  dirty.  In  fact  the  conditions  were  such  that  when 
the  health  officer  desired  to  obtain  milk  which  should  be  clean  and  suita- 
ble for  pasteurization  he  could  not  find  a  single  dealer  able  to  supply  it, 
and  Dr.  Getty  in  Yonkers  bad  much  the  same  experience.  The  veter- 
inarian of  the  District  of  Columbia  states  that  on  his  first  inspection  he 
found  the  thinks  of  hundreds  of  cows  caked  with  manure,  thus  ensur- 
ing dirty  milk.  The  same  undesirable  conditions  were  found  in  Mil- 
waukee "     where    a    microscopical     examination    of    the    milk    showed 

I  New  York.  Report  <.f  Department  of  Health  (1896),  \<.  124. 
-Denver.  Report  of  Bureau  of  Health  (1896),  p.  81. 

Massachusetts,  State  Board  of  Health  Report  (1896),  p.  881. 
'  Minneapolis,  Report  of  Health  Department  (1899),  i>.  .°>7. 
"Omaha,  Report  of  Health  Department  (1897),  p.  L2. 

District  of  Columbia,  Report  of  Health  Officer  (1897),  p.  78. 
'Syracuse,  Report  of  Board  of  Health  (1899),  p.  7. 

Philadelphia,  Report  of  Bureau  of  Health  (1899),  p.  L25. 
ISt  Paul,  Report  of  Commissioner  of  Health  (1899),  p.  7. 

Haiti re,  Report  of  Health  Department  (1894),  p.  18. 

II  Massachusetts,  Mate  Board  of  Health  Report  (1897),  p.  668. 

merville,  Report  of  Board  of  Health  i  L897). 
Rochester,  Report  of  Health  Department  (1897). 
u  .Milwaukee.  Report  of  Commissioner  of  Health  for  year  ending  April,  1897,  p.  L0. 


410  DAIRY  PRODUCTS. 

"  manure,  bits  of  cow  food,  numerous  hairs,  mould  and  fungous  growths, 
bits  of  insects,  threads,  human  hair,  moss,  and  other  disgusting  sub- 
stances." The  secretary  of  the  state  board  of  health  in  Providence 
could  not  get  a  quart  of  milk  which  did  not  show  an  appreciable  sedi- 
ment of  dirt,  and  an  examination  of  the  dairies  in  that  city 1  showed 
that  twenty-five  per  cent,  were  in  bad  condition.  Out  of  eighty-three 
applications  for  dairy  farm  licenses  in  the  District  of  Columbia  in  1897 
thirty-nine  were  refused.  In  New  Orleans  2  an  inspection  showed  that 
many  of  the  cow  stables  were  in  a  filthy  condition  and  the  water  used 
for  washing  was  grossly  contaminated.  Photographs  of  the  premises 
are  shown  in  the  report  referred  to.     In  St.  Louis  : 3 

"An  examination  of  the  dairies  disclosed  that  a  fearful  condition  existed.  Cows 
covered  with  filth  were  confined  continually  in  small,  hadly  ventilated  stables,  the 
manure  forced  into  sewers  or  thrown  into  small  water  courses,  creating  a  stench 
that  was  intolerable;  the  milk  cooled  in  wells  and  cisterns,  the  water  of  which  from 
the  surroundings  must  necessarily  be  impure ;  milk  placed  in  filthy  cans  by  unwashed 
hands,  and  the  atmosphere  of  the  stables  where  the  milk  cans  were  allowed  to 
remain  charged  with  odorous  gases  and  teeming  with  pestiferous  germs;  the  cows 
showing  unmistakable  signs  of  being  unhealthy,  everything  and  everywhere  show- 
ing a  complete  absence  of  the  first  principles  of  cleanliness,  and  a  total  ignorance 
of  any  of  the  requirements  of  sanitation;  in  fact,  the  condition  of  the  cows,  the 
places  where  the  milk  was  kept,  and  the  general  surroundings  being  simply  inde- 
scribable." 

Besides  inspecting  dairy  farms  and  stables  and  testing  and  tagging 
cows,  another  and  very  effectual  method  of  controlling  milk  production 
may  be  adopted,  and  that  is  the  licensing  of  the  producer.  This  is  cer- 
tainly the  best  way  of  controlling  the  milk  supply  produced  within  the 
city  limits,  for  the  license  may  be  withheld  or  revoked  if  the  conditions 
are  not  satisfactory.  For  producers  outside  the  municipality  a  similar 
control  may  be  exercised  if  license  to  import  or  sell  is  refused  unless 
the  conditions  of  production  are  satisfactory.  Such  discriminating 
licensing  presupposes  a  complete  knowledge  of  the  sources  of  supply 
and  a  thorough  inspection  of  all  producers'  premises  and  animals.  How 
this  may  be  accomplished  has  been  shown  on  the  preceding  pages. 
Among  the  cities  which  license  cow  stables  only  within  their  corporate 
limits  may  be  mentioned  Baltimore,  Boston,  Brookline,  Mass.,  Chicago, 
Cincinnati,  District  of  Columbia,  Newark,  New  Bedford,  Newton,  New 
York,  Paterson,  Pittsburgh,  Somerville,  and  Waltham,  Mass.  In 
Philadelphia  it  is  forbidden  to  keep  cows  in  the  city  except  in  the  rural 
portions,  and  the  health  officers  of  Newark,  Milwaukee,  and  other  cities 
express  a  desire  to  do  the  same.      Usually  no  fee  is  charged  for  such  a 


1  Providence,  Report  of  Superintendent  of  Health  (1896),  p.  44. 

2  Louisiana,  Report  of  Board  of  Health  (1892-93),  p.  114. 

3  St.  Louis,  Report  of  Health  Commissioner  (1895-6),  p.  27. 


DAIRY  PRODUCTS.  41 1 

license  but  sometimes  it  is,  as  in  Buffalo,  where  it  is  one  dollar,  and  in 
Newark,  where  it  is  ten  cents. 

The  following  cities  make  a  more  or  less  determined  effort  to  con- 
trol on  the  lines  laid  down,  their  entire  milk  supply  :  Buffalo,  Detroit, 
Denver.  Indianapolis.  Meadville,  Pa.,  Milwaukee,  Minneapolis,  Mont- 
clair.  X.  .J..  Nashua,  N.  H.,  Omaha,  Portland,  Me.,  Ninth  Adams,  Mass.. 
St.  Louis,  St.  Paul,  and  several  smaller  Minnesota  cities.  Pittsfield, 
Mass.,  Westbrook,  Me.,  and  Warren.  ( ).  The  District  of  Columbia  at- 
tempted to  control  its  rural  supply  by  requiring  a  certificate  of  inspec- 
tion of  all  of  the  country  herds  from  which  milk  was  sent  to  the  city: 
hut  this  resulted  in  failure,  as  the  farmers  could  enploy  any  veteri- 
narian and  most  of  them  did  not  prove  reliable.  But  good  results  are 
obtained  when,  as  in  Lynn,  Portland  and  Westbrook,  the  certificate  must 
be  from  the  cattle  commissioners  or  some  veterinarian  satisfactory  to 
tlieni  or  the  board  of  health  or  the  city  officers,  or  in  Asbury  Park, 
N.  J.,  where  the  inspection  is  made  under  the  direction  of  the  state 
dairy  commissioner. 

In  St.  Louis  two  veterinary  physicians  are  appointed  by  the  health 
commissioner  with  the  approval  of  the  hoard  of  health,  who  receive 
$175  per  month  each,  and  are  obliged  to  keep  a  horse  and  buggy  at 
their  own  expense,  and  are  empowered  to  visit  dairy  farms  within  150 
miles  of  the  city. 

The  larger  cities  have  not  accomplished  as  much  as  the  smaller : 
of  the  former,  Denver,  Minneapolis  and  St.  Louis  have  done  the  most. 
Minneapolis  having  been  the  most  successful.  The  best  examples  of 
milk  control,  so  far  as  the  producer  is  concerned,  are  to  be  sought  among 
the  smaller  cities  and  towns. 

Regulation*  for  the    Care  of  Milk. 

A  number  of  cities  have  made  rules  for  the  proper  care  of  milk  so 
thai  it  shall  be  delivered  to  consumers  in  the  best  possible  condition. 
Man\  of  these  rules  are  not  intended  to  be  enforced  by  penalties  hut 
pre  rather  intended  as  directions  for  the  education  of  the  producer  and 
dealer.  A  number  of  states,  as  Illinois,  Minnesota,  West  Virginia,  and 
Wisconsin,  have  general  provisions  in  their  milk  laws  requiring  thai 
cows  shall  be  properly  cared  for,  housed  and  fed,  but  iii  the  absence  of 
■pec i fie  regulations  ii  is  not  Likely  that  they  can  accomplish  much. 
Such  general  provisions  are  also  found  in  a  number  of  cities,  as  Atlanta, 
Boston,  Buffalo,  Chicago,  Cincinnati,  Denver,  .Memphis,  Minneapolis, 
Omaha,  and  Paterson.     The  following  from    Minnesota1   ma\    be  given 

ils   One     Of  I  he    mosl    explicit    Of   these  J 

1  Minnesota,  Chapter  295  of  L890,  Sec.  •"». 


412  DAIRY  PRODUCTS. 

"  No  person  shall  keep  cows  for  the  production  of  milk  for  sale  or  consumption 
within  the  City  of  Minneapolis  in  an  over-crowded  condition,  or  in  stables  which  are 
not  properly  ventilated,  or  which  are  filthy  from  an  accumulation  of  animal  refuse, 
or  from  any  other  cause;  nor  shall  milk  for  such  purposes  be  drawn  from  cows 
which  are  themselves  in  a  condition  of  filth  or  uncleanliness,  or  from  cows  which 
are  affected  with  tuberculosis  or  any  other  form  of  disease,  or  from  cows  which  are 
fed,  either  wholly  or  in  part,  upon  distillery  waste  or  brewery  grains,  or  the  waste 
of  vinegar  factories,  in  a  fermented  condition,  or  upon  any  other  form  of  food  which 
will  produce  milk  which  is  unhealthy  or  unwholesome,  or  from  cows  which  are 
supplied  with  water  which  is  impure  or  unwholesome;  and  all  milk  thus  produced 
is  hereby  declared  to  be  unclean,  impure,  unhealthy,  and  unwholesome  milk.11 

To  accomplish  anything  in  the  way  of  education,  rules  must  be 
more  explicit  and  cover  a  wider  range.  The  following  rules  are  given 
as  a  basis  for  preparing  such  a  set  of  regulations  for  municipal  use. 
These  rules  were  prepared  by  the  bureau  of  animal  industry  of  the 
department  of  agriculture,  and  are  especially  worthy  of  consideration 
because  they  come  from  such  a  source.  The  department  of  agricul- 
ture has  primarily  at  heart  the  interests  of  the  producer  and  strives  to 
recommend  such  measures  as  will  serve  the  pecuniary  interests  of  the 
dairymen.  The  department  evidently  believes  that  it  pays  the  pro- 
ducer to  furnish  high  grade  products  and  attempts  to  show  how  it  may 
be  done.  These  rules  which  are  here  given  are  intended  to  be  printed 
on  a  large  card  and  hung  in  the  stable  : 

FIFTY  DIaRY  RULFS. 
UNITED  STATES  DEPARTMENT  OF  AGRICULTURE, 

BUREAU    OF    ANIMAL    INDUSTRY  —  DAIRY    DIVISION. 

(from  farmers1  bulletin  no.  G.3. ) 


THE    OWNER    AND    HIS    HELPERS. 

1.  Read  current  dairy  literature  and  keep  posted  on  new  ideas. 

2.  Observe  and  enforce  the  utmost  cleanliness  about  the  cattle,  their  attendants, 
the  stable,  the  dairy,  and  all  utensils. 

3.  A  person  suffering  from  any  disease,  or  who  has  been  exposed  to  a  contagious 
disease,  must  remain  away  from  the  cows  and  the  milk. 

THE    STABLE. 

4.  Keep  dairy  cattle  in  a  room  or  building  by  themselves.  It  is  preferable  to 
have  no  cellar  below  and  no  storage  loft  above. 

5.  Stables  should  be  well  ventilated,  lighted  and  drained ;  should  have  tight  floors 
and  walls  and  be  plainly  constructed. 

0.     Never  use  musty  or  dirty  litter. 

7.  Allow  no  strong  smelling  material  in  the  stable  for  any  length  of  time.  Store 
the  manure  under  cover  outside  the  cow  stable  and  remove  it  to  a  distance  as  often 
as  practicable. 


DAIRY  PRODUCTS.  41 S 

8.  Whitewash  the  stable  once  or  twice  a  year;  use  land  plaster  in  the  manure 
gutters  daily. 

9.  Use  no  dry,  dusty  feed  just  previous  to  milking;  if  fodder  is  dusty  sprinkle 
it  before  it  is  fed. 

10.  Clean  and  thoroughly  air  the  stable  before  milking;  in  hot  weather  sprinkle 
the  floor. 

11.  Keep  the  stable  and  dairy  room  in  good  condition,  and  then  insist  that  the 
dairy,  factory,  or  place  where  the  milk  goes  be  kept  equally  well. 

THE    COWS. 

12.  Have  the  herd  examined  at  least  twice  a  year  by  a  skilled  veterinarian. 

13.  Promptly  remove  from  the  herd  any  animal  suspected  of  being  in  bad  health, 
and  reject  her  milk.  Never  add  an  animal  to  the  herd  until  certain  it  is  free  from 
disease,  especially  tuberculosis. 

14.  Do  not  move  cows  faster  than  a  comfortable  -walk  while  on  the  way  to  place 
of  milking  or  feeding. 

15.  Never  allow  the  cows  to  be  excited  by  hard  driving,  abuse,  loud  talking,  or 
unnecessary  disturbance;  do  not  expose  them  to  cold  or  storms. 

16.  Do  not  change  the  feed  suddenly. 

IT.  Feed  liberally,  and  use  only  fresh,  palatable  feed  stuffs;  in  no  case  should 
decomposed  or  moldy  material  be  used. 

18.  Provide  water  in  abundance,  easy  of  access,  and  always  pure;  fresh,  but  not 
too  cold. 

19.  Salt  should  always  be  accessible. 

20.  Do  not  allow  any  strong  llavored  food,  like  garlic,  cabbage,  and  turnips,  to 
be  eaten,  except  immediately  after  milking. 

21.  Clean  the  entire  body  of  the  cow  daily.     If  hair  in  the  region  of  the  udder 

is  riot  easily  kept  clean  it  should  be  clipped. 

22.  Do  not  use  the  milk  within  twenty  days  before  calving,  nor  for  three  to  five 
days  afterwards. 


■i-',.     The  milker  should  be  clean  in  all  respects;  he  should  not  use  tobacco;  he 
should  wash  and  dry  his  hands  just  before  milking. 

24.  The  milker  should  wear  a  (dean  outer  garment,  used  only   when    milking, 
and  kept  in  a  clean  place  at  other  times. 

25.  Brusli  the  udder  and  surrounding  parts  jusi  before  milking,  and  wipe  them 
wit  h  a  clean,  damp  clot  h  or  sponge. 

•_'<',.     Milk  quietly,  quickly,  cleanly,  and    thoroughly.     Cows  do  not    like   nunc, 
Bssary  noise  or  delay.     Commence  milking  at  exactly  the  same  hour  every  morning 
and  evening,  and  milk  the  cows    in  the   same  older. 

•_'T.     Throw  away  (but  not  on  the  floor    better  in  the  gutter)  the  firsl  lew  streams 

from  each  teat  ;    this  milk  is  very    watery  and  of    little    value,  bill     it    may    injure    the 

lest. 

28.  If    in    any    milking  a  part   of    the    milk    is    bloody  or   stringy    or    unnatural    in 
appearance,   the  whole  mess  should  he  rejected. 

29.  Milk  with  dry  hands:    never  allow    the    hands    to    come    in    contact    with    the 
milk. 

30.  Do  not  allow  dogs.  eats,  or  loafers  to  he  around  at   milking  time. 

31.  If  any  accident  occurs  bj   which  a  pail   lull  or  partlj    lull  of  milk  becomes 

dirty,  do  not  trj  to  remedj  this  bj  straining,  hut    reject   all   this  milk  and  rinse  the 
pail'. 

.;■_'.     Weigh  and  record  the  milk   given  bj   each  row.  and  take  a   sample   morning 
and  night,  at   least  once  a  week,  for  testing  by  the  fat  test. 


414  DAIRY  PRODUCTS. 

CAKE    OF    MILK. 

33.  Remove  the  milk  of  every  cow  at  once  from  the  stable  to  a  clean,  dry  room, 
where  the  air  is  pure  and  sweet.  Do  not  allow  cans  to  remain  in  stables  while  they 
are  being  filled. 

34.  Strain  the  milk  through  a  metal  gauze  and  a  flannel  cloth  or  layer  of  cotton, 
as  soon  as  it  is  drawn. 

35.  Aerate  and  cool  the  milk  as  soon  as  strained.  If  an  apparatus  for  airing  and 
cooling  at  the  same  time  is  not  at  hand,  the  milk  should  be  aired  first.  This  must 
be  done  in  pure  air,  and  it  should  then  be  cooled  to  45  degrees  if  the  milk  is  for 
shipment,  or  to  60  degrees  if  for  home  use  or  delivery  to  a  factory. 

36.  Never  close  a  can  containing  warm  milk  which  has  not  been  aerated. 

37.  If  cover  is  left  off  the  can,  a  piece  of  cloth  or  mosquito  netting  should  be 
used  to  keep  out  insects. 

38.  If  milk  is  stored,  it  should  be  held  in  tanks  of  fresh,  cold  water  (renewed 
daily),  in  a  clean  dry,  cold  room.  Unless  it  is  desired  to  remove  cream,  it  should 
be  stirred  with  a  tin   stirrer  often  enough  to  prevent   forming  a  thick  cream  layer. 

39.  Keep  the  night  milk  under  shelter  so  rain  can  not  get  into  the  cans.  In 
warm  weather  hold  it  in  a  tank  of  fresh  cold  water. 

40.  Never  mix  fresh  warm  milk  with  that  which  has  been  cooled. 

41.  Do  not  allow  the  milk  to  freeze. 

42.  Under  no  circumstances  should  anything  be  added  to  milk  to  prevent  its 
souring.     Cleanliness  and  cold  are  the  only  preventives  needed. 

43.  All  milk  should  be  in  good  condition  when  delivered.  This  may  make  it 
necessary  to  deliver  twice  a  day  during  the  hottest  weather. 

44.  When  cans  are  hauled  far  they  should  be  full,  and  carried  in  a  spring 
wagon. 

45.  In  hot  weather  cover  the  cans,  when  moved  in  a  wagon,  with  a  clean  wet 
blanket  or  canvas. 

THE    UTENSILS. 

46.  Milk  utensils  for  farm  use  should  be  made  of  metal  and  have  all  joints 
smoothly  soldered.     Never  allow  them  to  become  rusty  or  rough  inside. 

47.  Do  not  haul  waste  products  back  to  the  farm  in  the  same  can  used  for  deliv- 
ering milk.  When  this  is  unavoidable,  insist  that  the  skim  milk  or  whey  tank  be 
kept  clean. 

48.  Cans  used  for  the  return  of  skim  milk  or  whey  should  be  emptied  and 
cleaned  as  soon  as  they  arrive  at  the  farm. 

49.  Clean  all  dairy  utensils  by  first  thoroughly  rinsing  them  in  warm  water; 
then  clean  inside  and  out  with  a  brush  and  hot  water  in  which  a  cleaning  material 
is  dissolved;  then  rinse  and,  lastly,  sterilize  by  boiling  water  or  steam.  Use  pure 
water  only. 

50.  After  cleaning,  keep  utensils,  inverted,  in  pure  air,  and  sun  if  possible, 
until  wanted  for  use. 

Rules  ill  regard  to  the  care  of  cows  and  milk  have  been  promulgated 
by  the  Illinois  state  board  of  health  (30  September,  1895),  and  have 
been  adopted  in  Boston,  District  of  Columbia,  Fitchburg,  Haverhill,  In- 
dianapolis, New  York,  Philadelphia,  and  St.  Louis.  A  few  rules  touch- 
ing two  or  three  of  these  points  are  found  in  a  number  of  other  cities 
and  sometimes  in  state  legislation.  None  of  the  municipal  regulations 
equal  in  fullness  those  above  given  though  they  may  in  some  respects  be 
more  suitable  for  municipal  needs. 


DAIRY  PRODUCTS.  415 

The  necessity  of  providing  more  explicitly  for  the  construction  of 
new  stables  is  felt  in  cities.      Thus  in  St.  Louis  : 1 

'•.  .  .  All  single  stalls  shall  be  at  least  three  feet  wide,  double  stalls  six  feet 
wide,  and  all  stalls  shall  be  at  least  seven  feet  long;  the  height  of  ceilings  from  the 
floor  shall  be  at  least  eight  feet;  the  floors  must  be  of  tight  plank,  or  be  paved  with 
brick  or  stone,  laid  in  cement:  if  payed  with  brick  or  stone,  then  the  earth  below  it 
shall  be  sufficiently  solid  to  prevent  its  becoming  a  receptacle  of  filth  and  offensive 
matter:  the  floors  of  the  stalls  shall  slope  down  into  a  drain  or  gutter,  which  shall 
be  at  least  twelve  inches  wide  and  four  inches  deep,  and  said  drain  or  gutter  shall 
Connect  with  and  lead  into  a  sewer  through  two  intervening  catch  basins  or  tightly 
cemented  cesspools,  so  that  waste  matter  can  be  carried  or  hauled  away.  Openings 
tor  ventilation  must  be  placed  on  at  least  two  sides  of  the  building,  with  openings 
not  less  than  two  feet  square  for  every  double  stall  or  two  single  stalls,  and  there 
must  lie  roomj  ventilators  in  the  roof  not  less  than  one  for  every  twenty  feet  or 
fraction  thereof  in  the  length  of  the  building." 

In  St.  Louis  provision  is  also  made  for  the  reconstruction  of  old 
Stables.2     See  also  rules  in  regard  to  stables  on  page  161. 

The  rules  of  the  Illinois  state  board  of  health  (which  were  adopted 
on  the  suggestion  of  the  Chicago  commissioner  of  health),  of  the  Dis- 
trict of  Columbia  and  other  cities  also  require  the  connection  of  stables 
with  the   sewer. 

The  area  provided  for  the  cows  is  variously  prescribed  :  in  the 
Illinois   rules,   Brookline,  the    District   of  Columbia,   and  Indianapolis. 

1  St.  Louis.  Ordinance  of  6  April.  1896. 

-  St.  Louis.  <  Ordinance  of  6  April,  1896: 

"Sec.  9.  All  dairies  or  cow  stables,  now  erected  or  established,  when  found  to 
be  so  badly  lighted  or  ventilated  as  to  be  injurious  or  unhealthy  for  cows,  or  not 
provided  with  legal  caoh  basins  or  tightly  cemented  cesspools,  so  thai  waste  matter 

can  be  carried  or  hauled  away,  or  shall  be  conducted  iii  an  uncleanly  manner,  shall 
be  deemed  a  nuisance.  It  shall  be  the  duty  of  the  board  of  Health  when  any  report 
shall  be  made  of  the  bad  or  improper  construction  of  any  dairy  or  cow  stable,  or  of 
any  nuisance  created  by  any  dairy,  cow  stable  or  cow  lot.  to  notify  the  owner  or 
proprietor  thereof  to  shovi  cause  before  the  said  board  of  Health  at  the  time  and 
place  specified  in  said  notice,  why  said  dairy  or  cow  stable  should  not  be  altered  or 
changed,  or  such  detects  remedied  or  nuisance'  removed,  which  notice  for  the  part] 
complained  against  to  appear  shall  be  served  at  hast  five  days  before  the  date 
specified  in  such  notice;  said  notice  shall  be  served  bj  leaving  the  same  al  the  place 
of  business  or  residence  of  the  parties  to  be  affected  therebj  bj  some  officer  or  per- 
son duly  qualified  to  certifj   to  such  not  ice;  and  all  not  ices  of  this  kind  issued  by  the 

board  of  Health  shall  he  signed  by  the  presiding  officer  of  the  board  of  Health  or 
the  Health  Commissioner.  At  the  time  fixed  in  said  notice  the  parties  may  appear 
in  person  or  bj  attorney,  or  cause  maj  be  shown  bj  affidavit,  and  if  in  the  opinion 
of  the  Board  of  Health  and  Health  Commissioner  no  good  and  sufficient  cause  he 
show  ii   w  h\   the  said  nuisance  should  not  be  abated,  discontinued  or  removed,  or 

•aid  cow  stables  reconstructed,  the  Healtb  Commissi r  shall  order  t  he  sail  I  parties 

to  abate,  discontinue,  re ve,  or  reconstruct   the   same   within  such   time  as  the 

Health  Commissioner  may  deem  reasonable  and  necessary.  It.  upon  the  hearing  of 
the  affidavits  and  the  evidence  adduced  in  the  case,  the  Hoard  shall  find  the  tacts  to 

he  in   favor  Ol    the   parties  before  them,   and  so  decide,   the    case    shall    be    dismissed. 


416  DAIRY  PRODUCTS. 

each  animal  must  have  500  cubic  feet  of  space ;  but  in  new  stables  in 
Brookline  they  must  have  700  cubic  feet;  in  Oregon1  800  cubic  feet,  in 
Boston  and  Brookline,  1,000  cubic  feet.  In  Oregon,  Illinois,  and  the 
District  of  Columbia  the  stalls  must  be  four  feet  wide.  In  New  York 
City  and  in  the  rural  parts  of  Rochester,  only  fifteen  cows  are  allowed 
per  acre,  and  in  Buffalo  only  one  cow  per  acre.  In  the  built  up  por- 
tion of  Rochester  and  Macon,  Ga.,  there  may  be  one  cow  to  each  lot 
(33  feet  by  100  feet).  In  Boston  one  cow  to  each  3,000  square  feet. 
In  Brookline  stables  must  have  ventilators  in  the  roof  and  sliding  glass 
windows  at  the  sides.  In  Fitchburg  the  walls  and  ceilings  must  be 
thoroughly  cleaned  of  all  litter,  cobwebs,  etc.,  at  least  once  a  month. 
No  swine  may  be  kept  in  a  cow  stable  in  Newton,  Mass.,  and  no  manure 
shall  be  kept  in  the  cellar  in  the  latter  town.  The  Illinois  and  District 
of  Columbia  rules  require  that  the  manure  shall  be  kept  in  a  water 
tight  receptacle  outside  of  the  stable.  The  condition  of  the  cow  yard 
is  prescribed  in  Illinois  and  District  of  Columbia.2 

In  regard  to  cows  the  Fitchburg  rules  require  grooming  only  three 
times  a  week.  In  Philadelphia  the  feeding  of  turnips,  cabbage  and  any- 
thing which  may  give  a  taste  to  the  milk  is  forbidden  entirely,  and 
there  is  a  similar  rule  in  Indianapolis.  In  Cincinnati  cows  must  be  put 
out  to  pasture  twelve  hours  daily  from  May  1  to  October  1. 

There  is  a  difference  of  opinion  as  to  the  advisability  of  washing 
the  teats  and  udder,  but  it  is  prescribed  in  the  New  York,  Philadelphia. 
and  Fitchburg  rules,  and,  in  addition,  the  Fitchburg  rules  require  that 
the  udder  and  flank  shall  be  carded  and  brushed  before  milking. 

The  experience  of  Detroit,3  Grand  Rapids4  and  Providence,  and  prob- 
ably other  cities,  that  milkmen  will  carry  garbage  back  to  their  farms  in 
milk  wagons  and  even  in  milk  cans  has  led  to  the  addition  to  the  milk 
rules  of  a  prohibition  of  this  practice. 

The  use  of  bottles  for  delivering  milk  has  its  advantages  in  that 
there  is  less  handling  and  exposure  of  the  milk,  and  hence  it  can  he 
kept  cleaner.  Tests  of  bottled  milk  at  Montclair,  N.  J.,  showed  that 
samples  contained  24,817  bacteria  per  c.  c.  while  the  average  of  can  milk 
was  208,875  per  c.  c. 


1  Oregon,  Act  of  25  February,  1893,  Sec.  3. 

-  District  of  Columbia,  Rules  of  the  Health  officer: 

Lt  Sec.  12.  Any  inelosure  in  which  cows  are  kept  shall  be  graded  and  drained  so 
as  to  keep  the  surface  reasonably  dry  and  to  prevent  the  accumulation  of  water 
therein,  except  as  may  be  permitted  for  the  purpose  of  supplying  drinking  water: 
no  garbage,  urine,  fecal  matter,  or  similar  substances  shall  be  placed  or  allowed  to 
remain  in  such  inelosure,  and  no  open  drain  shall  be  allowed  to  run  through  it.11 

3 Michigan,  Proceedings  Third  Annual  Convention  of  Health  Officers,  p.  57. 

4  Same,  p.  6"). 


DAIRY  PRODUCTS.  417 

The  objection  to  the  use  of  bottles  is  that  they  are  not  readily  ster- 
ilized with  boiling  water  without  serious  breakage,  and  that  as  they  may 
be  carried  into  the  houses  and  even  rooms  and  put  into  the  hands  of 
persons  sick  with  contagious  disease,  such  disease  may  be  spread  in  that 
maimer.  Instances  of  such  are  reported.  It  is  said  also  that  quart 
bottles  a  little  under  size  are  readily  purchased.1  To  prevent  danger 
from  contagious  disease  in  bottles  the  Buffalo,  Chicago,  and  Yonkers 
rules  forbid  their  delivery  where  there  is  contagious  disease.  In  bos 
Aug* des  the  use  of  bottles  is  forbidden  at  all  times.2  The  following 
statute  in  regard  to  cleansing  bottles  and  other  vessels  is  found  in 
Minnesota."     See  also  the  New  York  rules  below. : 

"Any  person  or  persons,  linn  or  corporation  who  receives  any  milk  or  cream, 
in  cans,  bottles,  or  vessels,  which  has  been  transported  over  any  railroad  or 
boat  line,  where  such  cans,  bottles,  or  vessels  are  to  be  returned,  shall  cause  the 
said  cans,  bottles,  or  vessels  to  be  emptied  before  the  said  milk  or  cream  contained 
then  in  shall  become  sour,  and  shall  cause  the  said  cans,  bottles,  and  vessels  to  be 
immediately  washed  and  thoroughly  cleansed  and  aired." 

The  rules  proposed  by  the  Massachusetts  Association  of  Boards  of 
Health  4  in  addition,  prescribe  that  all  utensils  in  which  milk  is  delivered 
to  the  consumer  shall  be  not  only  cleaned  but  be  sterilized  before  they 
are  used  again.  This  rule  has  been  adopted  in  Boston.  The  New  York 
City  rules  require  that  all  utensils  shall  be  washed  with  boiling  water 
and  soda,  soap  or  alkali,  ami  then  rinsed  with  plain  boiling  water. 

The  rules  of  the  department  of  agriculture  relate  to  the  producer, 
rather  than  the  dealer,  and  experience  has  shown  that  additional  care 
must  be  exercised  by  every  dealer  if  it  is  desired  that  the  milk  shall 
reach  the  consumer  in  the  best  possible  condition.  The  following  are 
the  rides  adopted    in  New    York  City: 

••  .Milk  should  In-  kept  in  some  place  where  diisl  and  other  impurities  cannot  tall 
Into  it.  such  as  a  box  with  tight-fitting  cover;  preferably  an  icebox. 

■■  The  milk  should  be  kept  ai  as  low  a  temperature  as  possible,  not  above  fifty 

degrees  Fahrenheit. 

"After  I  he  day's  sales  are  over,  the  measures  and  utensils  used  in  t  he  sale  of  milk 

shoulil  he  thoroughly  cleaned  with  boiling  water,  to  which  a  small  amount  of  soda 
has  been  added  in  the  proportion  of  one  tablespoonful  of  washing  soda  to  a  gallon 
of  water. 

I  he  overflow  pipe  from  the  icebox  in  which  the  milk  is  kepi   must  not  b< 

ne, -ti-il    directly    with    the  ilniiii    pi| •   sewer,    lull    must    discharge    in|o    an   open, 

water-supplied,  properly-trapped,  sewer-connected  sink  (see  Section  tl  of  the  Sani- 
tary (  'ode  I. 


i  Philadelphia,  Report  of  Board  of  Eealth  i  1896),  p.  I  I". 

Angeles,  Resolution  of  Board  ol  Eealth,  10  April.  18H0, 
Minnesota.  Chapter  ■-'"'-'  -I'  L895. 
4  Journal  ol  Massachusetts  Association  of  Hoards  of  Health.  Vol.  VII.,  p.  120. 


418  DAIRY  PRODUCTS. 

"  The  icebox  in  which  the  milk  is  kept  should  be  cleaned,  by  scrubbing  out  with 
hot  soda  solution  made  as  in  No.  3,  at  least  twice  a  week. 

"  In  selling  milk,  stir  up  the  contents  of  the  can  thoroughly  before  measuring 
out  the  amount  desired.  This  will  prevent  unintentional  skimming.  In  this  way 
the  last  quart  of  milk  sold  from  the  can  will  contain  as  much  cream  as  the  first  quart 
sold. 

"  It  sometimes  happens  that  in  cold  weather  the  milk  may  be  delivered  to  the 
dealer  more  or  less  frozen.  If  such  is  the  case,  detach  the  ice  from  the  side  of  the 
can  and  gently  heat  the  contents  until  the  ice  is  all  melted.  If  there  is  much  ice  in 
the  can  it  is  absolutely  necessary  to  do  this  before  selling  the  milk,  otherwise  the 
liquid  part  dipped  out  and  sold  at  first  will  contain  more  of  the  solid  part  of  the 
milk  and  cream,  while  the  ice  remaining  and  consisting  principally  of  water,  will 
after  a  time  melt,  and  the  result  will  be  milk  containing  more  water  than  pure  milk, 
and  this  might  be  enough  to  appear  as  though  the  milk  had  been  adulterated  with 
water. 

"Do  not  place  ice  in  the  milk  if  it  is  desired  to  cool  it  or  keep  it  cold,  as  the  ice 
will  melt  and  you  will  then  have  adulterated  the  milk  with  water. 

"  Milk  shall  not  be  kept  for  sale  or  stored  in  any  room  used  for  sleeping  or  domes- 
tic purposes  or  opening  into  the  same. 

"  Milk  must  not  be  transferred  from  cans  to  bottles  or  other  vessels  on  streets  or 
on  ferries  or  at  depots,  except  when  transferred  to  vessel  of  purchaser  at  time  of 
delivery. 

"  Milk  shall  not  be  sold  in  bottles  except  under  the  following  rules: 

"Bottles  must  be  washed  clean  with  a  hot  water  solution  of  soap,  or  soda  or 
some  other  alkali,  and  then  with  hot  water  before  filling  with  milk. 

"  Bottles  must  not  be  filled  except  at  the  dairy  or  creamery,  and  in  the  city  only 
in  rooms  so  situated  as  to  prevent  the  contamination  of  the  milk  by  dust  from  the 
streets  or  other  impurities. 

"  Bottles  must  not  be  washed  or  filled  witli  milk  in  any  room  used  for  sleeping  or 
domestic  purposes  or  opening  into  the  same.11 

The  rules  of  the  board  of  health  of  Little  Rock,  X.  Y.,  require  that 
every  person  delivering  milk  "  shall  prevent  the  temperature  thereof 
rising  above  sixty-two  degrees  by  the  use  of  ice,  covered  conveyances  or 
preferably  by  the  use  of  separate  bottles  kept  on  ice." 

The  following  rule  in  regard  to  conveyances  was  adopted  in  Mil- 
waukee :  1 

"  No  person  or  persons  shall  bring  to  or  deliver  milk  in  the  City  of  Milwaukee, 
for  the  purpose  of  retailing  the  same  to  consumers  in  the  City  of  Milwaukee, 
in  any  open  or  uncovered  wagon,  cart  or  conveyance  of  any  kind;  and  all  milk  here- 
after to  be  brought  to  the  City  of  Milwaukee  to  be  retailed  to  consumers,  or  for  that 
purpose  to  be  delivered  in  the  City  of  Milwaukee,  shall  be  brought  to  said  city  and 
delivered  in  cars,  wagons  or  carts  so  constructed  that  the  covering  hereinbefore  pro- 
vided for  shall  not  come  in  contact  with  the  cans  or  vessels  containing  the  milk,  and 
shall  protect  such  milk  and  the  cans  or  vessels  containing  the  same  from  the  sun  and 
rain,  and  as  far  as  practicable  from  the  dust  and  all  the  impurities  of  the  air.11 

In  Erie,  Penn.,  the  wagons  must  be  equipped  with  iceboxes  in  June, 
July,  August,  and  September.  In  Indianapolis  milk  on  the  way  to 
dealers  must  be  covered  with  canvas. 


1  Milwaukee,  Ordinance  of  19  October,  1891,  Sec.  4. 


DAIRY  PRODUCTS.  419 

The  committee  appointed  by  the  Massachusetts  Association  of  Boards 
of  Health  prepared  with  great  care  some  rules  on  this  subject  which  in  a 
slightly  modified  form  have  been  adopted  in  Boston : 1 

"No  person  in  the  City  of  Huston  engaged  in  the  business  of  producing  milk 
for  sale,  and  no  person  engaged  in  the  business  of  storing  or  delivering  milk  in 
said  city,  shall  store,  cool  or  mix  said  milk  in  any  room  which  is  occupied  by  horses, 
cows  or  other  animals.  All  rooms  in  which  milk  is  stored,  cooled  or  mixed,  shall 
be  provided  with  tight  walls  and  floor  and  kept  constantly  clean.  The  walls  and 
floors  of  said  rooms  to  be  of  such  a  construction  as  to  allow  easy  and  thorough 
eleansing.  The  room  or  rooms  aforesaid  shall  contain  proper  appliances  for  wash- 
tog  or  sterilizing  all  utensils  actually  employed  in  the  storage,  sale  or  distribution 
of  milk,  and  all  such  apparatus  and  utensils  shall  be  washed  witli  boiling  water  or 
sterilized  by  steam  regularly  after  being  so  used. 

•■  No  urinal,  water-closet  or  privy  shall  be  located  in  the  rooms  called  for  in  the 
preceding  section,  or  so  situated  as  to  pollute  the  atmosphere  of  said  rooms. 

"All  milk  produced  in  the  City  of  Boston  for  sale  shall  be  strained, cooled  or 
stored  as  soon  as  it  is  drawn  from  the  cow." 

The  danger  of  the  spread  of  contagious  disease  through  the  agency 
of  milk  naturally  receives  fur  more  attention  from  health  officers  than 
from  dairy  officials.  Though  the  danger  from  this  source  is  not  great, 
relative  to  the  amount  of  business  done,  yet  in  the  aggregate  it  is  con- 
siderable, and  a  large  number  of  outbreaks  of  typhoid  fever,  scarlet 
fever,  and  diphtheria  have  been  traced  to  contaminated  milk  vessels  or 
infected  milkmen.2  There  is  considerable  legislation  found  in  regard  to 
infected  milk,  though  very  little  of  it  is  statutory.  The  following  is 
the  New  Jersey  law  : ,; 

•■  That  w  hen  the  state  board  of  health,  or  any  officer  thereof,  duly  author- 
ized in  writing  by  such  board  to  act  for  or  on  behalf  of  said  board,  shall  have 
reason  to  believe  thai  any  milk  has  been  contaminated  by  the  emanations,  exhala- 
tions or  discharges  of  anj  person  sick  with  communicable  disease,  it  shall  he  lawful 

for  the  said  state  hoard  of  health,  or  the  officer  so  authorized  to  act   in  the  premises. 

to  prohibit  the  transportation  or  sale  of  any  milk  suspected  to  be  contaminated  as 

aforesaid,  and    also  to    prohihit  the  transportation  or  sale  of   any  milk  which  may  lie 

produced,  stored,  kepi  or  found  upon  anj  [premises  infected  by  such  disease ;  such 
prohihit  ion  shall  continue  until  t  he  state  board  of  health,  or  the  officer  authorized 
to  acl  in  the  premises  as  aforesaid,  shall  in  writing  remove  such  prohibition.11 

Regulations  intended   t<>  prevent   the  spread  of  contagious  disease 

through  the  agency  of  milk  are  found    in  the  rides  of  the  Illinois,  Ii.ua, 

a iic I  North  Dakota  state  boards  of  health,  and  of  Boston,  Buffalo,  Chit 
Colorado   Springs,  the    District   of  Columbia,   Milwaukee.  Omaha,  St. 

Louis,  and  other  cities,  hut   the  best    provisions  that  the  writer  has  seen. 

1  Boston,  bull's  of  Hoard  of  Health,  22  December,  18! 
-The  District  of  Columbia,  Report  of  Bealth  Officer  (1895),  p.  299. 
\.u  Jersey,  Chapter  :;Ti  of  L896. 


420  DAIRY  PRODUCTS. 

are  those  proposed  by  the  Massachusetts  Association  of  Boards  of 
health.1 

Some  of  the  rules,  as  those  of  Iowa  and  North  Dakota,  abso- 
lutely forbid  the  sale  of  milk  from  premises  where  there  is  contagious 
disease.  In  Brookline,  Mass.,  no  person  with  phthisis  can  be  employed 
in  the  milk  business. 

In  Chicago  milkmen  are  notified  of  contagious  diseases  among  their 
customers.  The  use  of  tickets  for  the  payment  of  milk  is  forbidden  in 
Gardner,  Mass.,  Little  Rock,  N.  Y.,  Meadville,  Pa.,  and,  Richmond,  Ind. 

To  insure  compliance  with  its  rules,  the  Philadelphia  board  of  health 
has  added  to  its  rules2  that 

tl  Failure  or  neglect  to  comply  with  the  foregoing  rules  and  regulations  will 
subject  the  offender  to  the  seizure  of  his  or  her  cows  and  their  delivery  to  the 
Guardians  of  the  Poor  in  accordance  with  the  provisions  of  the  act  of  April  5, 
1849." 

PASTEURIZED    .MILK. 

As  soon  as  the  danger  of  feeding  to  infants  milk  rich  in  bacteria 
was  recognized,  the  attempt  was  made  to  overcome  the  difficulty  by 
sterilization;  but  it  was  soon  found  that  this  rendered  the  milk  less 
digestible,  and  that  nearly  as  good  practical  results  could  be  obtained  by 
a  partial  sterilization  at  lower  temperature,  by  which  all  but  the  most 
resistent  germs  would  be  destroyed,  and  at  which  temperature  the  milk 
would  be  only  slightly  altered.  This  pasteurization  like  sterilization  was 
first  done  in  private  families  on  the  advice  of  physicians,  but  soon  cer- 
tain dairymen  took  up  the  practice  in  order  to  meet  the  demand  of  the 
better  class  of  their  customers  who  called  for  it  on  their  physicians" 
advice.  At  present  there  are  in  most  large  cities  private  dealers  or 
dairymen  who  supply  a  limited  demand  for  pasteurized  milk.  The 
advantages  of  pasteurized  milk  as  an  infants*  food  are  so  great,  and  the 


1  Journal  of  Massachusetts  Association  of  Boards  of  Health,  Vol.  VII.,  p.  122: 

u  Every  person  engaged  in  the  production,  storage,  transportation,  sale,  deliv- 
ery, or  distribution  of  milk,  shall  immediately,  on  the  occurrence  of  any  case  or 
cases  of  infectious  disease,  such  as  typhoid,  scarlet  fever  or  diphtheria,  either 
in  himself  or  in  his  family,  or  amongst  his  employees  or  within  the  building  or 
premises  where  milk  is  stored,  produced,  sold,  or  distributed,  take  care  that  the 
local  board  of  health  is  notified  of  such  case  or  cases,  and  at  the  same  time  suspend 
the  sale  or  distribution  of  milk  until  authorized  to  resume  the  same  by  the  local 
board  of  health. 

l'It  shall  be  unlawful  for  any  person  suffering  from  a  contagious  or  infectious 
disease,  such  as  typhoid  fever,  scarlet  fever,  or  diphtheria,  to  handle,  transport, 
deliver,  mix,  taste,  work  over,  or  distribute  milk,  or  in  or  about  places  where 
milk  is  stored,  sold,  or  distributed,  or  to  serve  as  a  milker  or  milkman.  No  vessels 
which  have  been  handled  by  persons  suffering  from  such  diseases  shall  be  used  to 
hold  or  convey  milk.1' 

J  Philadelphia,  Report  of  Board  of  Health  (1895),  p.  278. 


DAIRY  PRODUCTS.  421 

chances  of  the  poor  who  need  it  most,  appreciating  it  and  paying*  for 
it  are  so  slight,  that  the  necessity  for  its  distribution  quickly  appealed 
to  the  hearts  of  the  charitable.  The  distribution  of  pasteurized  milk  at 
a  price  below  cost  has  become  a  feature  of  the  charitable  work  in  New 
York,  Brooklyn.  Cleveland,  Rochester,  Yonkers,  and  other  cities.  The 
most  important  of  these  charities  is  that  conducted  by  the  Hon.  Nathan 
Strauss  of  New  York  and  begun  by  him  in  1893.1  Through  the  efforts 
of  Mr.  Strauss  596,677  bottles  of  pasteurized  milk  were  distributed  in 
1900.  He  also  furnished  a  certain  amount  of  milk  modified  according 
to  the  formula  of  certain  well  known  physicians.  During  the  years 
that  bis  milk  has  been  coming  into  use.  there  has  been  a  decided  falling 
off  in  infant  mortality  in  New  York,  and  it  is  claimed  that  it  is  due  to 
that  cause.      Similar  reports  are  sent  out  from  Brooklyn.2 

Rochester  is  the  only  city  so  far  as  the  writer  knows  where  such  dis- 
tribution of  milk  has  been  undertaken  by  the  health  department.  An 
account  of  the  method  employed  in  that  city  may  be  found  in  the  report 
Off  the  health  department  for  1897,  p.  13,  from  which  the  following 
extracts  are  taken  : 

•We.  therefore,  established  a  milk  depot  in  one  of  the  most  populous  districts 
of  the  city  where  we  supplied  milk  in  nursing  bottles,  ready  for  feeding,  after  the 
plan  of  Siebert,  of  New  York  City,  slightly  modified  to  meet  the  small  fund  avail- 
able for  this  [impose.  For  this  depol  we  had  a  large,  light,  uewly-papered,  clean 
store  with  counters  dividing  it  in  half.  In  the  rear  of  the  counter  a  long  work  table, 
gas  stove,  large  sink  and  large  refrigerator  were  placed.  A  supply  of  four  and  eight 
oiiuee  nursing  bottles  and  corks,  together  with  an  Arnold  sterilizer,  capable  of  bold- 
Log  six  dozen  bottles  ami  the  necessary  cleaning  appliances,  etc.,  completed  our  out- 
tit.  At  this  depot  was  stationed  a  nurse,  whose  services  were  donated  by  the 
Rochester  City  Hospital.     A  woman  to  wash  bottles  assisted  the  nurse. 

•■  The  milk  was  received  from  rows  that  had  passed  the  tuberculin  test  and  who 
were  daily  groomed,  well  fed,  and  watered,  and  their  udders  well  washed.  The 
COWS  were  inspected  by  our  milk  inspector.  The  milk  was  received  in  squat  twelve 
quart  cans  belonging  to  the  department.  These  cans  were  sterilized  for  forty-five  min- 
utes in  the  steam  sterilizer  and  then  sealed.  Around  the  neck  of  these  cans  was  placed 
a  wide  rubber  hand  and  a  sterile  paper  envelope  containing  two  squares  of  sterile 
eheese  cloth  sufficient  to  cover  the  mouths  of  the  cans.  Through  one  of  these  cloth 
gguares  the  cov»  was  to  have  been  milked  directly  into  the  sterilized  can.  When  the 
milking  was  finished,  the  first  piece  of  cloth  was  to  have  been  thrown  awaj  and  the 
lecond  piece  placed  over  the  mouth  of  the  can,  while  t  lie  can  was  placed  in  ice  water 
t"  cool.     When  the   milk   was  received  at  the  depot   it  was  immediately  prepared, 

Pasteurized,  and  put   up  in  bottles  as  indicated  in  Siebert's  table. 

■  When  a  mothei  came  to  the  depol  for  milk,  the  nurse,  in  the  absence  of  direc- 
tion from  a   physician,  advised  about  the  general  can    of  her  child,  using  the  little 

pamphlet  as  a  guide.       If   the  mother  was  QUrsing  her  child,  tie    nurse  endeavored  to 

tier  continue  to  do  so,  if  the  age,  weight,  and  general  devolopmenl  of  the  child 
seemed   to  indicate  thai  it  was  best.     It  the  child   was  a  bottle-fed  child,  the  nurse 


Forum,  November,  1894,  and  circular  letter  of  Nathan  Strauss,  IS  Nov.,  1900. 
2  Brooklyn.  Report  of  Health  Department  (1896),  pp.  55  and 89. 


422  DAIRY  PRODUCTS. 

weighed  the  child,  and,  in  the  absence  of  any  direction  from  the  physician,  directed 
the  mother  how  to  feed  it.  The  milk  was  sold  in  nursing  bottles  only,  at  the  uni- 
form price  of  about  two  cents  per  pint,  the  cost  of  the  milk.  No  milk  Was  sold  by 
measure.  Milk  was  only  sold  after  the  weight  and  general  development  of  the  child 
had  been  observed  by  the  nurse. 

"The  difficulty  of  securing  clean  milk  to  start  with  was  an  almost  insuperable 
obstacle  to  the  success  of  the  project. 

"Notwithstanding  the  care  taken  to  sterilize  the  milk  cans,  the  bottles,  corks, 
and  everything  that  could  possibly  come  in  contact  with  the  milk,  the  difficulties  in 
producing  a  clean  milk  supply  were  very  great.  Wheu  our  milk  station  was  started, 
one  of  the  most  intelligent  and  painstaking  milk  producers  in  this  section  was  asked 
to  supply  us  with  milk.  Specific  directions  were  given  to  him  as  to  just  how  the 
milk  should  be  put  into  our  cans.  Our  cans  after  they  were  sterilized,  closed  and 
sealed,  were  to  be  sent  to  his  dairy.  The  cows1  udders  were  to  be  washed,  and 
milked  directly  into  our  cans;  the  cans  were  to  be  covered  with  a  double  thickness 
of  dairy  cloth  and  placed  in  ice  water  to  cool.  We  found  upon  examination  that 
those  directions  were  not  being  carried  out.  The  cows  were  being  milked  into  the 
milkman's  own  cans,  the  milk  put  into  a  cooler,  stirred  with  a  piece  of  broomstitk. 
poured  into  our  cans,  which  were  allowed  to  stand  open,  and  sent  to  our  milk  depot 
for  distribution.  Some  of  the  milk  that  came  to  lis  was  absolutely  bad.  Upon  uncl- 
ing this  state  of  things  we  immediately  stopped  getting  milk  from  this  man,  and 
upon  advice  of  our  milk  inspectors  selected  a  man  whom  they  thought,  out  of  all 
the  milk  producers  sending  milk  into  the  city  of  Rochester,  would  be  the  man  best 
calculated  to  give  us  a  good,  clean  milk  supply.  Our  further  observation  proved 
that  this  was  not  so.  Inspections  by  our  milk  inspectors  of  this  stable  showed  that 
the  milkmen  were  milking  with  dirty  hands  into  their  own  pails  in  a  dusty  stable; 
that  they  were  leaving  our  sterilized  milk  cans  open,  and  upon  several  occasions  we 
received  milk,  with  a  dusty,  cowey  taste,  and  on  one  occasion  milk  that  was  sour. 

"  These  experiences  have  taught  us  that  the  only  way  in  which  we  can  secure  a 
good  milk  supply  for  little  children  is  to  rent  our  own  cows,  rent  a  stable  and  pas- 
ture for  the  season,  and  produce  our  own  milk  under  conditions  over  which  we  have 
absolute  control." 

In  Rochester  in  1899,  there  were  five  stations  with  a  nurse  at  each 
station.  The  nurses  were  paid  $10  per  week  and  four  cents  per  quart 
was  paid  for  the  milk.  The  total  cost  was  about  one  cent  per  bottle. 
About  40,000  bottles  were  distributed  to  100  children,  most  of  whom 
were  sick.  The  milk  that  was  purchased  averaged  under  25,000  bac- 
teria per  c.  c.  Excellent  work  of  a  similar  character  has  been  done 
in  Yonkers  under  the  direction  of   Dr.  S.  E.  Gettv. 


Statutes  Consulted  in  the  Peparation  of  this  Chapter. 

Alabama.     Butter,  Chapter  408  of  1895  and  597  of  1897. 
Arkansas.     Butter,  Statutes  (1894),  Sees.  1586-90. 
California.     Butter,  Chapters  75  of  1897  and  25  of  1899. 

Cheese,  Chapter  76  of  1897. 

Dairy  bureau,  Chapters  38  of  1897,  75  of  1897  and  136  of  1899. 

Milk,  Chapter  136  of  1899. 
Colorado.     Butter,  Annotated  Statutes  (1891),  Chapter  I,  Sees.  1-8. 

Dairy  Commissioner,  (butter  and  milk),  Chapter  19  of  1895. 

Milk,  Act  of  17  April,  1893,  Sees.  69-72. 


DAIRY  PRODUCTS.  423 

COHHECTICUT.     Butter.  Chapters  114  of  1893  and  32  of  1895. 

Dairy  Commissioner,  Chapter,  114  of  1893. 

Milk  and  butter,  General  Statutes  (1888),  Sees.  14-03. 

Milk  Inspectors,  Chapter  209  of  1899. 
Delaware.     Butter,  Chapter  209  of  1895. 
District  of  Columbia.     Butter,  Act  of  25  January,  1879. 

Milk,  Act  of  2  March,  1895. 
Florida.     Butter,  Chapter  328  of  1881. 
Georgi  \.     Butter  and  cheese,  Act  of  16  December,  1896. 

Milk,  Act  of  16  December,  Ism;,. 
In aiio.      Butter,  Act  of  6  March,  1899. 

ILLINOIS.      Butter  and  cheese.  Annotated  Statutes  (1896),  Chapter  38,  Sees.  19-35; 
Act  of  14  June,  1897. 

Milk.  Annotated  Statutes  (1896),  Chapter  38,  Sees.  37-42;  Rules  of  State  Board  of 
Health,  30  September,  1895;  Act  of  7  June,  1897. 
Indiana.     Milk,  Statutes  (1897).  Sees.  2191-2. 

Butter.  Statutes  (1897),  Sees.  2171a. 
Iowa.     Dairy  products,  Code  (1897),  Sees.  2515-28. 

Milk,  Code  (1897),  Sees.  4989-91. 
Kan-  vs.      Milk.  General  Statutes  (1897),  Sees.  322-:;. 
Kentucky.     Butter,  statutes  (1894),Sec.  1283. 

Milk,  Statutes  i 1894),  Sec.  1274. 
Loi  isian  \.     Butter,  Act  of  8  July,  1886. 
Maine.     Butter  and  cheese,  Revised  statutes  (1883),  Chapter  128,  Sees.  3-0. 

Milk.  Revised  Statutes  (1883),  Chapter;;-.  Sees.  44-7. 

Chapters  20  of  1887,  255  of  1893  and  292  of  1897. 

Testing  Milk,  Chapter  109  of  L895. 
Maryland.     Butter  and  cheese  Public  General  Laws  (1888),  Art.  27,  Sees.  88-91 : 
Chapter  604  of  1890. 

Milk.  Chapter  306  of  L898. 
Massachusetts.     Butter  and  cheese,  Public  Statutes  (1882),  Chapter  50,  Sec   17 
etseq.     Chapters  310  of  1884,  317  of   1886,356  of  1885,  58of   1891   and  340  of 
L890. 

Dairy  bureau.  Chapters  112  of  189]  and  280  of  1894. 

Milk.  Public  Statutes  i  L882),  Chapter  57;  chapters  310  of  1884,  352  of  1885,  318  of 
1886,  425  of  1894,  264  of  1896;   condensed  milk.  109  and  223  of  1899. 
Michigan.     Butter  and  cheese,  Compiled  Laws  (1897),  Sees.  5013-17;  Chapters  147 
and  254  of  L899. 

Milk.  Compiled  Laws    1897),  Sees.  11,412  25;  Chapter  L06  of  1899. 
Minn  i. -(.i  \.     Dairy  products,  Chapters  94,  257,  295  of  1899. 

Milk.  Statutes  (1894),  Sees.  6992  7005. 

Milk,  powers  of  cities,  Chapter  203  of  1895. 
Mi  isissippi.     Butter,  Code  |  L892),  Sec.  L242. 

MlSHOI    RI.        Blltter  and    cheese.    Le\  ised    S|;i|  ulcs  |  1899),    Sees.   2270     6, 
Milk,    powers   Of  cities.    Revised    StatUteS   i  L899),    See.    6165. 

Montana.     Butter  and  cheese,  Penal  Code  (1895),  Sees.  684  6,  Political  Cod< 
4064. 

Milch  cows,  Penal  Code  i  L895),  Sec.  L095. 
Nehrask  \.     1  lu tier  and  cheese.  Compiled  Statutes  (1899),  Sees.  8211  8211g. 

Milk.  Compiled  Statutes  (1899),  Sees.  6898,  6940. 

Food  Commission  (1899),  Sees.  8207  and  321  lg. 
Ni.\  \o\.      Butter,  Compiled  Laws  (1900)    Sees.    1906  8. 

Milk.  Compiled  Laws  ,  L900),  Set  !.  1897   1901. 
Ni  \\    Hampshire.     Dairy  products,  Public  Statutes  (1891),  Chapter  127;  Chapters 

37  of  L893,  115  of  L895  and  58  ol 


424  DAIRY  PRODUCTS. 

New  Jersey.     Butter  and  cheese,  General  Statutes  (1895),  p.  1167,  Sees.  4-22,  p.  1167. 
Sees.  23-28,  p.  1169,  Sees.  29-30. 

Milk,  General  Statutes  (1895),  p.  1169,  Sees.  3,  33^3,  51-54,  65-66;  Chapters  152 
of  1897  and  182  of  1898. 

Dairy  Commissioner,  General  Statutes  (1895),  p.  1169,  Sec.  31-2,  p.  1177,  Sec.  91. 
New  York.     Butter  and  cheese,  Revised   Statutes  (1895),  p.  38  (Agricultural  Law, 
Sees.  20  et  seq. ) ;  Chapter  149  of  1899. 

Milk,  Revised  Statutes  (1895),  p.  38,  (Agricultural  Law.  Sec.  20  et  seq.);  Chapter 
153  of  1898. 

Commissioner  of  Agriculture,  Revised  Statutes  (1895),  p.  38,  (Agricultural  Law, 
Sees.  1-12. 
Noeth  Carolina.     Butter,  Chapter  106  of  1895. 

North  Dakota.     Dairy  products,  Chapter  49  of  1895,  and  72  of  1899. 
Ohio.     Butter,  Annotated  Statutes  (1900),  Sees.  4200(-14),  et  seq. 

Milk,  Annotated  Statutes  (1900),  Sees  4200(-9),  et  seq. 
Oklahoma.     Dairy  products,  Compiled  Statutes  (1893),  Sec.  2443. 
Oregon.     Milk,  Annotated  Laws  (1892),  Chapter  36,  Sees.  3,  13. 

Dairy  products,  Act  of  25  February,  1893. 
Pennsylvania.     Butter  and  cheese,   Brightly1*   Purdon's  Digest   (1894),   p.   1621, 
Chapter  234  of  1895. 

Milk,  Brightly1*  Purdon's  Digest  (1894),  p.  1332,  Chapter  118  of  1897. 

Cheese,  Chapter  164  of  1897. 

Renovated  Butter,  Chapter  121  of  1899. 

Dairy  Commission,  Brightly1*  Purdor^s  Digest  (1894),  p.  1621. 
Rhode  Island.     Butter,  General  Laws  (1896),  Chapter  146. 

Milk,  General  Laws  (1896),  Chapter  147,  and  Act  of  13  May,  1896. 
South  Carolina.     Dairy  products,  Actof  9  March,  1896. 
South  Dakota.     Butter,  Chapter  65  of  1897. 
Tennessee.     Butter.  Chapter  101  of  1895. 
Utah.     Butter  and  cheese,  Revised  Statutes  (1898),  Sees.  734-40. 

Milk,  Revised  Statutes  (1898),  Sees.  731-3,  Chapter  34  of  1898. 

Dairy  Commission,  Revised  Statutes  (1898),  Sees.  2446-50. 
Vermont.     Butter  and  cheese,  Statutes  (1894),  Sees.  4332-7. 

Milk,  Statutes  (1894),  Sees.  4327-30,  4975,  Chapter  81  of  1898. 
Virginia.     Butter  and   cheese,  Code  (1887),  Sees.  1900-1,   Chapters  526  of  1891-2, 
and  146  of  1897-8. 

Milk,  Code  (1887),  Sec.  1899,  Chapter  526  of  1891-2,  Sec.  3. 
Washington.     Butter  and  cheese,  Code  (1899),  Sees.  2844-7,  Chapter  43  of  1899. 

Milk,  Code  (1899),  Sees.  2842-3,  2851-4. 

Dairy  Commission,  Code  (1899),  Sec.  2848  et  seq. 
Wj:st  Virginia.     Butter  and  cheese,  Code  (1899),  Chapter  150,  Sec.  20a. 
Wisconsin.     Butter,  Statutes  (1898),  Sec.  4607 c-e,  Chapter  76  of  1899. 

Milk,  Statutes  (1898),  Sees.  4607-b,  Chapter  313  of  1899. 

Food  Commission,  Statutes  (1899),  Sees.  1410-10d. 


CHAPTER   IX. 

COMMUNICABLE    DISEASES. 
Legislation. 

IN  one  sense  the  prevention  of  the  importation  of  communicable  dis- 
eases, or  quarantine  service,  is  the  most  important  work  of  the  health 
officer.  That  prevention  is  better  than  cure  is  as  true  of  the  outbreak 
of  disease  in  a  community  as  it  is  of  its  attack  on  the  individual:  but 
after  all,  it  is  only  in  comparatively  few  instances  that  quarantine  can 
be  successfully  invoked.  It  is  only  at  seaports  that  maritime  quarantine 
can  be  enforced,  and  inland  quarantine  is  of  use  in  only  the  rarer  dis- 
eases, so  that  very  few  health  officers  really  have  any  quarantine  duties 
to  perform  and  most  of  them  only  give  a  part,  and  often  a  small  part  of 
their  time  to  them;  bu1  there  are  few  boards  of  health  which  do  no1 
bave  some  of  the  commoner  tonus  of  communicable  diseases  constantly 
present,  so  that  the  problem  of  how  to  deal  with  communicable  diseases 
actually  existent  occupies  a  Large  part  of  the  attention  of  sanitary 
authorities  and  is  the  important  problem  with  which  they  have  to  deal. 
The  attempt  to  check  the  spread  of  communicable  diseases  by  proper 
management  is  no  new  thing  and  was  made  in  early  colonial  times. 
During  the  smallpox  outbreak  in  .Massachusetts  Bay  in  1678,  the  town 
officers  of  Boston  '  and  Salem2  adopted  measures  of  isolation  and  disin- 
fection not  unlike  what  would  he  employed  at  the  present  time.  From 
that  time  to  the  present  our  town  and  state  governments  have  con- 
tinued to  practice  and  to  improve  methods  of  control,  doI  onh  of  small- 
P"\.  but  of  an  increasing  number  of  other  communicable  diseases. 

The  local  management  of  communicable  dise;ise>  i>  usuall}  left  in 
the  hands  of  the  local  authorities,  county  or  municipal,  hut  sometimes 
it  is  assumed  by  the  state  government  and  more  rarely  h\  the  federal 
government.  In  Florida,  where  the  local  hoards  of  health  have  been 
abolished,  the  control  of  communicable  diseases  must  he  in  the  hands 

Boston,  Record  Commissioners1  I ;* ■  | >< ■  rt^.  Vol.  7.  p,  119. 
-Act  of  Salem  Selectmen,  18  October,  1678. 


426  COMMUNICABLE   DISEASES. 

of  the  state  officers.     In  other  states  the  state  authorities   are  to  take 
charge  of  outbreaks  under  certain  circumstances.     Thus  in  Mississippi : l 

"When  yellow  fever  or  other  epidemic  or  contagions  disease  shall  make  its  ap- 
pearance, the  state  board  of  health  shall  take  charge  of  the  infected  district  or 
locality  and  enforce  such  rules  and  take  such  measures  as  it  may  deem  necessary  to 
prevent  the  spread  of  the  disease  or  to  suppress  it." 

And  in  Massachusetts  :  2 

"  If  smallpox  or  any  other  contagions  or  infectious  disease  dangerous  to  the  pub- 
lic health  exists,  or  is  likely  to  exist  in  any  place  within  the  state,  the,  state  board 
shall  investigate  the  same,  and  the  means  of  preventing  the  spread  thereof,  and  shall 
consult  thereon  with  the  local  authorities,  and  shall  have  co-ordinate  powers  as  a 
board  of  health,  in  every  place,  with  the  board  of  health  or  health  officer  thereof,  or 
with  the  mayor  and  aldermen  or  the  selectmen,  if  no  such  board  or  officer  exists  in 
such  place.1' 

In  a  few  other  states,  as  Maryland,  Minnesota,  North  Carolina,  and 
Ohio,  it  is  provided  that  in  emergencies  the  state  board  of  health  shall 
assume  control  of  outbreaks  of  communicable  diseases,3  and  as  was  shown 
on  page  5,  the  state  board  of  health  in  several  states  is  authorized  to  exer- 
cise executive  functions  in  those  communities  where  the  local  authori- 
ties fail.  Furthermore  in  many  states  the  state  board  of  health  is  estab- 
lished as  an  advisory  board,  and  in  almost  all  states  local  health  officers 
are  accustomed  to  call  on  the  state  board  of  health  for  advice  and  assist- 
ance in  outbreaks  of  communicable  diseases  and  not  infrequently  the 
state  board  is  invited  to  take  entire  charge. 

Even  in  such  a  state  as  Massachusetts,  which  probably  contains  more 
efficient  local  boards  than  any  other  state,  the  advice  of  the  state  board 
is  frequently  called  for  even  in  such  cities  as  Lowell,  Newburyport,  and 
Springfield.  The  board,  owing  to  the  increase  in  this  work,  has  recently 
detailed  a  medical  man  as  special  inspector.  It  is  his  duty  to  visit  all 
towns  which  apply  for  advice  in  regard  to  communicable  diseases  and 


1  Mississippi,  Annotated  Code  (1892),  Sec.  2279. 

2Masssachusetts,  Public  Statutes  (1882),  Chapter  80,  Sec.  2. 

3  Ohio,  Annotated  Statutes  (1900),  Sec.  2143: 

"  The  state  board  of  health,  or  the  board  of  health  of  any  city,  village  or  town- 
ship, in  time  of  epidemic,  or  threatened  epidemic,  may  establish  a  quarantine  on 
vessels,  railroads,  stages,  or  any  other  public  or  private  vehicles  conveying  persons, 
baggage  or  freight,  or  used  for  such  purpose,  and  may  make  such  rules  and  regula- 
tions as  may  be  deemed  wise  and  necessary  for  the  protection  of  the  health  of  the 
people  of  the  community  or  state.  Such  quarantine  and  rules  and  regulations,  when 
.established  by  a  local  board  of  health,  after  careful  investigation  by  the  proper  officer 
of  the  state  board  of  health,  may  be  altered,  relaxed,  or  abolished  by  the  order  of 
said  state  board  of  health,  and  thereafter  no  change  shall  be  made  except  by  order 
of  the  state  board  of  health,  or  to  meet  some  new  and  sudden  emergency.  (O.  L., 
vol.  90,  March  14,  1893.)" 


COMMUNICABLE   DISEASES.  427 

in  some  cases  when  the  board  learns  that  the  local  officers  do  not  seem 
able  to  cope  with  the  outbreaks  the  state  board  takes  the  initiative. 

It  is.  however,  more  in  accord  with  American  principles  of  govern- 
ment that  the  control  of  communicable  disease  should  be  entirely  in  the 
hands  of  local  officers,  and  in  the  vast  majority  of  cases  it  is  so.  The 
Local  sanitary  authority  is  established  chiefly  for  this  purpose,  and  in 
very  many  states  the  law  expressly  confers  the  necessary  executive  and 
legislative  authority,  and  requires  strict  performance  of  duty  on  the  part 
of  the  local  officers.  Local  sanitary  officers  are  authorized  to  maintain 
isolation,  to  remove  to  a  hospital,  to  disinfect,  and  often  to  carry  out 
the  rides  and  directions  of  the  state  board  of  health.  An  example  of  a 
rather  full  narration  of  such  powers  and  duties  is  found  in  Maine.1 

Sometimes  the  authority  is  granted  in  less  specific  terms,  as  in  New 
Jersey.2 

The  powers  above  given  are  very  broad,  but  they  are  broader  still 
for  certain  cities.  The  extraordinary  powers  given  to  the  board  of 
health  in  the  City  of  New  York  will  be  noted  in  connection  with  the 
consideration  of  epidemics,  and  in  addition  that  board  is  authorized  in 
such  emergencies  to  spend  $80,000  in  excess  of  its  appropriation.3  Sim- 
ilar provisions  are  found  in  Buffalo4  and  Pennsylvania  cities  of  the 
second  class/1  and  certain  cities   which   have  been  given  very   broad  san- 


1  Maine,  Chapter  L23  of  L887,  as  amended  by  Chapter  L39  of  L895: 

•■  Si.c  .  t.     III.     To  guard  against  the  introduction  of  contagious  and  infectious 

diseases,  by  tl zeroise  of  proper  and  vigilant  medical  inspection  and  control  of  all 

persons   and    things  coming  wit  Inn  the  limits  of  its  jurisdiction  from  infected  places. 

or  which  tor  any  cause,  are  Liable  to  communicate  contagion;  to  give  public  notice 
of  infected  places,  by  displaying  red  flags  or  by  posting  placards  on  the  entrances  of 
the  premises;  to  require  the  isolation  of  all  persons  and  things  that  are  infected 
with,  or  have  been  exposed  to,  contagious  or  infectious  diseases,  and  to  provide 
tuitable  places  foi  the  reception  of  the  same;  and  to  furnish  medical  treatment  and 
Care  for  persons  sick  with  such  diseases  who  cannol  otherwise  he  provided  tor;  to 
prohibit  and  prevent  all  intercourse  and  communication  with,  or  use  of,  infected 
premises,  places  and  things,  and  to  require,  and,  if  necessary,  to  provide  the  means 
for  the  thorough  cleansing  and  disinfection  of  the  same  before  general  intercourse 

therewith,  or  use  thereof,  shall  he  allowed.      And  it  shall  he  its  duty  to  report  to  the 

state  board  of  health  promptly,  facts  which  relate  to  infectious  and  epidemic  dis- 
eases, ami  every  case  of  smallpox,  varioloid,  diphtheria,  and  scarlet  fever,  occurring 
wit  hin  t  he  limits  of  its  jurisdiction.11 

»  New  Jersey,  General  Statutes  (1895),  p.  1644,  Sec.  19,  III: 

"  To  |  ire  vent  the  spreading  of  dangerous  epidemics  or  contagious  diseases,  and  to 

declare  that   the  same  has  become  epidemic,  ami    to  maintain   and  enfore  proper  ami 

sufficient  quarantine  whenever  dee d  necessary.'1 

Neu  York,  Chapter  878  of  1897,  Sec.  iitt. 
\cw  York,  chapter  LOB  of  L801,  Sec.  --'::<•>. 
Pennsylvania,  Act  of  26  June,  1896,  Sec.  28. 


428  COMMUNICABLE   DISEASES. 

itary  authority  by  statute  have  conferred  the  same  upon  their  board  of 
health  or  health  commissioner,  as  St.  Louis1  and  Chicago.2 

While  the  executive  control  of  communicable  diseases  is  chiefly  in 
the  hands  of  the  local  health  authorities,  it  is  not  so  with  legislation. 
Communicable  diseases  are  largely  dealt  with  by  statutory  legislation, 
though  there  is  also  a  great  amount  of  municipal  law-making  on  this 
subject. 

All  but  the  following  states  have  some  restrictions  applicable  to  com- 
municable diseases  upon  their  statute  books.  These  states  are  Nebraska, 
Kansas,  Arkansas,  Oregon.  This  statement  has  no  reference  to  quar- 
antine regulations. 

Furthermore,  a  number  of  states  have  given  their  state  board  of 
health  authority  to  make  regulations  in  regard  to  communicable 
diseases.  It  is  recognized  that  the  framing  of  rules  for  the  manage- 
ment of  communicable  diseases  requires  a  high  degree  of  technical 
knowledge  and  also  that  the  science  of  preventive  medicine  and  our 
knowledge  of  these  diseases  is  advancing  rapidly,  and  laws  on  this  sub- 
ject need  frequent  revision.  The  following  states  give  the  state  board 
of  health  authority  to  make  regulations  in  regard  to  contagious  diseases  : 
Florida,  Illinois,  Indiana,  Iowa,  Kentucky,  Louisiana,  Maine,  Maryland, 
Minnesota,  Mississippi,  Missouri,  New  Hampshire,  North  Dakota,  Ohio, 
South  Dakota,Tennessee, Vermont, Virginia,  Wisconsin  ;  but  in  Maryland 
and  Missouri  this  power  is  only  to  be  exercised  in  serious  outbreaks. 
Such  rules  have  been  adopted  in  Florida.  Indiana,  Iowa,  Mississippi, 
Missouri,  North  Dakota,  Ohio,  South  Dakota,  Vermont,  Wisconsin.  But 
in  Wisconsin  such  rules  have  been  declared  unconstitutional  by  the 
Supreme  Court.3 

While  legislative  power  is  thus  exercised  by  the  legislature  and  con- 
ferred upon  the  state  board  of  health  in  many  states,  in  no  instance  is  it 
withheld  from  the  local  units  of  government.  Counties  or  municipali- 
ties, or  both,  can  in  all  states  make  rules  in  regard  to  communicable 
diseases.  When  cities  or  boards  of  health  can  make  rules  "  in  regard 
to  health  '"  they  can  certainly  make  rules  in  regard  to  communicable 
disease,  so  that  any  general  grant  of  legislative  power  in  sanitary 
matters  would  involve  the  power  to  make  rules  concerning  the  subject 
that  we  are  now  considering.  In  a  few  states  only,  as  Connecticut, 
Illinois,  New  Hampshire,  New  Jersey,  New  York,  North  Carolina,  and 
in  a  few  cities,  as  Baltimore  and  Providence,  does  the  local  government 

1  St.  Louis  Ordinances  (1893),  Chapter  14,  Sec.  436. 

2  Chicago  Municipal  Code  (1881),  Sec.  1189. 

3  Wisconsin  Supreme  Court,  23  February,  1897.  State  ex  rel.  Adams  vs.  Burdge 
et  (d,  School  Board. 


COJIJfCXK  \  1 BLK    DISK  A  SBS.  420 

depend  on  such  general  provisions.  In  most  states  authority  is  expressly 
given  to  make  regulations  in  regard  to  communicable  diseases.  Thus 
in.  Maine1  "  towns  may  establish  by-laws  for  protection  against  conta. 
gious  diseases."  In  Massachusetts2  the  board  of  health  shall  make  reg- 
ulations concerning  "causes  of  sickness  "  and  concerning"  articles  which 
are  capable  of  i  ontaining  or  conveying  infection  or  contagion,  or  of 
creating  sickness."  In  Alabama ::  ••  the  court  of  county  commis- 
sioners •  •  •  may  make  such  rules  and  regulations  as  are  necessary  to 
prevent  the  introduction  and  spread  of  contagious  or  infectious  diseases." 
Although  Pennsylvania  has  as  explicit  statute  law  as  any  state  for  the 
prevention  of  communicable  diseases,  nevertheless,  power  is  given  to 
local  boards  of  health  to  supplement  the  state  law  with  rules  of  their 
own.4 

Sometimes  authority  to  make  these  rules  is  granted  to  the  local 
sanitary  authorities,  as  in  Massachusetts  and  Pennsylvania  above,  and 
sometimes  to  the  township,  city  or  county,  as  in  Alabama  and  Maine,  in 
which  case  of  course  the  ordinances  are  enacted  by  the  representative 
legislative  assembly  of  the  township,  city  or  county  as  the  case  ma\  be. 

Having  thus  noted  the  statutory  basis  for  the  regulation  of  con- 
tagious diseases  we  may  proceed  to  consider  the  regulations  actually  in 
force  and  the  means  taken  to  secure  their  enforcement. 

Report*  of   Communicable    Diseases. 

Before  the  health  officer  can  do  anything  to  prevent  the  spread  of 
feommunicable  disease  he  must  be  aware  of  its  existence.  As  early  as 
17215  the  colony  of  Rhode  Island  provided  that  tavern  keepers  should 
report  cases  of  communicable  disease,  and  in  1 7 4 -V'  the  law  was  enacted 
in  nearly  its  present  form.  Similar  laws  were  enacted  in  the  other 
colonics,  and  from  that  time  until  the  present  the  report  of  smallpox 
to  the  local  authorities  has  been  compulsory.      It  was  not  however  until 

Maine,  Revised  Statutes,  Chapter  14,  Sec.  :!'''. 
J  Ma ssaoh u setts  Public  Statutes,  Chapter  18,  Sec.  18. 

Uabama,  Civil  Code  (1896),  Sec.  1515. 
1  Pennsylvania,  Chapter  124  of   1895,  s'-<'.  19: 

"The   health  authorities  of  the  several   municipalities  of   this  Commonwealth 
shall,  and  they  are  hereby  authorized  and  empowered  to  establish  rules  and  regula- 
tions   regarding    the    isolation  of    persons  who   may   be   suffering  from   any  of   the 
es  mentioned  in  section  four  of   this  act,  and    for  the  destruction,  disinfection 
:ni'i   fumigation  of   bedding,  clothing  or  other  infected  articles,  and  for  the  disinfei 
tion  and  fumigation  of  houses  and  premises,  and  for  the  carrying  oul  of  the  provis- 
ions of  this  act,  as  thej  may  in   good   faith  declare  the  public  safety  and  health  de- 
Band,  which  rules  and  regulations  they  may  from  time  bo  time  alter  or  amend/1 
•  Rhode  Island  Digest  of  1730,  p.   119. 
1  Digest  of  17  1."..  p,  _'7  I. 


430  C  OMM I  XI CABLE    D  ISIS  A  SE\S. 

the  latter  half  and  almost  the  last  quarter  of  the  nineteenth  century 
that  the  notification  of  the  more  common  communicable  diseases  was 
generall}r  required. 

At  present  the  following  states  have  state  laws  requiring  the 
report  of  communicable  diseases  :  Alabama,  Colorado,  Connecticut, 
Florida,  Georgia,  Kentucky,  Maine,  Maryland,  Massachusetts,  Michi- 
gan, Minnesota,  Mississippi,  New  Hampshire,  New  Jersey,  North 
Carolina,  Ohio,  Oklahoma,  Pennsylvania,  Rhode  Island,  South  Caro- 
lina, Tennessee,  Utah,  Vermont,  Washington,  West  .Virginia,  Wiscon- 
sin, and  Wyoming  have  statutes  covering  the  subject,  while  Indiana, 
Iowa,  Mississippi,  New  Hampshire,  North  Dakota,  South  Dakota, 
Ohio  Texas,  Vermont,  have  regulations  made  by  the  state  board  of 
health,  and  Mississippi,  New  Hampshire,  Ohio,  and  Vermont  have  both. 
In  the  states  which  do  not  by  state  law  require  the  report  of  com- 
municable diseases  there  are  many  communities  which  have  made  it  a 
part  of  their  local  regulations.  Thus  it  is  required  by  the  model  sani- 
tary regulations  of  New  York  and  has  been  adopted  by  all  the  principal 
cities  and  by  a  large  number  of  the  smaller  communities  in  that  state. 

Persons  Required  to    Report. 

The  physician  who  attends  a  case  of  communicable  disease  is  ex- 
pected to  have  the  first  and  best  knowledge  of  the  case,  and  it  is  he  who 
in  every  instance  is  required  to  report  it  to  the  authorities.  The  fol- 
lowing is  the  wording  of  the  law  in  Pennsylvania  :  2 

".  .  .  That  every  physician  located  or  practicing  in  any  of  the  municipalities 
of  this  Commonwealth  who  shall  know  that  any  person  whom  he  or  she  is  called 
upon  to  visit  or  who  comes  or  is  brought  to  him  or  her  for  examination  is  suffering 
from  or  is  afflicted  with  cholera,  smallpox,  etc.     .     .     ." 

When  more  than  one  physician  has  been  called  to  a  case,  the  case  is 
sometimes  not  reported  as  each  physician  may  think  the  other  has  ful- 
filled the  law.  This  is  guarded  against  by  the  sanitary  code  of  the 
City  of  New  York.2 

In  Camden3  it  is  provided  that  reports  of  communicable  disease  by 
physicians  shall  be  confidential,  but  how  the  subsequent  necessary  steps 

1  Pennsylvania,  Chapter  124  of  1895,  Sec.  1. 

2  The  City  of  New  York,  Sanitary  Code,  1899 : 

"  Sec.  145.  That  every  physician  shall  report  to  the  Sanitary  Bureau,  in  writing, 
every  person  having  a  contagious  disease  (and  the  state  of  his  or  her  disease,  and 
his  or  her  place  of  dwelling  and  name  if  known),  which  such  physician  has  pre- 
scribed for  or  attended  for  the  first  time  since  having  such  a  contagious  disease,  dur- 
ing any  part  of  the  preceding  twenty-four  hours;  but  not  more  than  two  reports 
shall  be  required  in  one  week  concerning  the  same  person;  but  every  attending  or 
practicing  physician  thereat  must,  at  his  peril,  see  that  such  report  is  or  has  been 
made  by  some  attending  physician." 

3  Camden,  Sanitary  Code  (1894),  Sec.  11. 


C OMMUNICA  BLE    DISK.  1 8E8.  431 

for  the  control  of  the  case  can  be  taken  and  this  provision  be  respected, 
it  is  difficult  to  see.  But  it  not  infrequently  happens  that  a  physician 
is  not  called,  and  sometimes  this  is  intentionally  done  so  that  the  case 
may  not  be  reported.  Consequently  it  is  often  required  that  the  head 
of  the  household  or  an)-  person  having  a  knowledge  of  the  case  shall 
report.  Usually  the  responsibility  is  laid  conjointly  on  both  the 
physician  and  the  head  of  the  household,  but  in  New  Hampshire,  New 
Jersey  and  Wisconsin  the  latter  is  only  required  to  report  when  there 
is  no  physician  in  attendance.  The  "head  of  the  family"  is  made 
responsible  in  Alabama,  Kentucky,  Ohio,  and  Vermont,  the  "head  of 
the  household"  in  Tennessee;  the  u  householder  **  in  Colorado,  Maine, 
Massachusetts,  Michigan,  New  Hampshire,  New  Jersey.  North  Carolina, 
Rhode  Island,  and  Wisconsin,  and  the  "tenant"  in  Michigan.  Any 
gterson  knowing  of  ;i  case  of  contagions  disease  is  required  to  report  in 
Georgia,  Indiana,  Minnesota.  North  Dakota,  Rhode  Island,  and  New 
York  City.  In  Ohio  "the  owner  or  agent  of  the  owner  of  any  build- 
ing in  which  a  person  resides "  is  responsible.  Many  of  the  old  laws 
required  innkeepers  to  report,  and  this  is  true  at  present  of  the  laws  in 
Michigan,  Minnesota  ;tnd  New  York  City.  In  Minnesota,  "every 
keeper  of  any  private  house,  boarding  house  or  lodging  house  and  every 
inn  keeper  and  hotel  keeper  .  .  .  and  every  person  knowing  of 
any  person  sick  with  contagious  disease  shall  report  the  same."1  In 
Buffalo  '-the  nurse  or  midwife  in  charge  "  and  "the  officer  in  charge  of 
any  public  institution,"  in  Denver  "  any  policeman,"  in  St.  Louis  ••  the 
police  department,"  in  Reading  and  Rochester  "  the  nurse."  in  Albany 
ami  Fitchburg  the  " parent  or  guardian,"  in  Atlanta  any  "citizen,"  and 
in  Chicago  "  any  other  person  hearing  of  a  case"  are  required  to  report. 
Examples  of  other  municipal  regulations  are  given  below.2 

■  Minnesota  Chapter  132  <>t  L883,  Sees.  22  :;. 
New  Orleans,  Ordinances  No.  1916,  Administration  Scries  1879,  An.  155(21): 

"  The  coroner  or  coroners,  or  his  or  their  deputies,  masters  "t  any  water-craft, 
boarding  or  I-  ■<  t  u  i  u  ^  house  keepers,  principals  or  masters  of  any  boarding  schools  or 
seminary,  and  all  practitioners  of   medicine,  surgeons,  obstetricians  or  physicians, 

apothecaries,  chemists,  druggists,  midwives  and  all  persons  who  as '  pretend  to 

ase  medical,  obstetrical  or  surgical  means  I'm-  t  he  treatment  of  disease,  disorder  "i 
lesion,  are  herebj  required,  each,  any,  or  all  of  them,  ;is  the  case  maj  be,  to  report 
i"  the  1m. aid  of  health.  of  the  Mate  of  Louisiana,  all  eases  oi  :  ontagious,  infectious, 
epidemological  diseases,  especially  cholera,  yellow  fever,  trichinosis,  typhus  or  ship 
lever,  smallpox,  diphtheria,  or  any  of  the  grades  of  such  diseases,  or  any  others  that 
ma\  he  specified  by  the  board  of  health,  or  maj  !»<■  generally  adjudged  contagious 
or  infectious,  within  twenty-four  hours  after  t he  same  maj  come  under  their  treat 
nient .  i  ognizance  or  supen  ision." 

Minneapolis,  Ordinance  "f  26  June,  1897,  Sec.  I 

"  I. very  proprietor,  manager,  superintendent,  principal,  owner,  agent,  or  ether 
person  in  charge ol  anj  hotel,  boarding   house,  boarding  school,  tenement    hou 


432  COMMUNICABLE    DISEASES. 

Rules  like  that  of  New  York  shown  below  are  found  in  many  mari- 
time cities  and  several  inland  cities,  as  Denver,  Memphis,  and  Omaha1 
have  applied  the  principle  to  railroad  trains. 

While  many  persons  beside  the  physician  are  thus  made  responsible, 
it  is  he  who  is  chiefly  looked  to  for  official  information  of  communicable 
diseases,  and  it  is  he  who  reports  nearly  all  recognized  cases.  Legal 
action  for  failure  to  report  is  rarely  brought  against  any  one  other  than 
a  physician.  Occasionally,  however,  the  law  is  by  the  local  board  of 
health  enforced  against  the  head  of  the  family.  Thus  in  Fitchburg2 
during  an  outbreak  of  measles  in  1897  over  half  the  cases  were  reported 
by  parents.  In  Boston  both  parents  have  been  fined  $100  for  failure  to 
report. 

While  the  great  majority  of  cases  of  communicable  disease  are 
treated  by  physicians,  and  if  the  notification  laws  are  enforced  are 
reported  by  them,  it  is  undoubtedly  the  small  minority  of  unreported 
cases  which  do  the  most  harm  in  spreading  the  disease.  Hence  health 
officers  have  made  great  efforts  to  get  at  these  cases.  Often  the  in- 
spector of  the  department,  while  making  his  visits,  learns  of  cases  in 
the  neighborhood,  cases  which  have  not  received  a  physician's  care,, 
either  because  of  intention  to  conceal  the  case  or  because  of  careless 
neglect.  School  teachers  often  learn  of  cases,  and  for  many  years  it  has 
been  the   practice   in   Fitchburg,  Oakland,  Cal.,  Providence,  and   other 

other  place  of  residence,  or  of  any  hospital,  asylum  or  other  public  institution 
within  said  city,  in  which  any  contagious  or  infectious  disease  may  be  discovered, 
shall  give  immediate  notice  to  the  department  of  health  of  said  city  of  the  exist- 
ence therein  of  such  contagious  or  infectious  disease,  and  of  the  name  or  names  of 
the  person  or  persons  affected  therewith.11 

New  York,  Chapter  378  of  1897,  Sec.  1251 : 

"  Every  master,  owner  or  consignee  of  a  vessel  lying  at  a  wharf  or  in  the  harbor 
of  the  City  of  New  York,  shall  make  a  like  report,  and  within  the  same  period,  of 
the  name  of  every  sick  person  on  board  of  such  vessel.'1 

1  Omaha,  Rules  of  the  Department  of  Health,  Rule  5: 

tl  Whenever  any  person  on  any  railroad  train  coming  into  Omaha  shall  show 
symptoms  indicating  an  attack  of  small-pox  or  other  contagious  disease,  or  when- 
ever any  such  facts  shall  come  to  the  knowledge  of  the  conductor  or  the  person  in 
charge  of  any  such  train,  as  shall  lead  him  to  suppose  that  any  person  on  his  train 
is  attacked  with  small-pox,  or  is  infected  with  the  disease,  it  shall  be  his  duty, 
before  he  shall  have  reached  a  point  within  five  miles  of  the  city  limits,  to  telegraph 
such  fact  to  the  mayor  or  commissioner  of  health,  and  whenever  it  shall  be  impossi- 
ble to  send  such  telegram,  said  conductor,  or  person  having  such  train  in  charge, 
and  having  a  person  on  board  so  suspected  by  him  of  having  the  small-pox  or  other 
contagious  or  infectious  disease,  shall  detain  such  person  on  the  train  on  reaching 
Omaha  until  he  shall  have  notified  the  mayor  or  commissioner  of  health,  or  some 
officer  of  the  health  department  thereof  of  such  fact,  and  until  a  reasonable  time 
shall  have  elapsed  after  such  notice  for  the  health  department  of  the  city  to  take 
charge  of  such  person.11 

2  Fitchburg,  Report  of  Board  of  Health  (1897),  p.  32. 


COMMUNICABLE   DISEASES.  433 

cities  to  supply  the  public  school  teachers  with  cards  similar  to  those 
furnished  physicians  to  report  to  the  health  department  any  suspicious 
eases  of  communicable  disease  that  they  may  hear  of.  These  cases  are 
then  investigated  by  the  inspector.  In  Iowa1  a  rule  requiring  reports 
from  teachers  has  recently  been  adopted. 

Teachers  are  also  required  to  report  in  Cincinnati,2  Minneapolis,3 
Omaha,4  New  Orleans,5  and  the  City  of  New  York,6  and  in  the  latter 
city  the  rule  is  made  applicable  to  teachers  in  private  schools,  night 
schools  and  Sunday  schools.  Boston  improved  upon  this  plan  by  estab- 
lishing in  1894  a  daily  medical  inspection  of  schools.  This  will  be 
more  fully  considered  in  another  connection,  and  it  is  sufficient  here  to 
state  that  many  cases  of  communicable  disease  are  thus  found  and 
isolated,  which  would  otherwise  have  mingled  freely  with  the  other 
pupils,  and  doubtless  often  served  as  the  starting  point  of  outbreaks. 

In  most  instances  the  physician  or  other  person  is  to  report  cases 
occurring  in  the  city,  township,  county,  or  other  sanitary  district  to 
which  the  law  applies,  but  in  St.  Louis  cases  within  twelve  miles  of 
the  city,  in  Omaha  within  three  miles,  and  in  Memphis  within  one  mile, 
are  to  be  reported. 

Officer*  to  whom  Report   is  Made. 

In  almost  all  cases  the  reports  an-  to  be  made  to  the  health  authori- 
though  iii  some  of  the  older  laws  it  is  otherwise.  Thus  in  Rhode 
Island  the  report  is  to  the  "  town  council,"  in  Iowa  to  the  " mayor  01 
township  clerk."  in  (Georgia  and  Florida  (where  there  are  no  local  boards 
of  health)  to  the  mayor  or  county  commissioner,  and  also  to  the  state 
board  <>!'  health  in  Florida,  and  in  Mississippi  and  New  Orleans  reports 
are  to  be  made  to  the  state  board  of  health,  in  Pennsylvania  and  Ten- 
eessee  to  the   health   authorities,   in    Alabama,  Colorado,  Connecticut, 

Florida,  Maine,  Michigan,  North  Carolina,  and    Vevi it    to  the  health 

officer,  but  in  most  of  the  laws  the  report  is  to  be  made  to  the  board  of 
health.     In    Brooklyn  reports  were  to  be  made  to  the   inspectors  of  the 

district   where  the  case  resided. 


i  Iowa,  Kules  of  the  State  Board  of  Health,  Feb.  24,  1899,  Rule  I: 
"Every  school  teacher  who  discovers  among  his  or  her  pupils  a  case  of  these 
Contagious  diseases,  must    immediately  reporl    the  fact    to  the  mayor  or  township 

elerk,  ;in  i! ase  may  be;  als...  to  the  superintendent  or  principal  of  the  school,  and 

t"  the  parents  of  the  children,  and  must  scud  the  pupils  thus  afflicted  m  their  homes 
at  once.'1 

Cincinnati,  Manual  of  Health  Department  (1898),  Sec.  89. 
Se<    p.  131. 
'Omaha,  Rules  and  Regulations  ol  Board  of  Health  (1892),  Sec.  13. 
See  p.  131. 
\.  w  Vork,  Rules  oi  the  Board  of  Education  (1899)    S< 


434  COMMUNICABLE    DISEASES. 

How  Made. 

Often  no  reference  is  made  to  the  manner  in  which  the  report  shall  be 
sent.  In  a  good  many  regulations,  however,  it  is  required  that  it  be 
in  writing,  as  in  Connecticut,  Maryland,  Massachusetts,  Michigan,  Min- 
nesota, New  Jersey,  and  North  Dakota.  In  Maine  the  "  notice  shall  be 
given  either  at  the  office  of  the  health  officer  or  by  a  communication 
addressed  to  him  and  duly  mailed  within  the  time  specified  " ;  in  New 
Hampshire  it  "  shall  be  given  verbally  to  one  of  the  health  officers,"  or 
else  mailed.  In  Washington  "  the  notices  required  may  be  sent  by 
mail  or  except  in  the  case  of  cities,  may  be  given  to  or  left  at  the 
residence  of  any  member  of  the  board  of  health." 

The  writer  has  seen  no  reference  in  the  rules  to  the  use  of  the  tele- 
phone as  a  means  of  reporting  cases  of  contagious  disease,  but  it  is 
often  used.  In  Providence  physicians  are  requested  to  use  the  telephone 
when  they  can  conveniently  do  so,  and  more  than  half  the  reports  are 
received  in  that  way,  and  much  time  is  thereby  gained.  This  practice 
in  that  city  is  steadily  increasing.  The  report  as  received  is  at  once 
recorded  on  a  blank  form  like  that  used  for  mail  reports  and  the  hour 
of  reception  and  name  of  receiver  noted.  In  Buffalo,  where  the  tariff 
for  telephone  use  is  so  much  per  message,  the  health  department  pays 
the  cost  of  the  message.  In  Newark  the  use  of  the  telephone  is  dis- 
couraged, partly  because  as  a  payment  of  ten  cents  is  made  for  each 
return  a  written  report  is  desirable  as  evidence,  and  second  because  it  is 
claimed  that  there  is  greater  liability  to  error  in  the  use  of  the  telephone  ; 
but  the  experience  of  Providence  shows  that  as  many  mistakes  are  made 
in  writen  as  in  telephonic  reports. 

Time  for  Making  Reports. 

It  is  desirable  to  have  reports  of  communicable  diseases  made  as 
promptly  as  possible,  hence  in  Maryland,  Massachusetts,  Michigan,  New 
Hampshire,  Rhode  Island,  and  Washington  they  must  be  made  "  im- 
mediately "  or  "  at  once."  In  Texas  the  time  is  six  hours,  in  Con- 
necticut, Ohio,  Paterson,  and  St.  Louis  it  is  twelve  hours,  and  in  Iowa, 
Kentucky,  Maine,  Minnesota,  North  Carolina,  North  Dakota,  and  Wis- 
consin, twenty-four  hours.  In  New  York  City1  and  in  several  cities 
which  copy  from  it,  boarding-house  keepers  shall  within  six  hours  notify 
the  health  department,  if  a  seafaring  man  has  been  taken  sick  at  their 
house. 

The  following  rule  is  found  in  Reading  and  some  other  Pennsyl- 
vania cities2  and  in  Wilmington,  Del. : 

' '  Such  report  shall  be  made  within  six  hours  after  knowledge  of  such  case  or 
cases  occurring  between  six  o'clock  a.  m.  and  six  o'clock  p.  m.,  or  within  eighteen 

1  New  York,  Sanitary  Code  (1899),  Sec.  150. 

2  Reading,  Rules  and  regulations,  Board  of  Health  (1896),  Sec.  7. 


COMMUNICABLE   DISEASES.  435 

hours,  if  knowledge  of  such  case  be   received  between  six  o'clock  p.  m.  and  six 
o'clock  a.  in. 

In  Bradford,  Pa.,1  the  report  is  to  be  made  in  three  hours,  or  if  after 
six  P.  m.  before  nine  o'clock  the  next  morning.  In  Camden  and  Pater- 
son  deaths  from  communicable  disease  are  to  be  reported  in  three  hours 
and  six  hours  respectively,  while  cases  are  to  be  reported  in  twenty-four 
hours  and  twelve  hours.  In  Washington  the  physician  is  liable  to  a 
penalty  only  after  the  lapse  of  forty-eight  hours.  In  San  Antonio2 
boxes  of  printed  cards  for  the  report  of  communicable  diseases  are  left 
at  various  drug  stores  and  collections  are  made  from  these  stores  twice 
each  day  by  the  police. 

Most  of  the  state  laws  require  physicians  and  others  to  report  cases 
of  communicable  diseases  of  which  they  maj^  "  know."  This  is  true  of 
the  laws  in  Indiana,  Michigan,  Minnesota,  North  Carolina,  Pennsylvania, 
South  Dakota,  Vermont,  and  Washington.  In  Michigan  and  Minnesota 
they  are  to  report  cases  of  which  they  are  "informed"  or  "which  they 
hear  of."  A  more  important  provision  is  found  in  Florida,  Indiana, 
New  Hampshire,  Oklahoma,  Rhode .  Island,  and  South  Dakota,  namely, 
that  "suspected"  cases  shall  be  reported.  A  physician  or  other  person 
is  not  to  wait  until  fully  satisfied  as  to  the  diagnosis,  but  is  to  report 
tin-  cases  as  soon  as  suspicion  arises  that  it  may  belong  to  the  list  re- 
quiring notification,  if  it  is  desired  to  restrain  persons  who  have  the 
virns  of  the  disease  in  their  person  chough  they  may  not  be  sick,  it  is 
necessary  that  all  communicable  disease  laws  should  specifically  mention 
"infected  "'  as  well  as  -sick'*  persons,  but  this  as  yet  has  not  often  been 
done. 

The  following  definition  is  Erom  the  District  of  <  lolurabia  ::;  "  -A  case 
oi  contagious  disease'  shall  be  held  to  mean  any  person  suffering  from 
jury  such  disease.  Any  person  shall  be  held  to  be  suffering  from  a  con- 
tagious disease  who  is  so  infected  h\  such  disease  as  to  be  capable  of 
transmitting  it  toothers.  The  presence  of  the  ordinary  clinical  sym- 
totns  of  any  contagious  disease  shall  be  prima  facie  evidence  that  such 

ease  is  01'  was  such  a  disease:    and   the  presence  in  such  ease  of  the  spe- 
cific bacteria  of  such  disease  shall   he  conclusive  e\  ideiice  that   such  case 

is  or  was  such  disease." 

In  a  lew  cities,  as  Albany,4  report  isto  be  made  of  any  persons  "ex- 
posed to  such  contagious  disease."  I'snalh  the  statutes  and  regula- 
tions require  the  report  of  every  case  of  communicable  disease,  and  the 
Minneapolis  rules  specif}  thai  not   onlj  the  first,  but  subsequent  cases 

Bradford,  Rules  of  Board  of  Bealth,  Sec.  72. 

mi  Antonio,  Report  of  Department  of  Health,  1898,  p.  18. 
The  District  of  Columbia,  A.t  of  Congress,  S  March,  1897,  Sec.  L. 
1  Albam .  Rules  and  Regulations,  Board  of  Health,  1892,  Sec.  2. 


436  COMMUNICABLE   DISEASES. 

in  a  family  shall  be  reported.  In  Providence  where  the  medical 
inspector  maintains  supervision  of  the  family,  the  rule  in  regard  to  re- 
quiring reports  from  physicians  of  secondary  cases  is  not  enforced,  and. 
little  inconvenience  results.  In  some  cities  physicians  are  required  to 
report  to  the  health  department  when  the  patient  has  recovered.  In 
Mobile  also  in  cases  of  yellow  fever  a  daily  report  is  required  from  the 
physician. 

Diseases  to  be  Reported. 

In  most  regulations  the  diseases  to  be  reported  are  specifically 
named,  but  always  there  is  an  additional  requirement  that  communicable 
diseases  in  general  shall  be  reported.  This  broad  provision  is  variously 
worded.  Thus  "  pestilential  or  infectious  "  diseases  are  to  be  reported 
in  Alabama ;  diseases  "  dangerous  "  or  "  dangerous  to  the  public  health  " 
in  Colorado,  Massachusetts,  Michigan,  Wisconsin,  and  Vermont ;  "  con- 
tagious or  infectious  diseases  "  in  Connecticut,  Massachusetts,  Maryland, 
New  Jersey,  Rhode  Island,  and  South  Carolina ;  "  contagious  diseases  "  in 
Indiana,  Minnesota,  Vermont,  and  Wisconsin  ;  "  epidemic  diseases  "  in 
Kentucky  ;  "  virulent  contagious  diseases  "  in  Mississippi ;  and  the  dis- 
eases named  by  the  state  board  of  health  in  New  Jersey,  Ohio,  and 
Washington,  and  "  communicable  diseases  "  in  New  Jersey  and  Ten- 
nessee. In  West  Virginia  "  epidemic  "  diseases  are  to  be  reported.  In 
Connecticut  and  Tennessee  "  venereal  diseases  "  are  excepted  from  the 
contagious  diseases  to  be  reported.  In  St.  Louis  "  malignant "  diseases 
are  included  in  the  rule. 

Besides  the  requirement  as  to  the  class  of  diseases  to  be  reported, 
most  laws  specifically  mention  the  diseases  which  it  is  intended  shall  be 
covered  by  the  law.  Usually  the  local  health  authorities  insist  upon 
the  report  of  such  diseases  as  are  specifically  named  and  ignore  the 
requirement  of  the  law  as  to  other  communicable  diseases.  If  circum- 
stances require  the  report  of  another  disease  not  specifically  mentioned, 
or  of  a  new  disease,  the  health  authorities  usually  give  ample  notice  that 
such  disease  is  to  be  reported  before  any  action  is  taken  against  a  per- 
son for  failure  to  report.  In  a  few  states,  as  Alabama  and  South  Caro- 
lina, no  diseases  are  mentioned  by  name.  The  following  are  the  diseases 
that  are  usually  specifically  named  as  coming  under  the  notification  law 
in  American  states  and  cities: 

Smallpox.  Nearly  every  notification  law  specifically  mentions  small- 
pox as  a  disease  to  be  reported,  and  the  laws  of  Rhode  Island  :  and 
Georgia2  mention  no  other. 


1  Rhode  Island,  General  Statutes  (1896),  Chapter  94,  Sec.  13. 

2  Georgia,  Code  (1882),  Sec.  1386. 


( ' OMMUNIt  1ABL E   J)ISE\  1  8 ES.  4 :) 7 

Cholera.  Nearly  as  many  states  mention  this  disease  as  smallpox, 
Maryland,'  Massachusetts.  Minnesota,  and  North  Carolina  being  the 
exceptions. 

Scarlet  Fever  is  named  in  the  following  state  laws,  viz. :  those  of 
Colorado,  Connecticut,  Indiana,  Iowa,  Kentucky.  Maine,  Maryland' 
Massachusetts.  Michigan,  Minnesota.  Mississippi,  New  Hampshire,  New 
Jersey.  North  Carolina,  Ohio,  Pennsylvania,  South  Dakota.  Washing- 
ton. West  Virginia,  and  Wisconsin. 

Diphtheria  is  mentioned  in  same  states  as  scarlet  fever. 

<',-<>ii/,  <>,-  Membranous  <'rmij)  is  to  be  reported  by  the  laws  of  Con- 
necticut. Indiana,  Iowa,  Maine,  Maryland,  New  Hampshire,  New  Jersey, 
and  Pennsylvania. 

The  recognition  of  the  fact  that  a  large  proportion  if  not  all  cases  of 
membranous  croup  are  really  diphtheria  is  somewhat  recent,  and  as  city 
councils  or  hoards  of  health  are  usually  less  conservative  than  state 
legislatures,  it  is  not  surprising  that  a  number  of  cities  require  the 
report  <>i  croup,  although  it  is  not  required  by  their  state  law.  This  is 
true  of  Albany.  Boston,  Brookline,  Mass.,  Cambridge,  Chicago,  Cin- 
cinnati, Cleveland.  Fitchburg,  Grand  Rapids,  Haverhill,  Holyoke, 
Kansas  City,  Lowell.  Lynn,  Macon,  Memphis,  Minneapolis,  Newburg, 
New  Bedford,  Newport,  R.  I.,  New  York  City.  Omaha,  Providence, 
Salem.  St.  Louis,  Seattle.  Spokane,  Springfield,  Mass.,  Wilmington,  and 
Xoungstown,  O.  It  was  formerly  reported  in  Newton,  Mass.,  but  is  not 
now,  owing  to  the  objections  of  physicians. 

Sore  Throat.  Since  it  lias  been  demonstrated  that  diphtheria  is  due 
to  the  diphtheria  bacillus,  it  has  been  (dear  that  many  cases  of  appar- 
ently benign  sore  throat  are  really  diphtheria  and  are  not  only  danger- 
ous to  the  patients  themselves  but  to  the  public  The  advantage  of 
having  all  cases  of  sore  throat  submitted  to  bacteriological  examination. 
M  is  done  l>\  the  best  educated  pi i \ sieiai is  is  manifest.  In  Providence 
the  attempt  was  made  to  require  the  report   of  sore  throats,  but  at   the 

parnesl    solicitation    of    the    medical    profession    it    was    abandoned.      In 
Spokane  the  rule  given  below    has  been  adopted.1 


1  Spokane,  Ordinances,  Number  A.  661,  2  October,  L896,  Sec.  1 : 
I  hat  whenever  any  person  shall  know  of  the  existence  of  any  diphtheria]  symp- 
toms, and  whenever  an;  guardian,  parent  or  person  who  has  charge  ol  any  child, 
children  or  other  person,  and  such  child,  children  or  other  person  shall  show  indica- 
tions of  sore  throat  or  other  diphtherial  symptoms,  such  guardian,  parent  or  person 
having  the  charge  or  control  "I  any  child,  children  or  other  person  shall  immediately 
report  the  same  u>  the  health  officer  or  :>  member  of  the  board  of  health  of  the  City 
of  Spokane;  and  anj  guardian,  parent  or  other  person  having  charge  of  any  child, 
children  or  person,  either  temporarily  or  permanently,  \\h«.  shall  fail,  refuse  or 
neglect  to  comply  with  the  provisions  of  this  ordinance,  or  shall  fail,  refuse  or  neglect 


438  COMMUNICABLE   DISEASES. 

It  was  also  ordained  at  the  same  time  that  the  board  of  health  should 
investigate  such  cases,  but  that  section  was  repealed. 

Yellow  Fever  is  named  in  the  following  state  laws :  Connecticut, 
Florida,  Indiana,  Kentucky,  Mississippi,  New  Hampshire,  New  Jersey, 
North  Carolina,  Ohio,  Tennessee,  and  Vermont. 

Typhus  Fever  has  not  been  very  common  of  late  years,  although  it 
is  serious  enough  when  it  does  occur.     It  is  to  be  reported  in  Connec-, 
ticut,  Maryland,  Indiana,  Maine,  New  Hampshire,  New  Jersey,  North 
Carolina,  Ohio,  and  Vermont. 

Typhoid  Fever  is  required  in  physicians'  reports  in  only  a  few  states, 
viz. :  Connecticut,  Iowa,  Maine,  Maryland,  New  Hampshire,  New  Jer- 
sey, and  Ohio.  The  reason  for  this  probably  is  that  stringent  methods 
of  isolation  or  disinfection  are  not  usually  adopted  in  these  cases.  The 
chief  value  of  the  reports  of  typhoid  is  that  they  often  enable  the  sani- 
tary officers  to  discover  in  the  milk  or  water  supply  the  source  of  an 
outbreak  and  thus  to  check  its  spread.  Such  work,  however,  is  much 
more  often  possible  and  necessary  in  cities  than  in  the  country,  so  that 
most  cities  have  thought  it  wise  to  require  reports  of  typhoid.  Typhoid 
is  not  reported  in  the  District  of  Columbia,  Dayton,  Jersey  City,  Mem- 
phis, Omaha,  St.  Paul,  Terre  Haute,  and  Toledo. 

Measles  is  to  be  reported  in  Indiana,  Iowa,  Maryland,  New  Hamp- 
shire, Ohio,  South  Dakota,  Utah,  and  in  the  following  cities :  Chicago, 
Indianapolis,  Kansas  City,  New  Bedford,  Newburgh,  New  Haven,  New- 
port, Newton,  New  York,  Omaha,  Portland,  Me.,  Portland,  Ore.,  Raleigh, 
Rochester,  St.  Louis,  San  Antonio,  San  Francisco,  Savannah,  Scranton, 
Seattle,  Spokane,  Syracuse,  Terre  Haute,  Toledo,  Utica,  Worcester, 
Yonkers,  and  Youngstown. 

Whooping  Cough  is  to  be  reported  by  the  laws  of  Iowa,  Maine, 
Maryland,  and  Utah,  and  in  the  following  cities  :  Chicago,  Cincinnati, 
Cleveland,  Columbus,  Grand  Rapids,  Haverhill,  Minneapolis,  Mobile, 
New  Bedford,  Portland,  Raleigh,  St.  Louis,  San  Antonio,  Scranton, 
Seattle,  Spokane,  Toledo,  and  Youngstown. 

Phthisis  or  Consumption.  Much  discussion  has  arisen  as  to  the  • 
advisability  of  requiring  reports  of  this  disease  and  physicians  have  not 
very  generally  approved  of  it.  Nevertheless  it  is  required  in  Maine, 
Michigan,  and  a  considerable  number  of  cities.  Among  these  are 
Alameda,  CaL,  Asbury  Park,  Boston,  Buffalo,  Cincinnati,  New  York 
City,  Salt  Lake  City,  Trenton,  and  Yonkers. 

In  Washington,  Asbury  Park,  Minneapolis,  San  Francisco,  and 
Syracuse,  "  tuberculosis  "  is  to  be  reported. 

to  comply  with  all  the  orders  of  the  health  officer  or  physicians  appointed  by  him  or 
the  board  of  health,  shall  be  punishable  by  a  line  not  exceeding  one  hundred  dol- 
lars." 


COMMUNICABLE    DISEASES.  439 

The  rule  in  regard  to  reporting  consumption  in  New  York  City  is 
given  below.1 

Cerebrospinal  Meningitis  is  to  be  reported  in  Indiada,  Pennsyl- 
vania, Buffalo,  Evansville,  Fitchburg,  Holyoke,  Mass.,  Jerse}*  City, 
Lynn,  Michigan,  Minneapolis,  Xew  York  City,  Portland,  Me.,  Raleigh, 
Rochester,  St.  Louis,  San  Antonio,  Spokane,  Utica,  and  Yonkers. 

Chicken  Pox  is  to  be  reported  in  Albany,  Baltimore,  Cincinnati, 
Grand  Rapids,  New  York,  Raleigh,  and  St.  Louis.  In  Boston,  during 
outbreaks  of  smallpox,  the  board  of  health  requires  reports  of  chicken 
pox,  and  probably  under  such  circumstances  it  is  required  in  other 
cities. 

Lepras//  is  to  be  reported  in  California,  Connecticut,  Iowa,  Maine, 
New  Jersey,  North  Carolina,  and  Pennsylvania. 

Hydrophobia  in  animals  is  considered  in  connection  with  diseases 
of  animals.  ^Yhen  it  occurs  in  man,  it  is  to  be  reported  in  Ohio  and  in 
Scran ton. 

Erysipelas  is  to  be  reported  in  Detroit,  New  York  City,  Portland, 
Ore.,  Rochester,  and  St.  Louis,  and  "epidemic  erysipelas  "  in  Ohio. 

Mumps  is  to  be  reported  in  Maryland,  Grand  Rapids,  and   Raleigh. 

Puerperal  Fever  is  to  be  reported  in  Iowa,  Ohio,  Chicago,  Grand 
Rapids,  Raleigh,  Rochester,  St.  Louis,  and  Utica. 

Relapsing  Fever  is  to  be  reported  in  Pennsylvania,  Buffalo,  Roches- 
ter, (Jtica,  and  Yonkers. 

Dysentery  in  ••  epidemic  "  form  is  to  be  reported  in  Ohio.  It  is  also 
reported  in  Scranton. 

Grerman  Measles  is  to  be  reported  in  Seattle. 

Trichinosis  is  to  be  reported  in  New  Jersey  and  North  Carolina. 

Plague  is  to  be  reported  in  District  of  Columbia  and  New  Jersey. 


1  The  City  of  New   York,  Sanitary  Code  1899,  Sec.  153: 

■  That  pulmonary  tuberculosis  is  hereby  declared  to  be  an  infectious  and  com- 
municable disease,  dangerous  to  the  public  health.  It  shall  be  the  duly  of  every 
physician  in  i  his  city  to  report  to  the  Sanitary  Bureau  in  writ  ing  t  he  name,  age,  sex, 
Occupation  and  address  of  every  person  having  such  disease  who  has  been  attended 
by  or  who  has  come  under  the  observation  of  such  physician  for  the  first  time. 
within  one  week  of  such  time.  It  shall  also  be  the  duty  of  the  commissioners  or 
managers,  or  tin'  principal,  superintendent  or  physician  of  each  and  every  public  or 
private  institution  or  dispensary  in  tins  city  to  report  to  the  Sanitarj  Bureau  in 
writing,  or  to  cause  such  report  to  be  made  i>\  some  proper  and  competent  person, 
•the  name,  age,  sex,  occupation  ami  last  address  of  everj    person  afflicted  with  this 

disease  who  is  in  their  care  or  who  has  COU16  under  their  observation  within  one 
Week  o|  such  time.  It  shall  he  the  duty  of  every  person  sick  with  this  disease  and 
of    every    person    in    attendance    upon    anyone    sick     with    this    disease,    ami    of    the 

authorities  of  public  and  private  institutions  or  dispensaries,  to  observe  ami  enforce 
all  the  sanitary    rules  and    regulations  of  the  board  of  health  for   preventing  the 

spread  of  pulmonary   tllben  ulosis. " 


440  COMMUNICABLE    DISEASES. 

Pneumonia  is  to  be  reported  in  Hartford. 

Glanders  is  to  be  reported  in  Detroit,  District  of  Columbia,  and 
Scranton. 

Malaria  is  to  be  reported  in  Oakland,  Cal. 

Form  of  Report.     Very  many  of  the  statutes  prescribe  the  items 

which  shall  be  given  when  reports  of  a  case  of  communicable  disease  are 

sent  to  the  health  department.     In  Pennsylvania  l  the  physician  shall 

"  Forthwith  make  report  in  writing  or  upon  blanks  to  be  furnished  for  that 
purpose,  to  the  health  authorities  of  the  municipality  in  which  said  person  may  be 
located,  which  said  report  shall,  over  his  or  her  own  signature,  state  the  name  of 
the  disease  and  the  name,  age  and  sex  of  the  person  suffering  therefrom,  and 
shall  also  set  forth  by  street  and  number,  or  otherwise  sufficiently  designate  the 
house,  room  or  other  place  in  which  said  person  may  be  located,  together  with 
such  other  information  relating  thereto  as  may  be  deemed  important  by  said  health 
authorities." 

As  in  the  above  Pennsylvania  law,  provisions  are  found  in  other 
statutes  and  local  regulations  that  blank  forms  for  reports  shall  be  fur- 
nished by  the  health  authorities.  Whether  or  not  this  is  specified  in 
the  laws,  it  is  the  general  custom.  In  Newark,  however,  since  a  fee 
has  been  paid  for  returns,  blanks  are  not  furnished,  but  this  is  not 
approved  of  by  the  health  department.  These  blanks  are  distributed  to 
physicians  and  others  by  the  local  health  authorities  and  are  usually 
furnished  by  them,  but  sometimes,  as  in  Vermont  and  South  Dakota, 
they  are  furnished  by  the  state  board  of  health.  Generally  the  blanks 
are  in  the  form  of  a  postal  card  with  the  address  printed  on  the  face. 
Sometimes,  as  in  Mobile  and  Philadelphia,  a  letter  sheet  is  used.  Ex- 
amples of  forms  are  shown  in  Appendices  51-6.  It  will  be  seen  from 
these  that  the  number  of  items  varies  considerably.  It  is  probable  that 
the  fewer  blanks  the  physician  has  to  fill,  the  more  prompt  and  com- 
plete will  be  the  returns. 

Sometimes  cities  furnish  unstamped  cards  or  plain  sheets  for  these 
reports  in  order  that  they  may  be  mailed  in  an  envelope.  This  is  some- 
times done  at  the  request  of  physicians  who  do  not  wish  a  chance 
reader  to  be  informed  of  the  case.  When  stamped  return  letter  sheets 
were  furnished  by  the  post  office  department  they  were  used  for  reports 
in  Albany.  In  some  cities,  as  Milwaukee  and  Savannah,  the  blanks  are 
furnished  in  pad  form  with  a  stub  which  may  be  filed  and  kept  by  the 
physician  as  a  memorandum.  Occasionally,  as  shown  in  the  appendix, 
special  forms  are  used  for  special  diseases. 

Payment  for  Reports.  This  is  rarely  made  and  there  are  judicial 
decisions  which    show  that  it  is  not  necessary.2     Nevertheless  it  has 


1  Pennsylvania,  Chapter  124  of  1895,  Sec.  1. 

2  Connecticut  Supreme  Court,  1  December,  1887.     State  vs.  Nathaniel  E.  Wordin. 


COMMUNICABLE   DISEASES.  441 

been  considered  advisable  by  some  states  and  cities  to  make  a  small  pay- 
ment for  such  reports.  Michigan  and  New  Jersey  have  such  provision 
in  their  laws  and  the  amount  in  each  is  ten  cents  for  every  report.  In 
Newton,  Mass..  the  same  fee  is  paid. 

False  Reports.  Great  injury  might  be  done  by  the  false  report  of  a 
communicable  disease  but  no  penalty  for  such  has  been  noted;  the  fol- 
lowing from  Reading1  might  be  applied: 

••  No  physician  shall  intentionally,  in  his  reports  to  the  Board,  exaggerate  the 
number  of  cases  of  contagious  disease  under  his  care.11 

False  rumors  are  forbidden  by  the  Florida  statute  :2 

••  Any  person  or  persons  who  shall  falsely  or  maliciously  disseminate  or  spread 
rumors  or  reports  concerning  the  existence  of  any  infectious  or  contagious  disease, 
shall  be  guilty  of  a  misdemeanor,  and  upon  conviction  thereof,  shall  be  punished  as 
provided  by  section  765. 

Reports  to  the  State  Board  of  Health.  Besides  the  states  of  Flor- 
ida aod  Mississippi  which  require  reports  direct  to  the  state  board  of 
health,  a  number  of  states  require  reports  of  communicable  diseases 
fn nu  local  boards  to  the  state  board.3  Other  states  than  these  secure 
such  reports  either  by  voluntary  action  of  the  local  boards  or  because 
the  general  reports  which  local  boards  are  required  to  make  include 
returns  of  communicable  diseases.  In  some  cases  reports  are  to  be 
made  by  telegraph.  In  Wisconsin  the  health  officer  may  use  the  mail  or 
telegraph  as  he  sees  fit.  In  Vermont  reports  of  cholera,  smallpox, 
typhus  and  yellow  fever  are  to  be  telegraphed.  In  Massachusetts  cases 
of  smallpox  arc  to  be  reported  to  the  state  board  in  twenty-four  hours. 
In  Washington  smallpox,  cholera,  yellow  fever  and  typhus  are  to  be 
reported  in  three  days.  In  Illinois  the  first  case  of  smallpox,  typhoid 
fever,  cholera  or  yellow  fever,shall  be  promptly  reported  to  the  state 
board  and  the  prevalence  and  progress  of   any  epidemic  disease  shall  be 

promptly  reported.     In   Tennessee    Michigan,  and  New  Hampshire  the 

first  case  of  an  outbreak  is  to  be  promptly  reported,  and  in  New 
Hampshire  and  Michigan  its  subsequent  progress  is  to  be  reported 
weekly.  The  tonus  used  in  New  Hampshire  arc  shown  in  Appendices 
57  58. 

In  New  Jersey  weekly  reports  are  required.     These  are  on  cards  and 

arc  filed  alphabetically,  and  al80  recorded  by  tall)  in  a  large  book  so 
that  the  state  board  of  health  can  easily  keep  informed  of  the  amount  of 
communicable  disease  in  all  parts  of   the  state.     In  (' ecticut,  South 

1  Reading,  Rules  and  Regulations  of  the  Board  of  Bealth,  Sec.  8. 

1  Florida,  Revised  Statutes  (1892),  Sec.  766. 

Connecticut,    Illinois,    Kentucky,    Maine,  Maryland,  Massachusetts,   Michigan, 
New    Hampshire,   Ne^i   Jersey,   North  Carolina,  Ohio,   South  Dakoto,  Tenni 
Washington,  West  Virginia,  New  5Tork,  Wisconsin  and  Vermont. 


442  COMMUNICABLE   DISEASES. 

Dakota  and  New  York  monthly,  and  in  Kentucky  and  West  Virginia, 
quarterly  reports  are  made.  In  New  York  reports  of  phthisis  are  to  be 
made  annually. 

In  Vermont  health  officers  receive  fifteen  cents  for  each  case  of  com- 
municable disease  reported  to  the  state  board  of  health  and  in  New 
York  twenty  cents  except  for  phthisis  for  which  the  fee  is  ten  cents. 

In  Vermont  when  a  case  of  communicable  disease  is  brought  in  from 
another  town  in  the  state  the  health  officer  is  to  notify  that  town.1 

In  Michigan  a  very  full  report  must  be  sent  by  the  local  health 
officer  to  the  state  board  of  health  after  every  outbreak  of  communicable 
disease. 

Penalty.  Usually  quite  severe  penalties  are  prescribed  for  failure 
to  report  communicable  diseases.  From  twenty-five  dollars  to  one  hun- 
dred dollars  are  common  maxima  for  fines,  but  it  is  two  hundred  dollars 
in  Massachusetts  and  Michigan  and  one  thousand  dollars  in  Florida. 
In  Florida  the  delinquent  may  be  imprisoned  thirty  days  and  in  Michi- 
gan ninety  days. 

Placard*.  In  most  communities  the  first  step  to  be  taken  to  con- 
trol the  spread  of  communicable  diseases  is  to  put  a  placard  or  sign 
upon  the  infected  premises  to  notify  the  public  of  the  presence  of  the 
disease.  Signs  have  been  used  for  this  purpose  for  many  years  in 
smallpox  and  perhaps  other  serious  diseases ;  but  it  is  only  within  late 
years  that  the  custom  has  been  followed  in  such  diseases  as  scarlet 
fever,  diphtheria  and  measles.  At  present  placarding  is  a  very  general 
procedure  throughout  the  United  States.2 

1  Vermont  State  Board  of  Health  Rules: 

"Article  3.  Whenever  smallpox,  cholera,  yellow  fever,  diphtheria,  scarlet 
fever  or  typhoid  fever  appears  in  any  town  or  city,  the  health  officer  of  such  town  or 
city,  shall  personally  investigate  the  origin  of  the  disease.  In  case  he  shall  find  evi- 
dence that  the  disease  was  imported  to  his  town  or  city  from  some  other  town  or 
city  in  this  state,  he  shall  immediately  notify  the  health  officer  of  such  other  town 
or  city  giving  him  his  reasons  for  suspecting  the  disease  was  brought  from  such 
other  town  or  city." 

2  The  following  states  provide  by  statute  or  regulation  of  their  state  board  of 
health  for  the  placarding  of  infected  premises:  Colorado,  Iowa,  Indiana,  Louisiana, 
Michigan,  Minnesota,  North  Carolina,  Oklahoma,  New  Hampshire,  Ohio,  South 
Dakota,  North  Dakota,  Utah,  Vermont,  Wisconsin,  and  in  Maine  and  South  Caro- 
lina the  board  of  health  may  placard.  Outside  of  the  above  ftates  the  following 
important  cities  make  use  of  placards  or  other  warning  signs:  Bridgeport,  Boston, 
Fall  River,  Lowell,  Newbury,  New  Haven,  Newport,  R.  L,  Providence,  Newton, 
Mass.,  Omaha,  Portland,  Me.,  Rochester,  Somerville,  Spokane,  Springfield,  Mass., 
St.  Louis,  Charleston,  Milwaukee,  Taunton,  Cambridge,  Fitchburg,  Haverhill, 
Lynn,  Macon,  Memphis,  Mobile,  Salt  Lake  City,  San  Francisco,  Worcester,  District 
of  Columbia,  Yonkers,  Seattle,  Kansas  City,  Sacramento,  Norwich,  Conn.,  Buffalo, 
Newark,  New  Bedford,  New  Orleans,  Florence,  S.  C,  Knoxville,  Baltimore,  Cam- 
den, Jersey  City,  Lawrence,  Louisville,  Paterson,  Pawtucket,  R.  I  ,  Portland,  Ore., 
San  Antonio,  St.  Joseph,  Mo.,  Pittsburgh,  Allegheny,   Reading,  Scranton  and  Troy. 


COMMUNICABLE   DISEASES.  443 

A  great  many  smaller  places  of  which  the  writer  has  knowledge 
also  use  placards.  The  only  cities  which  he  has  visited,  or  with  which 
he  has  corresponded,  which  do  not  placard  at  all  are  Hartford,  Rich- 
mond. Wheeling,  Wilmington,  Del.,  and  Augusta,  (la.  In  Xew  Haven 
however,  the  health  officer  informed  the  writer  that  he  did  not  consider 
the  practice  a  good  one  and  in  Philadelphia  many  of  the  medical  pro- 
fession are  strongly  opposed  to  it.  On  the  other  hand  it  is  the  ex- 
perience of  the  writer  that  nothing  which  is  so  little  trouble  to  the 
health  department  and  causes  so  little  hardship  to  the  family  is  pro- 
ductive of  such  good  results. 

In  Richmond  placards  were  formerly  used,  but  are  not  now.  In 
New  York  City  placards  are  used  only  on  stores  and  tenement  houses. 
In  Chicago  it  is  at  the  option  of  the  attending  physician  whether  houses 
are  placarded  or  not;  it  is  not  done  if  he  assumes  the  responsibility  of 
isolation.  In  Mobile  notices  are  used  only  for  smallpox.  In  Atlanta, 
according  to  the  rule,  scarlet  fever  is  placarded  only  where  there  is 
absence  of  isolation.  In  Philadelphia1  the  rule  is  that  houses  are  not 
to  be  placarded  when  a  guard  has  been  placed  or  when  the  responsible 
head  of  a  family  guarantees  isolation. 

In  some  states,  as  in  New  Hampshire,  it  is  provided  that  all  com- 
municable diseases  |  which  require  notification)  shall  be  placarded.  This 
of  course  includes  typhoid,  but  it  is  probably  not  generally  done  in 
this  disease.  Indeed  there  is  no  reason  why  eases  should  be  so  desig- 
nated. 

Every  city  and  state   which    specifies  what   diseases   shall   be   thus 

_  nated.  names  smallpox,  scarlet  fever,  diphtheria,  and  croup  (if  re- 
ported). Cholera  is  named  in  Iowa.  New  Hampshire,  Indiana,  North 
Carolina,  Vermont,  and  South  Dakota,  and  St.  Louis,  Pittsburgh,  Mem- 
phis, and  Philadelphia.  Typhus  fever  is  named  in  Ohio,  New  Hamp- 
shire, North  Carolina,  Pittsburgh,   and    Philadelphia,   and   yellow    fever 

in    Louisiana,   North   Carolina,  Ohio,  Vein t.  Philadelphia   and  some 

southern  cities.  It  is  probable  that  besides  smallpox,  scarlel  fever, 
diphtheria  and  croup,  nearly  all  health  officers  would  placard  cholera, 
typhus  or  plague  or  else  put  a  guard  around  the  house  or  remove  it  to 
a  hospital.  The  public  in  an\  evenl  would  surelj  be  warned,  which  is 
one  of  the  purposes  of  the  placard. 

The  chief  contention  is  in  regard  t<>  measles.  Warning  signs  are 
perhaps  not  usually  employed  in  this  disease,  but  the}  arc  required  by 
the  laws  of  Iowa,  Michigan,  New  Hampshire,  Ohio,  and  Vermont,  ami 
an-  recommended  by  the  state  board  of  health  of  Maine,  ami  the\  are 
used   m    Bloomfield,  N.  J.,  Central   Palls,  lb   I..  Kansas  City,  Leomin- 

1  Philadelphia,  Rules  <.t  Board  ol  Health  1 1806),  Sec.  '.'::. 


444 


COMMUNICABLE   DlslJA  SE8. 


ster,  Mass.,  Lowell,  Macon,  Ga.,  Minneapolis,  Newton,  Mass.,  Norwich, 
Conn.,  Pawtucket,  R.  I.,  Pittsburgh,  Rhineland,  Wis.,  and  Rochester, 
but  most  if  not  all  of  the  other  cities  mentioned  on  page  442  do  not 
use  a  placard  for  this  disease. 

Mumps  are  placarded  in  Cleveland. 

( 'erebro-spinal  meningitis  is  placarded  in  Philadelphia  and  St.  Louis. 

Chicken  pox  is  placarded  in  Cincinnati,  and  in  Columbus,  ( ).,  but 
in  the  latter  city  the  card  merely  states  "  contagious  disease  within." 

Whooping  cough  is  to  be  placarded  in   Kansas  City  and  Michigan.1 

In  most  communities  it  is  the  duty  of  the  health  officer  or  other  ex- 
ecutive officer  to  place  the  warning  sign  upon  the  house  or  to  cause  it 
to  be  so  placed.  This  is  made  one  of  his  duties  in  most  of  the  statutes 
and  rules  as  in  that  of  Minnesota  given  below ;  but  in  South  Dakota 
"  the  county  board  of  health  shall  cause  the  attending  physician  to  see 
that  the  proper  cards  or  flags  of  warning  "  are  placed  on  the  house.  In 
Atlanta,  Bridgeport,  Grand  Rapids,  and  Newark  the  occupant  is  to  pla- 
card the  house. 

In  Wells  County,  Indiana,  when  there  is  doubt  as  to  the  nature  of 
a  disease  and  contagion  is  suspected,  the  card  shown  below  is  placed  on 
the  house  until  the  diagnosis  is  established.2 

It  is  generally  provided  as  in  the  Minnesota  law  that  the  sign  shall 
not  be  removed  without  the  permission  of  the  health  officer,  and  it  is  to 
be  kept  up  of  course,  as  long  as  it  is  deemed  necessary  to  maintain 
isolation.  A  penalty  is  imposed  for  removing  the  card,  but  as  may  well 
be  imagined,  it  can  rarely  be  enforced,  as  it  is  extremely  difficult  to 
secure  evidence  necessary  to  convict.  The  provisions  of  the  Minnesota 
law  making  the  occupant  responsible  are  intended  to  accomplish  the 
desired  object  in  a  better  way.3 


1  Michigan,  State  Board  of  Health  Report  (1896),  p.  30. 


NOTICE. 


Keep  Out. 


Contagion  Possima" 
Within. 


Five  Dollars  Fine  for  Removing  this  Card. 

Dr.  Broge  S.  Horxe, 

Comity  Health  Officer. 


3  Minnesota,  Chapter  133  of  1897: 

"  No  person  or  persons  shall  deface,  alter,  mutilate,  destroy,  tear  down  or  re- 
move any  snch  notice  posted  as  aforesaid  without  the  permission  of  the  com- 
missioner of  health  or  health  officer  who  posted  the  same;  and  the  occupant  and 
person  having   possession  or  control  of  any  house  or  building  upon  which  such 


<  OMMUJSrii  ABLE    DISE  1  sEs.  445 

The  occupant  is  also  made  responsible  by  the  ordinances  of  Chicago, 
Denver,  Memphis,  and  Milwaukee.  In  Buffalo  the  occupant  is  to 
notify  the  health  department  if  the  sign  is  illegally  removed.  In  Brad- 
ford, Pa.,1  if  the  placard  is  removed  the  board  of  health  shall  publish 
the  name  of  the  head  of  the  family  together  with  the  location  of  the 
house. 

Warning  signs  are  to  be  furnished  by  the  sanitary  authority  and 
this  is  specified  in  most  of  the  laws  and  rules  and  is  doubtless  the  uni- 
versal practice. 

The  place  where  the  warning  sign  is  to  be  posted  is  often  specified. 
In  Minnesota  it  is  "on  or  near  the  house."  In  Indiana,  Iowa,  Lynn. 
New  Hampshire,  and  Ohio,  in  a  conspicuous  place,  in  Rochester  in  a 
conspicuous  place  near  the  main  entrance,  in  Reading  and  Scrantou  on 
the  front  door  or  in  a  conspicuous  place,  in  Xorth  Carolina,  South 
Dakota,  Camden,  Cincinnati.  Cleveland,  and  Paterson,  on  the  front  of  the 
house.  It  is  apparently  intended  in  most  regulations  that  one  sign 
shall  suffice,  but  in  North  Dakota,2  Holyoke,  and  Providence  the  card 
is  placed  on  all  entrances.  In  a  few  cities  the  warning  sign  is  not 
placed  on  the  outside  of  the  house,  but  only  on  the  apartment  in  which 
the  sick  person  is  to  be  isolated,  the  isolation  in  such  cases  to  be  abso- 
lute.^ 


notice  shall  be  placed  or  posted  as  aforesaid  shall  within  twenty-four  (-J4)  hours 
after  the  destruction  or  removal  of  any  notice  placed  or  posted  on  his  house  or  build- 
ing as  aforesaid,  notify  the  commissioner  of  health  or  proper  health  officer  of  such 

dest ruction  or  removal  of  the  notice. 

The  feci  of  the  alteration,  destruction  or  removal  of  any  such  notice  shall  be 
prima  facie  evidence  that  such  notice  was  so  altered,  destroyed  or  removed,  as  the 
case  may  he.  by  the  occupant  and  person  having  possession  and  control  of  the  house 
6r building  on  which  such  notice  was  placed  or  posted." 

1  Bradford,  Rules  of  the  Board  of  Health,  Sea  74. 
-'  North  Dakota.  Rules  of  Male  Board  of  Health,  20  May,  1899: 
■■  The  health  officer  shall  give  notice  to  the  publicof  the  dangerof  infection  from 
such  disease,  in  the  house  or  building,  by  placing  placards  with  the  nan f  the  dis- 
ease upon  such,  in  large  and  distinct   printed  letters,  on  the  outer  walls  of  the  house 
or  building,  close  to  the  front,  tear  and  other  entrances. 

Milwaukee.  Ordinances,  Chapter  104  of  19 September,  1892,  amending  Sec.  l96of 
Chapter  1  t  of  1891 

.  .  .  "  Provided,  however,  thai  in  all  cases  where  an;  person  residing  in  any 
hotel,  tenement  house  or  other  building,  in  which  more  than  one  family  reside,  may 
he  infected  with  any  of  the  diseases  herein  mentioned,  the  commissioner  of  health 
may  in  his  discretion  cause  such  notice  to  he  placed  upon  the  door  of  the  room 
occupied  by  such  person,  or  upon  some  other  door  or  doors  in  or  to  such  building, 
and  tl •cupant.  manager  or  lessee  of  such  building  shall  be  subject  to  the  same 

duties  ami  to  a  like  line  of  any  violation  thereof  as  arc  herein  imposed  upon  the 
occupants  of  such  houses  where  such  notice  is  placed  upon  all  the  outside  dooN  of 
t  he  same." 


446  COMMUNICABLE   DISEASES. 

Similar  provisions  are  found  in  Denver  and  Newton,  Mass.,  and,  in 
the  latter  cit}T,  if  the  card  is  removed  it  shall  be  then  placed  on  the  front 
door,  or  above  the  latter  at  the  discretion  of  the  health  commissioner. 

In  Boston  if  isolation  in  one  room  or  apartment  is  complete  and  sat- 
isfactory, the  card  is  placed  on  the  inner  door,  if  isolation  is  not  satis- 
factory the  patient  is  removed  to  the  hospital.  If  the  patient  cannot 
be  moved  to  the  hospital  the  card  is  placed  on  the  outside.  In  Newark 
and  the  District  of  Columbia  the  apartment  only  is  placarded. 

The  form,  size  and  wording  of  the  warning  sign  are  frequently  pre- 
scribed in  the  regulations  and  vary  very  greatly  in  different  cities. 
"  Flags  "  are  used  instead  of  cards  in  Atlanta,  Camden,  Indianapolis, 
Macon,  Mobile,  and  New  Orleans.  In  Reading  a  "  patch,"  presumably 
a  piece  of  cloth,  is  prescribed.  Usually  a  card  is  to  be  put  up.  The 
largest  that  have  come  to  the  notice  of  the  writer  are  those  ordered  in 
Macon  which  are  24"  by  28"  and  by  the  Iowa  state  board  of  health, 
18"  square.  The  form  recommended  by  the  Pennsylvania  state  board 
of  health  is  9"  by  18",  in  Minneapolis  they  are  11"  by  13",  in  Indiana 
and  South  Dakota  12"  square,  in  New  Hampshire  6"  by  9".  Those 
used  in  Providence  are  5"  by  7"  and  about  that  size  is  very  commonly 
used.  The  smallest  cards  are  used  in  several  Massachusetts  cities  as 
Boston,  Cambridge,  Everett,  and  Fall  River ;  those  in  Cambridge  are  3i" 
by  54".  A  very  long  card  7"  by  24"  is  used  in  Defiance,  O.,  for  scarlet 
fever  and  one  4|"  by  12"  in  Denver  for  diphtheria. 

The  colors  of  the  cards  vary  as  much  as  the  size.  In  Pennsylvania, 
Utah,  Baltimore,  Bridgeport,  Fall  River,  Lynn,  Milwaukee,  Newark, 
New  Haven,  Newton,  Philadelphia,  Raleigh,  San  Francisco,  and  Seattle, 
the  same  color  is  used  for  all  diseases.  Sometimes  this  is  black  on  white 
as  in  San  Francisco  and  Seattle,  sometimes  red  on  white  as  in  Fall 
River  and  Newark,  and  again  black  on  yellow  in  Utah,  Baltimore,  New 
Haven,  and  Philadelphia.  More  often,  however,  different  colors  are 
used  for  different  diseases. 

For  smallpox  in  Rhode  Island,  the  sign  shall  be  of  white  with  small- 
pox in  black  letters  six  inches  high.  It  is  to  be  in  red  in  Macon  and 
Reading ;  yellow  in  Portland,  Ore.,  and  Mobile.  For  scarlet  fever  red 
is  usually  employed  if  distinguishing  colors  are  used,  sometimes  it  is 
black  on  red  ground,  and  sometimes  red  on  white  ground.  In  the  Dis- 
trict of  Columbia  the  color  is  pink.  In  Providence  white  on  red  ground 
is  used.  It  is  difficult,  however,  to  get  a  red  card  or  red  ink  which  will 
stand  sun  or  rain  without  fading. 

For  diphtheria  and  croup  in  Providence  black  on  white  is  used  as  it 
is  in  Boston,  Cambridge,  Denver,  and  New  York.  In  New  Hampshire, 
District  of  Columbia,  Macon,  and  Taunton  blue  is  the  color  chosen,  and 


COMMUNICABLE   DISEASES.  447 

green  in  Portland.  Ore.  Usually  the  same  color  is  used  for  croup  and 
diphtheria,  but  in  New  Hampshire  they  are  of  different  colors.  In 
New  ark  different  colors  were  formerly  used  for  diphtheria  and  croup, 
but  it  has  been  deemed  best  to  use  the  diphtheria  card  for  croup. 

For  measles  white  is  used  in  Macon,  yellow  in  New  Hampshire. 
The  signs  usually  contain  in  prominent  letters  the  name  of  the  dis- 
ease, and  a  warning  to  persons  not  to  enter  the  house  and  a  warning 
not  to  remove  the  card.  In  Denver  all  but  the  name  of  the  disease  is 
in  very-  small  letters.  Often  a  section  of  the  law  is  added.  Examples 
of  various  styles  of  placards  are  shown  in  Appendices  59—64. 

In  many  cities  the  cosmopolitan  character  of  the  population  requires 
that  cards  should  be  printed  in  different  languages.  Often  only  the 
language  predominating  in  the  neighborhood  is  used,  though  sometimes 
two  languages  are  used  on  the  same  card,  as  in  Buffalo,  where  the  mat- 
ter is  printed  in  both  English  and  German.  In  Fall  River  an  English 
and  a  French  card  are  posted.  In  Brooklyn  formerly  cards  were 
printed  in  English,  Italian,  Hebrew  and  German,  but  only  one  was  as  a 
rule  used  on  a  house.  The  cards  were  printed  with  one  language  on 
one  side  and  anotheron  the  other  so  as  to  lighten  by  one-half  the  weight 
of  cards  carried  by  the  inspector. 

Cards  are  usually  fastened  to  the  woodwork  of  the  house  with 
tacks,  and  in  Providence  copper  tacks  are  used  so  as  not  to  deface  the 
house  by  rust.  In  many  cases  in  that  city  the  card  is  simply  placed 
between  the  curtain  and  the  inside  of  the  glass  of  the  front  door.  In 
Philadelphia  the  warning  signs  are  gummed  on  the  back  and  are  moist- 
ened and  stuck  to  the  house  by  the  inspector.  As  might  be  inferred. 
they  are  not  infrequently  washed  off  by  the  rain. 

Usually  if  disinfection  is  done  by  the  sanitary  officials,  the  warning 
sign  is  removed  at  that  time,  but  in  Jersey  City  it  is  to  be  left  up  for 
twenty-four  boms  longer. 

Isolation. 

The  isolati f  communicable  disease  is  s times  prescribed  ly 

statute  or  by  rules  of  the  state  board  of  health,  but  more  often  by  local 
regulations.1 

In  some  of  these  laws  the  provisions  are  verj  general,  as  in  North 
Dakota,2  \\  here 

"The  health  officer  si  ml  I  ;tt  once,  after  receiving  such  notification,  sec  thai  the 
patient  is  completely  isolated  from  all  other  occupants  of  the  bouse  or  building,  or 
removed  to  a  hospital  lor  such  cases.11 

1  "  Isolation  is  directed  i».\  the  statutes  of  Arizona,  Florida,  Idaho,  Iowa.  Maine, 
Maryland,  Michigan,  Mississippi,  Montana.  \<w  Hampshire,  NYw  Jersey,  Nevada, 
North  Carolina.  Rhode  Island.  Virginia,  ami  by  the  state  board  of  health  rule-  of 
Indiana.  Mississippi,  New  Hampshire,  North  Dakota,  <>hio.  and  Vermont." 

J  North  Dakota.  Regulations  ol  the  State  Board  oi  Health,  Sec.  ■-'. 


448  COMMUNICABLE   DISEASES. 

In  some  states  the  force  of  the  statute  is  weakened  by  imposing  a 
penalty  only  for  wilful  failure  to  maintain  isolation,  as  in  Michigan  and 
Mississippi.  The  statute  in  Maine  is  much  more  explicit.1  The  Rhode 
Island  law  is  superior  in  omitting  the  word  wilful,  but  is  very  defective 
in  not  providing  that  in  the  case  of  minors  the  parents  shall  be  re- 
sponsible.2 As  the  majority  of  cases  of  communicable  diseases  are  in 
children,  this  is  a  serious  defect. 

Some  of  the  other  statutes  like  that  of  Rhode  Island  leave  the 
decision  as  to  isolation  in  the  hands  of  the  local  health  officer  by  re- 
quiring a  permit  from  him  for  ingress  or  egress.  In  Colorado  the 
health  officer  is  to  order  isolation,  in  Idaho,  the  county  board  of  health, 
and  in  Florida  the  state  health  officer.  Sometimes,  as  in  Ohio,3  the 
statute  without  ordering  isolation  authorizes  the  local  board  to  en- 
force it. 


1  Maine,  Chapter  123  of  1887,  as  amended  by  Chapter  139  of  1895: 

"Sec.  11.  No  householder  in  whose  dwelling  there  occurs  any  of  the  above- 
mentioned  diseases,  shall  permit  any  person  suffering  from  any  snch  disease,  or  any 
clothing  or  other  property  to  be  removed  from  his  house,  withontthe  consent  of  the 
board,  or  of  the  health  officer,  and  the  said  board,  or  health  officer,  shall  prescribe 
the  conditions  of  removal. 

"Sec.  12.  No  parent,  guardian,  or  other  person,  shall  carelessly  carry  about 
children  or  others  affected  with  infections  diseases,  or  knowingly  or  willfully  intro- 
duce infectious  persons  into  other  persons'  houses,  or  permit  such  children  under 
his  care,  to  attend  any  school,  theatre,  church  or  any  public  place. 

"  Sec.  15.  Persons  recovering  from  smallpox,  scarlet  fever,  diphtheria  or 
cholera,  and  nurses  who  have  been  in  attendance  on  any  person  suffering  from  any 
such  disease,  shall  not  leave  the  premises  till  they  have  received  from  the  board  of 
health,  or  health  officer,  a  certificate  that  they  have  taken  such  precautions  as  to 
their  persons,  clothing,  and  all  other  things  which  they  propose  bringing  from  the 
premises  as  are  necessary  to  insure  the  immunity  from  infection  of  other  persons 
with  whom  they  may  come  in  contact,  and  no  such  person  shall  expose  himself  in 
any  £>ublic  place,  shop,  street,  inn  or  public  conveyance  without  having  first 
adopted  such  precautions.'" 

2  Rhode  Island  General  Laws,  Chapter  94,  Sec.  24: 

"Every  person  in  any  house  where  there  is  any  one  sick  with  the  smallpox  or 
other  contagious  or  infectious  disease,  or  who  is  in  any  smallpox  hospital,  who  shall 
voluntarily  leave  the  same  without  a  permit  from  the  town  council  or  the  physician 
employed  by  such  town  council,  or  from  the  superintendent  of  health  in  cities,  shall 
be  tined  twenty  dollars  and  be  imprisoned  not  exceeding  ninety  days." 

3  Ohio,  Annotated  Statutes  (1900),  Sec.  2117: 

"And  when  complaint  is  made,  or  a  reasonable  belief  exists,  that  an  infectious  or 
contagious  disease  prevails  in  any  house  or  other  locality,  the  board  may  cause  such 
house  or  locality  to  be  inspected  by  its  proper  officers,  and  on  discovering  that  such 
infectious  or  contagious  disease  exists,  may,  as  it  deems  best,  send  persons  so 
diseased  to  the  pest-house  or  hospital,  or  may  restrain  them  and  others  exposed 
within  said  house  or  locality  from  intercourse  with  other  persons,  and  prohibit  in- 
gress or  egress  to  or  from  such  premises." 


COMMUNICABLE   DISEASES.  440 

Occasionally,  as  in  New  York  City,  the  statute  peremptorily  directs 
absolute  isolation.1 

Most  of  the  isolation  of  communicable  diseases  is  however  done 
under  local  regulations  adopted  by  the  legislative  bodies  of  cities,  town- 
ships, counties,  etc.,  or  by  the  hoard  of  health.  Local  governments,  as 
we  have  seen,  almost  always  have  ample  powers  granted  them  to  legis- 
late "  in  regard  to  health"  or  to  "prevent  disease."  Such  powers  have 
generally  been  exercised,  and  wherever  there  is  an  established  sanitary 
authority  to  enforce  them  and  sometimes  where  there  is  not,  regula- 
tions are  framed  prescribing  with  more  or  less  minuteness  for  the  isola- 
tion of  cases  of  communicable  diseases.  A  section  from  the  New  York 
code  with  very  general  provisions  is  given  below.2 

Laws  and  regulations  directing  the  isolation  of  persons  infected  with 
communicable  diseases  may  lie  exceedingly  strict,  even  requiring  the 
absolute  separation  from  the  outside  world  of  the  whole  household  or 
family,  as  in  the  provisions  of  the  charter  of  New  York  City  quoted 
above,  it  is  not,  however,  to  be  supposed  that  it  was  intended  that  the 
law  should  be  enforced  exactly  as  it  reads,  and  it  certainly  is  not  so 
enforced,  though  such  might  be  done  in  cholera,  plague  or  smallpox. 
It  is  not  every  contagious,  infectious  or  pestilential  disease  thai  public 
opinion  would  permit  to  be  so  treated,  and  in  the  opinion  of  many  such 
stringent  measures  are  not  necessary.  Instead  of  ordering  complete 
isolation  of  the  whole  household  in  all  cases  of  communicable  disease, 
laws  and  regulations  may  either  prescribe  under  what  circumstances  and 
to  what  extent  isolation  shall  be  maintained,  or  they  may  leave  the 
details  of  each  case  to  the  board  of  health  or  health  officer  or  to  the 
inspector.  Or  perhaps  some  of  these  matters  may  be  decided  by  the 
laws  and  others  left  to  the  discretion  of  the  executive  officer. 

In  most  eases  the  statutes  and  in  many  cases  the  local  regulations 
do    not    go    into   details    in    regard  to  the  diseases  to  be  isolated  and  the 


Sevr  York.  Chapter  378  of  L897,  Sec.  1219: 

•'It  shall  l»e  thr  duty  of  t  hi-  h., anl  of  health  bo  forbid  all  communication  with  the 
house  or  family  infected  with  any  contagious,  infectious,  or  pestilential  disease  ex- 
cept by  means  of  physicians,  nurses,  or  messengers  t"  carry  the  necessary  advice. 
medicines,  and  provisions  to  the  afflicted." 

\.w  Fork  City,  Sanitarj  Code  (1899),  Sec.  167: 
"That  in>  person  shall  within  this  city,  without  a  permit  from  this  department, 
carry,  remove,  or  cause  or  permit  to  be  carried  or  removed,  any  person  sirk  with 
smallpox  or  other  contagious  disease,  or  remove  or  cause  to  be  removed,  any  sucb 
peps,  iii  from  any  building  or  vessel  t"  any  other  building  or  \  esse  I  or  to  the  shore,  or 
to  or  from  any  vehicle  in  anj  pari  of  the  city.  Nor  shall  any  person,  by  anj  ex- 
posure of  any  individual  sick  of  an;  contagious  disease,  or  of  the  body  of  such  per- 
son, or  by  any  negligent  ad  connected  therewith,  or  in  respectof  the  care  or  custody 
thereof ,  or  bj  a  needless  exposure  of  himself,  cause  or  contribute  to,  or   promote 

the  spread  of  disease  from  any  such  person,  or  from  any  dead  body." 


450  COMMUNICABLE   DISEASES. 

strictness  and  the  length  of  the  isolation.  These  matters  are  very  often 
discretionary  with  the  health  officer  or  the  inspectors.  It  is  therefore 
not  easy  to  determine  what  is  the  practice  in  different  communities  for 
the  details  of  isolation  can  only  be  partially  learned  from  a  study  of 
printed  regulations.  It  is  very  often  necessary  to  personally  examine 
into  the  methods  adopted. 

Isolation  of  the  Patient  (when  not  removed  to  a  hospital).  For  the 
more  dangerous  communicable  diseases,  as  smallpox,  typhus  fever, 
cholera,  yellow  fever,  and  plague,  most  boards  of  health  and  health 
officers  require  the  complete  seclusion  of  the  patient  in  one  room.  For 
the  more  common  diseases,  as  scarlet  fever  and  diphtheria,  it  is  usually 
recommended  and  often  required.     The  Boston  rules  are  most  explicit.1 

The  card  shown  below2  is  used  on  the  door  of  the  infected  apart- 

1  Boston,  Rules  of  the  Board  of  Health,  1  July,  1895: 

"  1.  Whoever  is  infected  with  smallpox,  scarlet  fever,  diphtheria,  or  membraneous 
croup  shall  immediately  proceed  to  some  isolated  place  or  room  designated  by  the 
board  of  health,  and  no  person  who  has  been  so  affected  shall  leave  such  place  or 
room,  and  no  article  shall  be  removed  from  such  place  or  room,  until  the  board  of 
health  shall  certify  in  writing  that  all  danger  of  communicating  such  disease  to 
others  is  passed. 

"  2.  Every  parent  or  guardian  of  any  child  or  ward  infected  with  smallpox,  scarlet 
fever,  diphtheria  or  membraneous  croup  shall  immediately  cause  such  child  or  ward 
to  be  conveyed  to  some  isolated  place  or  room  approved  by  the  board  of  health,  and 
no  parent  or  guardian  shall  permit  such  child  or  ward  to  remove  from  such  place  or 
room  until  the  board  of  health  shall  find  and  certify  in  writing  that  all  danger  of 
communicating  such  disease  to  others  has  passed. 

"3.  No  person  other  than  the  attending  physician,  nurse  and  agents  of  the  board 
of  health  shall  enter  any  apartment  or  other  place  set  apart  for  the  treatment  of 
smallpox,  scarlet  fever,  diphtheria  or  membraneous  croup  until  the  board  of  health 
shall  certify  in  writing  that  such  apartment  or  place  has  been  satisfactorily  disin- 
fected. 

"  4.  No  person  having  the  care  of  any  other  person  who  has  been  affected  with 
smallpox,  scarlet  fever,  diphtheria  or  membraneous  croup  shall  advise  or  permit 
such  other  person  to  leave  any  place  designated  by  the  board  of  health  as  a  place  of 
isolation  of  such  infected  person  before  said  board  of  health  shall  have  certified  in 
writing  that  such  person  can  leave  such  designated  place  without  danger  to  others. 

"  5.  No  physician  who  has  been  in  attendance  upon  any  person  who  has  been 
infected  with  smallpox,  scarlet  fever,  diphtheria  or  membraneous  croup  shall  advise 
or  knowingly  permit  such  person  to  leave  any  place  designated  by  the  board  of 
health  as  a  place  of  isolation  of  such  infected  person  before  said  board  of  health 
shall  have  certified  in  writing  that  such  infected  person  can  leave  such  place  without 
danger  to  others.11 

2  Size  34x54-  Inches. 


DIPHTHERIA. 


This  door  opens  to  an  apartment  desig- 
nated and  set  apart  by  the  Boai'd  of  Health, 
City  of  Boston,  for  the  isolation  of  a  patient 
suffering  from  diphtheria. 


COMMUNICABLE    DISEASES.  451 

merit.  In  Newton  this  card  has  upon  it  a  copy  of  the  rules.  Similar  regu- 
lations are  found  in  Salem,1  Newton,2  Lynn,3  Fitchburg,4  Newark, 
Rochester,  and  for  smallpox,  yellow  fever,  typhus  fever  and  cholera  in 
the  District  of  Columbia.5 

An  examination  of  most  of  the  circulars  concerning  communicable 
diseases  issued  by  boards  of  health  will  show  that  this  isolation  in 
one  room  is  always  recommended  even  when  it  is  not  prescribed. 
Sometimes,  as  in  Cleveland  and  Providence,  isolation  for  the  patient  is 
ordered  only  under  certain  conditions,  as  when  the  wage-earner  is 
allowed  to  go  to  work  and  such  isolation  is  necessary  to  keep  him  apart 
from  the  patient.  While  it  is  easy  enough  to  order  such  a  separation 
of  the  sick,  it  is  a  very  difficult  matter  to  enforce  it.  The  writer  doubts 
if  it  can  be  done,  unless  there  is  a  pretty  constant  supervision  on  the 
part  of  the  sanitary  officers.  There  is  certainly  no  other  way  of  know- 
ing that  the  order  is  enforced.  Such  supervision  is  not,  however,  gen- 
erally maintained.  Then  again  among  persons  of  small  means  who  live 
in  from  two  to  four  rooms  and  perhaps  have  a  large  family,  it  is  impos- 
sible to  secure  such  isolation  as  is  ordered  by  the  Boston  rules  before 
given,  it  is  necessary  to  remove  to  the  hospital  cases  occurring  under 
such  conditions.  This  is  done  very  frequently  in  Boston  (in  about  fifty 
per  cent,  of  all  cases),  but  few  other  cities  have  the  facilities  to  care  for 
many  hospital  patients,  it  appears  to  be  doubtful  therefore,  if  more 
than  a  minority  of  eases  of  communicable  diseases  occurring  in  the  avcr- 
\  niericaii  community  are  really  isolated  in  one  room,  rules  and 
orders  notwithstanding. 

Sometimes   the   rules  make    no  pretence  of  keeping  the  sick  person 

in  ■  room,  but  only  forbid  egress  from  thehouse.6      The  keeping  of  the 

infected  person  in  the  house  is  another  matter,  and  it  is  doubtless  re- 
quired and  usually  secured.  Moreover,  there  is  no  good  reason  why 
with    ample   grounds   and    no   near  neighbors,  he  may  not  go  out  of  the 


1  S;il. 'in.  Report  of  Board  of  Health  <  1896). 

Newton,  Rules  ol  Board  of  Bealth  (1894),  Sec.  LI. 

I.\  mi.  Rules  of  Board  of  Health  (1896),  p.  5,  Sec.  3. 
1  Fitchburg,  Rules  ol  Board  of  Health  «  1897),  p.  is.  Sec.  •"-. 

District  of  Columbia,  A.cl  of  Congress,  8  March.  L897. 

•  Denver,  <  Ordinance  1 1  of  1898,  S< 
•  \  II  persons  having  smallpox  or  any  contagious  or  infectious  disease  in  the  city, 
nr  within  five  miles  of  the  city,  who  shall  refuse  to  go  or  cannot  be  taken  to  a  place 
prepared  or  designated  for  them,  arc  herebj  required  to  be  kept  closelj  confined 
within  their  respective  dwellings  or  places  of  abode,  and  to  "hey  such  rules  and 
regulations  as  maj  be  adopted  bj  the  bealth  commissioner  in  the  premises,  and  such 
Orders  as  may  be  issued  by  the  said  commissioner  under  the  law  and  ordinances  ol 
laid  city." 


452  (JOMMUNICABLE    DISEA  sKs. 

house  upon  the  grounds  surrounding  it.  During  convalescence  this 
would  often  be  better  both  for  the  patient  and  for  the  house  and  its  other 
inmates.  Public  opinion  is,  however,  strongly  against  this,  and  it  is 
rarely  permitted  except  under  very  favorable  conditions  in  rural  dis- 
tricts. Most  of  the  regulations  refer,  to  the  "  sick  "  person,  but  of  late 
the  expression  "  person  infected  "  is  used,  and  sometimes  there  is  added 
"  who  has  recently  had  "  the  disease. 

Isolation  of  the  Family.  When  cases  of  the  more  dangerous  com- 
municable diseases,  as  smallpox,  typhus,  cholera  and  yellow  fever  can- 
not be  removed  to  a  hospital,  the  complete  isolation  of  the  family  is 
invariably  required.  A  number  of  cities  in  their  rules  require  more 
stringent  measures  for  these  diseases  than  for  scarlet  fever,  diphtheria, 
measles,  etc.,  as  Buffalo,  Cincinnati,  Cleveland,  the  District  of  Colum- 
bia, Macon,  Reading,  and  Wilmington  ;  and  probably  all  boards  of 
health  insist  upon  it,  even  if  it  is  not  commanded  by  the  rules.  In 
scarlet  fever  and  diphtheria  isolation  of  persons  other  than  the  sick  is 
by  no  means  invariably  required.  It  is  probably  the  general  rule  that 
the  children  in  such  families  shall  be  kept  in  the  house ;  it  is  so  in  Bal- 
timore, the  District  of  Columbia,  Newark,  Pittsburgh,  Providence,  Wil- 
mington, and,  of  course,  also  in  all  cities  where  absolute  isolation  of  the 
family  is  maintained,  and  also  probably  in  most  of  the  cities  where 
wage-earners  are  kept  from  work.  In  Buffalo,  Fall  River,  and  Law- 
rence1 the  children  of  the  tenement  must  be  kept  off  the  street  while 
the  card  is  up.  This  is  not  done  in  Cambridge,  Chicago,  New  Haven, 
Paterson,  and  Rochester.  The  school  attendance  of  such  children  is. 
referred  to  on  another  page. 

In  most  communities  including  such  large  cities  as  Chicago,  Cin- 
cinnati, New  Haven,  New  York,  Paterson,  Philadelphia,  and  Rochester, 
wage  earners  in  families  with  scarlet  fever  and  diphtheria  are  not  kept 
from  work.  In  some  places,  as  Boston  and  other  Massachusetts  cities, 
and  in  Buffalo,  Cleveland,  Newark,  Pittsburgh,  Providence,  St.  Paul, 
and  Toledo,  they  are  not  permitted  to  work  unless  the  sick  person  is 
kept  isolated  from  the  workers,  and  it  is  not  even  then  allowed  if  the 
worker  is  brought  much  in  contact  with  children.  In  Providence  in 
cases  of  diphtheria  persons  may  not  go  to  work  unless  a  culture  taken 
from  the  throat  does  not  show  the  presence  of  diphtheria  bacilli.  In 
Baltimore  a  similar  requirement  is  made  by  the  proprietors  of  some 
of  the  mills.  The  following  rules  of  the  state  board  of  health  of  Iowa 
state  the  requirements  which  must  be  fulfilled  in  cases  of  diphtheria 
before  wage  earners  can  go  to  work  :  2 

1  Lawrence,  Rules  of  the  Board  of  Health,  1  May,  1893,  Sec.  VI.,  Rule  5. 

2  Regulations  for  Quarantine  of   Communicable  Disease,    Iowa    State   Hoard  of 
Health  (1899),   Rule  9. 


COMMUNICABLE    DISEASES.  453 

"  When  a  family  is  quarantined  for  Diphtheria,  the  head  of  the  family,  or  bread- 
winner, may  at  the  discretion  of  the  local  hoard,  have  the  privilege  of  attending  to 
his  regular  business,  and  of  going  to  and  from  his  house  only  when  complying  with 
the  following  conditions,  and  the  Mayor  or  Township  Clerk  (as  the  case  maybe), 
shall  issue  a  permit  therefor: 

"  First. — He  shall  change  his  clothing  before  going  to  and  leaving  his  home  to  go  to 
his  place  of  business. 

"  Second. — He  shall  wash  his  hands,  face,  head,  and  beard  with  a  two  per  cent, 
solution  of  carbolic  acid,  each  time  before  leaving  his  home  to  go  to  his  place  of 
business. 

•  Third. — While  in  the  house  he  shall  not  act  as  nurse  nor  live  in  the  same  room 
with  the  sick  person. 

••  Fourth. — He  shall  not  attend  any  public  meeting,  nor  attend  any  place  where 
persons  are  congregated. 

•  Fifth. — This  privilege  shall  not  be  granted  to  school  teachers,  nor  to  any  person 
whose  business  brings  him  in  intimate  contact  with  children.'1 

Explicit  rules  governing  members  of  the  family  other  than  the  sick 
are  tunnel  in  North  Dakota.1 

In  Newark,  Providence,  Rochester,  and  Toledo,  when  workers  are  to 
be  kept  from  their  tasks,  notice  is  sent  to  the  employer.  See  Appendix 
B3.  Other  forms  of  notices  and  of  permits  to  work  are  also  shown  in 
the  Appendices  64-67. 

In  certain  kinds  of  business  the  worker  is  obliged  to  remove  from 
borne.  This  in  most  communities  is  required  of  teachers,  and,  as  in 
Iowa  above,  the  privilege  of  remaining  at  home  is  denied  all  who  come 
¥  in  intimate  contact  with  children."     Letter-carriers,  dry  goods  clerks, 

1  North  Dakota,  Regulations  of  State  Board  of  Health: 

■  The  health  officer  shall  rigidly  quarantine  on  the  premises  upon  which  the 
infected  house  is  situated,  all  the  other  occupants  of  the  house  or  building,  not  ill 
of  the  disease,  until  after  :  (a)  The  removal  or  thorough  isolation  of  the  patient; 
(6)  Until  after  disinfection  to  the  satisfaction  of  the  health  officer,  of  those  not  ill  of 
the  disease,  their  persons,  clothing  and  that  part  of  the  house  occupied  by  them. 
After  all  such  precautions  have  been  taken,  such  persons  shall  not  engage  in  their 
usual  avocations,  or  in  any  other  way  mix  or  come  in  contact  with  other  individuals 
until  the  liea lth  officer  shall  have  given  a  certificate  that  in  his  opinion  t  he\  may  do 
so  without  danger  of  spreading  the  disease. 

••  in  ease  the  disease  be  scarlet  fever,  the  certificate  releasing  from  quarantine 

shall  not  he  given  by  the  health  officer,  to  the  persons  exposed,  and  who  have  not 
had  the  disease,  until  alter  the  usual  period  of  incubation  has  elapsed,  since  last 
exposure,  viz.:  a  period  of  at  least  tour  days,  or  longer,  at  the  discretion  of  the 
health  officer.      In  the  case  the  disease  he  diphtheria  the   quarantine  period  shall   he 

at  least  tour  days,  or  until  a  bacteriological  examination  of  the  secretions  of  the 
pbarnyx  or  naso-pharnyx  has  been  made,  and  ton  ml  tree  from  the  bacillus.  Such  ex- 
amination to  he  at  the  discretion  of  the  health  officer.     Incase  of  smallpox,  persons 

who  have  never  had  the  disease,  and  who  have  not  well  marked  vaccinal  scars,  must 
not  lie  released  until   after  a  period  Ol    fourteen   days    alter   last    exposure.      All  who 

have  been  ex  posed  must  he  vaccinated,  or  re-vaccinated,  at c.  and  t  lh.se  who  have 

had  smallpox,  or  who  have  on    their  persons  well    marked  typi<  al  vaccination 

ma\    he    released    alter   thorough    disinfection    of    pel-sons   and    clothing,   without 

fun  her  detention. 


454  COMMUNICABLE   DISEASES. 

dressmakers,  waiters,  policemen,  milkmen,  handlers  of  food  stuffs,  etc., 

are  among    business    people    who    are    required  to    remove    from    the 

infected  house.     Sometimes  these  matters  are  left  to  the  discretion  of 

the   officer  and  sometimes   they   are  expressed  in   formal  rules.     See 

page  453. 

Sometimes  while  the  members  of  the  family  who  are  well  are   not 

kept  in  the  house,  they  are  forbidden  to  go  in  public  places.     Thus  in 

Iowa1  "no  person  residing  in  such   household,   family  or  place  shall  be 

permitted  to  attend  any  public  meeting."     hi  Providence  :2 

"No  person  living  in  a  family  where  there  is  a  person  sick  with  smallpox, 
scarlet  fever,  diphtheria,  membranous  croup,  or  while  the  warning  sign  is  upon  the 
house,  shall  visit  a  theatre,  church,  a  public  library,  or  any  public  assemblage, 
without  the  permission  of  the  Superintendent  of  Health.'" 

The  Iowa  rule  denning  isolation  and  forbidding  ingress  and  egress 
from  the  house  is  given  below.3  The  regulations  of  many  other  cities 
still  more  explicitly  forbid  visiting  the  infected  family  or  house.4  In 
New  Orleans  the  householder  is  required  to  prevent  such  visits.5  In 
Lawrence  "  None  other  than  the  tenants  occupying  the  tenement  where 
the  contagion  exists,  will  be  allowed  to  enter." 

The  visits  of  the  physician  are  sometimes  regulated   as  in  Indiana.6 

1  Iowa,  Regulations  of  State  Board  of  Health  (1899),  Rule  4. 

2  Providence,  Rules  of  the  Board  of  Aldermen  (1899),  Chapter  I,  Sec.  4. 

3  Iowa,  Regulations  State  Board  of  Health,  in  regard  to  Communicable  Diseases 
(1889),  Rule": 

"Isolation  means  the  complete  exclusion  of  all  other  persons  from  the  sick  except 
the  nurse  and  attending  physician;  that  the  nurse  shall  be  restrained  from  going  to 
and  from  the  premises,  or  mingling  with  the  family;  that  all  well  persons  shall  be 
prevented  from  contact  with  bedding,  clothing,  food,  or  other  articles  that  have 
been  used  on  or  about  the  sick.  Where  from  necessity  the  parents  or  family  are 
nurses,  the  isolation  and  quarantine  applies  to  them.'1 

4  Albany,  Rules  and  Regulations  of  the  Board  of  Health  (1892),  Sec.  24: 

"No  person  or  persons,  excepting  those  in  prof  essional  attendance  upon  the  sick, 
shall  knowingly  visit  any  dwelling,  building  or  place  in  which  there  is  any  person 
or  thing  infected  with  any  malignant  or  contagious  disease,  or  hold  communication 
or  intercourse  with  any  person  or  thing  (to  his  or  their  knowledge)  exposed  to  such 
disease,  without  the  special  permit  and  by  the  direction  of  this  board  or  its  health 
officer. 

5  New  Orleans,  Ordinances,  Council  Series  2777,  Sec.  2: 

"That  no  householder,  whether  the  owner  of  the  premises,  or  any  part  thereof, 
or  possessor  or  occupant  thereof,  by  lease  or  otherwise,  shall  allow  or  permit  con- 
trary to  the  order  of  the  board  of  health  of  the  State  of  Louisiana,  any  person  or 
persons  to  visit  any  person  who  may  be  sick  or  confined  on  said  premises  with  any 
infectious  or  contagious  disease,  saving  and  excepting  such  person  or  persons  as 
may  be  actually  and  absolutely  necessary  and  essential  to  the  proper  care  and  atten- 
tion of  said  sick  person  or  persons." 

6  Indiana,  State  Board  of  Health  Rules,  15  April,  1898,  Rule  12: 

"  Every  physician  attending  a  case  of  smallpox,  scarlet  fever,  diphtheria,  mem- 
branous croup  or  other  communicable  disease  dangerous  to  public  health,  shall  use 
every  reasonable  precaution  to  prevent  communicating  the  disease  to  others." 


COMMUNICABLE    DISEASES.  455 

A   similar   rule    has    been   adopted   by   the  state   board    of    health    of 

North  Dakota  and  Ohio  except  that  the  word  possible   is   used  instead 

of  reasonable.     In  Utah1  and  Vermont2  the   physician   and  nurse  must 

disinfect   themselves   and   their  clothing  before  leaving  the  house  or 

premises. 

The  egress  of  the  nurse  is   referred  to  in  the  Iowa  rule  and  Maine 

statute   before  quoted   and   has  received   attention  from  the  Vermont 

legislators.      In   Detroit3  the   method    of    disinfection   is   described   as 

follows  : 

•'Any  person  nursing  or  taking  care  of  any  person  sick  with  either  of  said  diseases 
shall,  before  going  upon  the  streets  or  visiting  any  other  house,  take  a  warm  bath, 
and  disinfect  the  hair  of  the  head,  the  hands,  the  finger  nails,  by  means  of  the  above 
mentioned  spray,  changing  all  underclothing  and  clothing  which  had  been  worn 
while  in  attendance  on  the  patient,  and  see  that  the  former  underclothing  and 
clothing  are  thoroughly  disinfected  by  either  sulphur,  boiling  in  water,  steam,  or 
spraying  with  disinfectant  cologne,  and  allowed  to  dry,  and  shall  not  attend  any  non- 
contagious disease  without  a  permit  from  the  health  officer." 

Several  of  the  regulations  require  parents  and  others  to  protect 
from  contagion  the  children  in  their  care.4 

Other  Families  in  the  House.  It  is  rare  that  isolation  is  extended 
t'i  families  other  than  that  in  which  the  disease  exists  even  if  they 
live  in  the  same  house.  It  is  true  that  many  of  the  laws  referred  to 
above  mention  the  house  though  the  restrictions  are  only  intended  to 
apply  to  the  infected  family,  but  they  are  then  so  worded  that  their 
application  to  the  whole  house  is  left  to  the  discretion  of  the  health 
officer.  Tims  in  the  Rhode  Island  law  referred  to  on  page  44S  no  one 
may  leave  the  house  without  a  permit,  but  in  almost  all  cases  this  per- 
mit can  be  obtained  except  for  certain  members  of  the  infected  family. 
Sometimes  the  children  of  other  families  may  be  subjected  to  restric- 
tions, but  rarely  adults.  Children  from  the  whole  house  are  generally 
excluded  from  school.  The  rule  in  regard  to  children  in  Fall  River  is 
given  below.5 

1  Utah,  Revised  statutes  (1898),  See.  1112. 
Vermont,  Rules  of  State  Board  of  Health,  1  June,  L899. 
-    Detroit.  Ordinance  of  J)  Mas .  1892,  Sec.  8. 

1  Michigan,  Chapter  15  of  1891,  See.   1  : 
■■  .     .     .     No  <>ne  shall  iii  any  waj  knowingly  or  willfully  expose  or  cause  to  be 
exposed  a  minor  child  or  other  irresponsible  person  to  danger  of  contracting  any 
mi.-  of  1  he  aforesaid  diseases." 

Minneapolis,  Ordinance  of  25  July,  1897,  Sec.  11: 

No  parent,  guardian  or  custodian  of  any  minor  child  within  said  city  shall  per- 
mit sinh  child  to  i>e  unnecessarily  exposed  to  contagion' or  infection  from  any  con- 
tagious or  infect  iolls  disease." 

Fall  River,  Orders  of  the  Board  of  Health.  1 : 

il  Ordered,    That   no  child,  from  any  house  where  t  here  is   a    case  of    scarlet   fi 

or  diphtheria  shall  be  allowed   to  mingle  with  those  from  any  other  house,  until 


45G  COMMUNICABLE    DISEASES. 

Persons  Exposed.  Except  in  smallpox,  yellow  fever,  typhus  and 
cholera,  persons  who  have  simply  been  exposed  to  the  disease  are  rarely 
restrained.  In  the  diseases  above  mentioned,  persons  exposed  by  being 
in  the  same  house,  yard,  workshop,  vessel,  etc.,  are  often  detained  a 
sufficient  time  to  determine  whether  or  not  they  have  contracted  the 
disease.  This  will  be  further  considered  in  treating  of  the  management 
of  outbreaks.  In  the  Ohio  state  board  of  health  rules,  the  period  of 
isolation  for  all  persons  exposed  to  the  different  communicable  diseases 
is  specified,  but  the  rule  does  not  definitely  require  their  isolation.  The 
periods  are  as  follows  : 

Ohio  State  Board  of  Health  Rules. 

Diphtheria.  For  persons  associated  with,  or  in  the  house  with  the  patient: 
Quarantine  until  after  death  or  recovery  of  the  patient  and  disinfection  of  the  prem- 
ises. 

Scarlet  Fever.  Quarantine  of  children  associated  with  or  in  the  house  with  the 
patient  for  ten  (10)  days  after  complete  desquamation  or  scaling  of  patient  and  dis- 
infection of  the  premises. 

Smallpox.  For  exposed  persons:  Quarantine  for  fourteen  (14)  days  from  date 
of  last  exposure. 

Cholera  and  Yellow  Fever.  For  exposed  persons:  Quarantine  for  five  days  from 
date  of  last  exposure. 

Typhus  Fever.  For  exposed  persons:  Quarantine  for  twenty-one  (21)  days  from 
date  of  last  exposure. 

Duration  of  Isolation.  It  is  of  the  utmost  importance  that  isolation 
should  be  maintained  a  sufficient  length  of  time.  If  it  is  terminated 
too  soon,  great  hardship  is  inflicted  without  accomplishing  the  intended 
result.  It  is  not  an  easy  matter  in  most  communicable  diseases  to 
determine  with  accuracy  the  time  at  which  the  patient  ceases  to  be  in- 
fectious. Uncertainty  in  regard  to  this  is  well  shown  by  the  varying 
limits  that  are  set  for  isolation  in  different  places.  In  most  cases  the 
determination  of  the  period  of  isolation  is  left  to  the  local"  board  of 
health  or  health  officer,  as  in  Rhode  Island  (see  p.  448).  A  number  of 
municipal  ordinances  also  specifically  refer  the  matter  to  the  health 
officer. 

In  no  state  is  the  period  of  isolation  for  communicable  disease  fixed 
by  statute,  but  it  is  by  the  rules  of  the  state  board  of  health  (which 
have  the  force  of  law)  in  Iowa,  Missouri,  Ohio,  and  South  Dakota.  It 
is  also  fixed  by  ordinance  or  rule  in  the  cities  of  Colorado  Springs,  Con- 
cord, Denver,  Fall  River,  Framingham,  Mass.,  Holyoke,  Lowell,  Mil- 
waukee,  Minneapolis,   Montclair,  N.  J.,  New  Bedford,   Omaha,  Provi- 

after  the  recovery  or  death  of  the  patient  and  the  disinfection   of  the  premises  and 
the  removal  of  the  card,  by  a  duly  authorized  agent  of  the  board  of  health.'" 


( '  OMMUNIt  \  UJL  E    D  TSEu  \  8  E8.  4  5  7 

dence,   Salt    Lake   City.   Syracuse,  Utica,   and    Yonkers,   but   in   many 
cities  it  is  left  to  the  judgment  of  the  health  officer. 

A  number  of  cities  leave  the  duration  of  isolation  to  the  attending 
physician.  This  is  true  of  Baltimore,  Cincinnati,  Milwaukee,  Paterson, 
Pittsburgh  (in  scarlet  fever).  Charleston,  Chicago,  Cleveland,  Portland. 
Me.,  Reading,  St.  Paul,  and  Wilmington. 

This  period  of  isolation,  of  course,  varies  in  different  diseases  and 
the  data  collected  are  as  follows.     The  period  of  isolation  is  for: 
Smallpox. 

Four  weeks  in  Framingham,  .Mass. 

Forty  days  in  Colorado  Springs,  Iowa,  and  Missouri. 

Six  weeks  in  Concord,  Montclair,  N.  J.,  and  Newark. 

Five  days  after  desquamation  in  North  Dakota. 

Until  desquamation  is  completed  in  Boston,  Cincinnati,  Ohio,  Prov- 
idence, and  South  Dakota. 
Scarlet  Fever. 

After  desquamation  in  New  Haven  and  Seattle. 

Five  days  after  desquamation  in  North  Dakota. 

Ten  days  after  desquamation  in  Ohio  and  South  Dakota. 

Three  weeks  in  Buffalo,1  Cambridge,1  Grand  Rapids,  Holyoke,1 
Lowell,1  Leominster,  Mass.,1  Minneapolis,  Newark,1  New  York,1  Syra- 
cuse, Utah,  and  Utica. 

Four  weeks  in  Brookline,  Mass.,  Concord,  Kansas  City,  Newton* 
Mass.,  and  (  Mnaha.1 

Thirty  days  in  Milwaukee,2  Paterson,2  and  Pittsburgh.2 

Thirty-five  days  in  Colorado  Springs  and  Iowa. 

Five  weeks  in  Providence1  and  Rochester.1 

Six  weeks  in  New   Bedford,  St.  Paul,  and  Yonkers.1 

Six  weeks  in  Denver,  Fall  River,  Framingham,  Mass.,  and  Mont- 
clair,  N.  J. 

Of  102  replies  made  to  an  enquiry  by  the  state  board  of  health  of 
Minnesota3  of  towns   in  thai  state,  *  stated  thai   the  period  of  isolation 

\\;is    2   Weeks.    IT    reported    it      3    Weeks.   S    reported     1    Weeks.    1    reported     5 

weeks,  1\  reported  6  weeks.;!  reported  8  weeks, -and  11  determined  tin- 
period  of  isolation  l>\  the  duration  of  desquamation, 
Diphtheria. 

Until  the  discover}  of  the  pathogenicity  of  the  Klebs-Loeffler  bacil- 
lus and  the  developmenl  of  theculture  method  of  determining  its  pres- 

1  [solation  is  continued  longei  it'  desquamation  persists. 

J  isolation  i^  maintained  for  iliis  time,  unless  the  physician  certifies  thai  desqua- 
mation has  ceased,     li   is  never  maintained  longer  even  if  desquamation  continues. 
Minnesota,  Reporl  of  State  Board  of  Health  (1895  B),  p.  104. 


458  COMMUNICABLE   DISEASES. 

ence,  it  was  necessary  to  fix  an  arbitrary  time  limit  for  isolation  in 
this  disease.  As  the  infectious  period  in  this  as  in  most  of  the  com- 
municable diseases  varies  in  different  cases,  it  was  necessary  in  fixing  a 
time  limit  to  fix  some  arbitrary  time  which  was  supposed  to  suffice  for 
the  majority  of  cases.     This  was  : 

Two  weeks  in  New  Haven  and  Salt  Lake  City. 

Ten  days  after  disappearance  of  membrane  in  Chicago. 

Fourteen  days  after  recovery  in  Ohio,  South  Dakota,  and  Utah. 

Three  weeks  in  Concord,  Grand  Rapids,  Montclair,2  and  North 
Dakota. 

Four  weeks  in  Brookline,2  Fall  River  (or  a  negative  culture),  Fram- 
ing-ham, Mass.,  Kansas  City,  Milwaukee,  New  Bedford,  and  Yonkers.2 

Thirty  days  in  Cleveland,3  Paterson,8  Pittsburgh,1  and  St.  Paul. 

Thirty-five  days  in  Colorado  Springs  and  Iowa. 

An  investigation  by  the  Minnesota  state  board  of  health4  showed 
that  in  1898  121  cities  and  towns  had  a  time  limit  for  the  isolation  of 
diphtheria.  In  8  it  was  for  2  weeks,  in  11,  3  weeks;  in  10,  4  weeks; 
in  9,  6  weeks:  in  1,  7  weeks,  in  12,  2  weeks,  and  in  13,  3  weeks  after 
recovery.  Twenty-eight  health  officers  terminated  isolation  on  securing 
a  negative  culture  from  the  throat. 

With  the.  development  of  the  culture  method  of  determining  the 
presence  of  the  diphtheria  bacillus  it  was  believed  that  there  was  fur- 
nished a  much  more  satisfactory  method  of  deciding  when  a  patient  was 
free  from  infection.  Nearly  all  health  officials  who  are  so  situated  as  to 
have  laboratory  facilities  now  make  the  cessation  of  isolation  depend 
upon  the  obtaining  of  a  negative  culture  from  the  patient.  As  may 
be  seen  from  the  facts  above  given,  the  arbitrary  period  of  isolation 
fixed  upon  previous  to  the  advent  of  the  culture  method  was  about  four 
weeks.  By  terminating  isolation  by  the  usual  culture  method,  the 
average  period  of  isolation  is  considerably  shortened,  the  method  thus 
resulting  in  a  very  considerable  saving  in  time. 

In  most  cities  one  negative  culture  from  the  throat  of  all  persons 
sick  is  all  that  is  required.  In  Boston,  Brookline,  Holyoke,  Newton, 
Springfield,  and  Waltham,  Mass.,  two  successive  negatives  are  neces- 
sary, and  in  New  Bedford  two  if  four  weeks  has  not  elapsed,  but  if 
it  has,  one  will  suffice.  In  Minnesota  the  state  board  of  health  has 
made  it  a  rule  that  isolation  shall  continue  four  weeks  unless  two  nega- 


1  Isolation  never  continues  over  thirty  days  even  if  diphtheria  bacilli   persist  in 
the  throat.     The  card  is  removed  before  thirty  days  if  the  bacilli  disappear. 

2  Isolation  is  continued  longer  if  diphtheria  bacilli  still  remain  in  the  throat. 

3  The  time  is  shortened  if  the  attending  physician  certifies  that  there  is  no  danger. 

4  Minnesota,  State  Board  of  Health  Report  (1895-8),  p.  403. 


( '  OMMUNIi  A  B  L  E    J>lsL\  1 8  E&  4  5  9 

tive  cultures  are  obtained.1  In  Boston,  Newton,  and  Springfield  the 
two  negative  cultures  must  be  at  least  twenty-four  hours  apart,  and  the 
last  one  is  taken  by  the  health  officer. 

In  Providence  and  St.  Paul  a  negative  culture  is  required  from  the 
throat  of  every  member  of  the  family,  and  it  has  been  found  that  Klebs- 
Loeffler  bacilli  are  found  in  the  throats  of  from  twelve  to  eighteen  per 
cent,  of  the  well.2  In  Denver  the  throats  of  all  the  children  in  the 
family  are  in  most  cases  examined.  This  practice  has  met  with  much 
opposition  in  both  cities. 
Measles. 

One  week  in  Detroit. 

Two  weeks  in  Buffalo,  ('uncord.  New  York,3  Providence,  and 
V<  inkers. 

Two  weeks  after  eruption  fades  in  Brookline  and  Fall  River. 

Two  weeks  after  recovery  in  Boston. 

Three  weeks  in  Montelair,  \.  J..  New  Bedford,  and  Ottumwa,  la. 
Whooping  Cough. 

Six   weeks  in  Montelair.  X.  .J. 

On  recovery  in  Providence. 

As  long  as  the  cough  lasts  in  Boston. 

The  time  limit  that  is  thus  set  refers  of  course  to  those  cases  in 
which  the  patient  recovers.  If  the  patient  dies  the  isolation  may  ter- 
minate sooner.  In  most  places  a  private  funeral  is  required  and  the 
Warning  sign  is  kept  up  till  after  the  funeral,  and  then  the  premises 
must  usually  be  disinfected  before  the  placard  is  removed.  Usually  the 
isolation  then  ceases:  sometimes,  however,  it  is  required  that  it  be 
maintained  awhile  longer;  thus  in  Iowa  it  must  be  maintained  for 
Seventeen  days  after  death,  in  Salt  Lake  City,  seven  days. 

While  a  time  limit  for  isolation  is  thus  fixed  by  formal  ride  in  many 
states  and  cities,  numbers  of  these  rules  have  the  proviso  that  isolation 
shall  he  for  at  least  the  specified  time,  and  the  health  officer  or  the  hoard 
of  health  has  the   authority  to    extend  it.      Again    as    the    warning   sign 

may  not  be  re ved  without  permission,  the  health  officer  has  it  in  his 

power  nearly  always  to  extend  the  period  of  isolation  if  he  deems  neces- 
sary. This,  however,  is  rarely  done  ;  more  often  the  health  officer  ex- 
hibits   laxness    by    terminating    isolation    before  the  authorized    time. 

Removal  of  Communicable  Diseases.  The  removal  of  a  case  of  com- 
municable disease  is  such  a  serious  matter  thai  it  is  specificalrj  forbid- 
den in  several  states  and  a  large  number  of  cities.     Of  course,  if  the 

1  Minnesota,  Regulations  State  Board  oi  Health,  L2  April,  1898. 
*  Providence,  Reports  of  Superintendent  "i   Health,  1897  to  L900. 
I  f  desquamal  ion  has  ceased. 


460  COMMUNICABLE   DISEASES. 

rules  for  isolation  were  carried  out  from  the  beginning,  there  would  be 
no  need  of  additional  regulations  forbidding  the  removal  of  the  case 
from  the  house,  but  these  latter  regulations  are  rather  intended  for  the 
period  before  the  case  is  placed  under  municipal  supervision.  The  pur- 
pose of  one  class  of  these  regulations  is  to  prevent  the  removal  of  the 
patient  so  that  there  may  not  be  established  a  second  or  perhaps  third 
focus  of  the  disease.  Section  167  from  the  sanitar}*  code  of  New 
York  City,  given  on  page  449,  is  an  example  of  this  and  has  been  very 
frequently  copied  by  other  cities.  A  somewhat  different  rule  in  Cin- 
cinnati applies  to  persons  exposed  as  well  as  to  the  sick.1  A  similar 
provision  is  found  in  the  District  of  Columbia.  Of  course,  these  rules 
are  not  intended  to  forbid  removal  to  the  hospital,  and  this  exception  is 
formally  made  in  Buffalo  and  Fitchburg.  In  Omaha  the  physician  is 
particularly  forbidden  to  remove  the  patient. 

Another  class  of  rules  aims  at  preventing  danger  to  others  during, 
or  by  the  act  of  transportation,  and  provides  for  the  disinfection  of  the 
vehicle.  Maryland,  Michigan,  Mississippi,  ( )hio,  and  Pennsylvania2 
have  such  rules,  and  they  are  found  in  many  cities.  The  Pennsylvania 
law  puts  the  penalty  upon  the  sick,  but  sometimes  it  is  the  owner  of  the 
vehicle  who  is  made  responsible  as  in  the  Cincinnati  rule  given  below, 
and  also  in  Mississipi  :3 

No  common  carrier  shall  accept  for  transportation  any  person  suffering  with 
smallpox,  yellow  fever,  cholera,  diphtheria  or  scarlet  fever  or  any  infected  article  of 
any  character  whatever." 

Usually  the  owner  of  the  vehicle  is  made  responsible  for  disinfec- 
tion as  in  the  District  of  Columbia  :4 

"  The  owner  or  driver  of  any  public  conveyance,  either  or  both  of  them,  in  which 
has  been  conveyed  any  person  suffering  from  a  contagious  disease  shall  immediately 
have  such  conveyance  properly  disinfected,  and  said  conveyance  shall  not  again  be 

1  Cincinnati,  Manual  of  Health  Department  (1808),  Sec.  76: 

lL  Infected  Person  not  to  be  Removed  without  Permit.  Xo  person  shall,  without 
a  permit  from  the  department,  carry  or  remove  from  one  building  to  any  other,  or 
from  any  railroad  depot  to  any  house,  or  through  the  public  streets,  or  from  any 
vessel  to  the  shore,  any  person  sick  of  any  contagious  disease,  or  person  that  has 
been  exposed  to  and  is  liable  very  soon  to  develop  any  such  contagious  disease,  nor 
any  articles  that  have  been  exposed  to  any  such  disease.''1 

2  Pennsylvania,  Chapter  124  of  1895,  Sec.  15: 

••  No  person  suffering  from  any  of  the  diseases  mentioned  in  section  four  of  this 
act,  nor  any  one  who  has  charge  of  a  person  so  suffering,  shall  enter  any  hired 
vehicle  or  other  public  conveyance,  or  permit  any  one  in  his  or  her  charge  who  is  so 
suffering  to  enter  such  vehicle  without  previously  notifying  tho  owner  or  driver 
thereof  that  he  or  the  person  in  his  charge  is  so  suffering,  and  the  owner  or  driver 
of  such  vehicle  shall  immediately  provide  for  the  disinfection  of  such  conveyance 
after  it  has  with  the  knowledge  of  such  owner  or  driver  conveyed  any  such  sufferer, 
under  the  direction  of  the  health  authorities. 

3  Mississippi,  Rule  of  State  Board  of  Health  (1898),  Sec.  9. 

4  The  District  of  Columbia,  Act  of  Congress,  3  March,  1897,  Sec.  19. 


COMMUNICABLE   DISEASE s.  4(31 

used  until  it  has  been  disinfected  to  the  satisfaction  of  said  health  officer,  as  certified 
by  him." 

In  Maryland1  the  person  who  was  conveyed  must  pay  for  the  disin- 
fection. In  order  that  the  health  officer  may  know  of  the  facts  and  see 
that  disinfection  is  done,  the  District  of  Columbia  rule  provides 

•■  That  any  person  suffering  from  such  disease  and  any  person  in  charge  of  one 
so  suffering  having  entered  any  public  conveyance  shall  forthwith  report  in  writing 
to  said  health  officer  the  time  of  Mich  use,  the  number  and  kind  of  conveyance  used, 
and.  if  known,  the  name  of  the  driver." 

and  there  is  a  similar  provision  in  Maryland.  In  Buffalo2  the  hospital 
superintendent  must  report  to  the  health  commissioner  when  a  case  of 
communicable  disease  is  brought  in  a  public  conveyance.  In  Scranton 
it  is  required  that  a  copy  of  the  law  be  posted  in  each  public  carriage 
by  the  owner,  the  notice  to  be  furnished  by  the  board  of  health.  In 
Haverhill  all  carriages  carrying  persons  from  a  commmunicable  disease 
funeral  are  within  the  meaning  of  "-transporting  communicable  diseases." 
( See  carriages  for  funerals,  page  474.) 

Tnfected  'r<>n,Js.  As  infection  is  sometimes  carried  in  articles  of 
various  kinds,  it  is  common  to  forbid  the  removal  from  a  house  where 
there  is  communicable  disease  of  anything  winch  may  have  become  in- 
fected. Such  regulations  are  found  in  most  cities  and  in  a  few  slate 
laws.3 

Si  line  of  the  regulations  forbid  the  removal  of  articles  without  a 
permit  from  the  health  authorities,  and  sometimes  it  is  made  an  offence 
to  carry  infected  articles  in  a  public  conveyance-4 

As  nothingis  more  likely  to  infect  clothing  than  the  making  of  it 
by  persons  with  communicable  disease  or  persons  who  have  the  care  of 
such  cases,  the  making  of  clothing  in  infected  houses  is  forbidden  in 
Buffalo,  Fitchburg,  New  York  City,  Providence,  and  probably  other 
cities."'     Iii  Providence  the  restriction  applies  only  to  the   family  where 

1  Maryland,  Chapter  1."..".  of  1882,  See.  <;. 
Buffalo,  Ordinances  (1892),  Chapter  25,  Sec.  151. 
Pennsylvania,  Chapter  124  of  1895,  Sec.  IT: 

•■  No  person  shall  without  previous  disinfection  give,  lend,  sell,  transmit,  "i  ex 
pose  any  bedding,  clothing,  rags,  or  other  articles  which   have  been  exposed  to  in- 
fection: Provided,  Thai  such  rest  rid  ion  shall  n.  .t  apply  to  the  transmission  of  arti- 
cles with  proper  precautions  for  the  purpose  of  having  the  same  disinfected." 

'  Bridgeport,  Ordinances  (1892),  Chapter  l  I.  Sec.  7: 

••  \'( e  shall  enter  :i  passenger  <-.ir.  street  car,  steamboat,  hack,  cab,  stage  or 

other  public  conveyance,  wearing  or  having  in  liis  or  her  possession  any  clothing  oi 
articles  with  which  he  or  she  shall  have  been  in  attendance  upon  a  person  sick  with 
diphtheria,  smallpox,  scarlet  fever,  or  typhus  fever,  without   having  had   the  same 
disinfected  to  the  satisfaction  of  tli"  li  >ard  of  health.11 
Buffalo,  Ordinances  (1892),  Chapter  25,  Sec.  24: 

"No  person   shall  make,  proem- •  cause  to  be  made,  any  clothing  or  wea 

apparel  "i  any  kind,  in  any  hous '  building  wherein  any  person  shall  he  sick  \\  ith 


462  COMMUNICABLE   DISEASES. 

the  communicable  disease  exists.  A  number  of  the  tenement  house 
laws  also  forbid  the  making  of  clothing  or  carrying  on  of  other  trades 
in  tenements  where  there  is  communicable  disease. 

Milk  business  when  carried  on  from  a  house  with  communicable 
disease  is  dangerous,  as  the  infection  may  be  carried  by  members  of  the 
family  and  may  also  get  into  the  milk.  Regulations  concerning  the 
sale  of  milk  when  communicable  disease  invades  the  family  of  the  pro- 
ducer or  dealer  have  been  referred  to  on  page  419.  It  is  almost  always 
forbidden  to  sell  milk  in  such  cases  unless  the  milk  and  those  who 
handle  it  are  removed  from  the  infected  house. 

When  the  milkman  leaves  bottles  or  cans  with  the  infected  family 
and  removes  those  left  the  day  before,  there  is  danger  that  the  latter 
may  be  infected,  and  that  by  this  means  the  milkman  may  carry  the 
disease  to  others.  It  is  for  this  reason  that  the  use  of  bottles  has  been 
forbidden  in  Los  Angeles.  In  other  cities  it  is  onl}'  forbidden  when 
there  is  communicable  disease  in  the  house. 

Sometimes  tickets  are  used  by  dealers  in  payment  for  milk,  bread, 
etc.,  and  it  is  provided  in  Richmond,  Ind.,1  Meadville,  Pa.,  and  Little 
Rock,  N.  Y.,  that  such  shall  be  collected  from  infected  houses  and 
burned.     See  also  page  420. 

It  has  been  supposed   that  pet  animals   as  dogs  and  cats  are  very 

likely  to  carry  infection,  and  the  following  rule  is  found  in  Meadville,  Pa.: 

"No  clogs,  cats  or  other  household  pets,  shall  be  permitted  to  remain  in  any 
house  in  which  there  may  he  a  contagious  disease;  if  any  such  animal  has  been  ex- 
posed to  the  contagion  it  must  be  disinfected  when  removed,  and  not  returned  until 
after  the  house  shall  have  been  fumigated.2 

In  Missouri  the  rules  of  the  state  board  of  health  require  that  all 
pet  animals  exposed  to  smallpox  shall  be  killed  and  burned. 

Public  Libraries  and  Communicable  Disease.  Books  if  handled  by 
persons  with  a  communicable  disease  are  particularly  liable  to  be  in- 
fected, and  if  they  are  infected  it  is  very  difficult  to  disinfect  them.  It 
is  therefore  wise  to  guard  against  the  infection  of  public  libraries  which 
would  from  their  free  circulation  be  especially  likely  to  spread  disease. 
A  great  many  cities,  and  some  states,  as  Indiana,  Ohio,  and  Vermont, 
now  have  regulations  in  regard  to  this  and  seek  to  prevent  the  infection 
of  such   books.     Sometimes   the    infected  family  is   forbidden  to  take 


smallpox,  varioloid,  or  other  infectious  or  pestilential  disease,  except  for  the  per- 
sonal use  of  some  of  the  inmates  of  said  house,  and  no  person  shall  sell  or  expose 
for  sale  any  clothing  or  wearing  apparel  which  shall  have  been  made  in  any  house 
or  building  in  which  there  shall  have  been  at  the  time  when  said  clothing  was  made, 
any  person  sick  or  infected  with  any  such  disease." 

1  Richmond,  Ind.,  Report  of  Board  of  Health  1896,  p.  5. 

2  Meadville,  Rules  and  Regulations  (1895),  Rule  30. 


<  ■  OMMl  Wit  L I B  L  E    DISEA  sEs.  4  Q  3 

books  from  the  library  as  in  Cambridge,  Fitchburg,1  and  Lynn.  "  Cir- 
culating library  "  is  included  in  the  rule  as  in  Cambridge.  In  other 
cases,  as  in  Indiana  and  Vermont,2  the  librarian  is  not  to  send  out  books. 
In  order  that  the  librarian  may  be  enabled  to  carry  out  this  law  the 
Vermont  rule  provides  that  the  health  officer  shall  immediately  send 
notice  to  the  librarian  of  the  name  and  address  of  every  case  of  com- 
municable disease.  Similar  rules  are  found  in  many  cities  and  in  others 
where  there  is  no  such  rule  notice  is  regularly  sent  by  the  health 
department.  In  Providence  notices  are  sent  to  private  circulating 
libraries  as  well.  In  Providence  a  separate  card  is  sent  for  each  case 
giving  the  name,  residence,  disease  and  date.  These  are  kept  in 
alphabetical  arrangement  by  the  librarian  and  no  books  are  issued  to  the 
infected  houses  and  all  that  have  been  issued  are  by  him  returned  to 
file  health  department  for  disinfection. 

After  the  case  has  recovered  notice  is  sent  to  the  librarian  in  Cin- 
cinnati, Fitchburg,  Lynn,  Providence  and  some  other  cities. 

School  Attendance.  It  is  extremely  important  that  children  infected 
with  communicable  disease  should  be  kept  out  of  school.  The  very  great 
danger  to  which  large  numbers  of  children  would  be  exposed  is  reason 
enough  for  this  :  and  the  public  school  system  is  held  in  such  high  esteem. 
and  such  strenuous  efforts  are  made  to  prevent  everything  which  would 
interfere  with  its  success  that  it  is  much  easier  to  enforce  exclusion  from 
School  than  it  is  any  other  form  of  isolation.  Jt  is  a  well  nigh  universal 
rule  to  exclude  from  school  children  infected  with  communicable  disease. 
State  regulations  to  this  effeel  are  found  in  many  states,3  and  in  almost 
every  city  or  township  which  has  any  sanitary  regulations  at  all. 

Hoards  of  health  usually  have  under  the  Legislative  power  granted 
them,  authorit)  to  make  rules  in  regard  to  school  attendance,  but  in 
New  Jersey  this  authority  is  reserved  to  the  board  of  education.'  In 
Massachusetts  and  South  Carolina  also  the  school  board  has  this  power. 

1  Fitchburg,  Regulations  of  Board  of  Health,  25  August,  1894,  Rule  11: 

■  No  person  from  ;i  family  wherein  :i  <-;im'  of  Asiatic  cholera,  yellow  fever,  small- 
pox, varioloid,  diphtheria,  membraneous  croup,  or  scarlet  fever  exists,  shall  take 
:in\  1 k  to  or  from  the  public  library." 

J  Vermont,  Regulations  ol  Man-  Board  of  Health,   Lrt.  I. 

'■  Librarians  receiving  sucli  notice  shall  no!  alkwi  any  I ks  or  period icals  to  !"• 

taken  by  such  family  after  such   notice,  and  they  skill  nol   ;ill"\\    anj    I I<s   then 

held  by  any  member  of  a  family  where  there  is  contagious  disease  to  be  returned  to 
their  libraries  until  disinfected  under  the  direction  of  the  health  officer.1 

Colorado,  Delaware,  Indiana,  Iowa,  Kentucky,  Maryland,  Massachusetts,  Mich- 
igan, Minnesota,  North  Carolina,  <>lii",  Oklahoma,  Pennsylvania,  South  Dakota, 
South  Carolina,  Tennessee,  Utah,  Vermont,  Virginia,  and  Wisconsin. 

1  New  Jersey,  General  Statutes  (1895),  p.  1689,  Sec.  22: 

"That  any  board  of  education,  school  trustees  or  other  bodj  having  control  of 
the  public  schools  may,  on  account  of  the  prevalence  of  anj  contagious  disease,  ox 


464  COMMUNICABLE   DISEASES. 

The  following  are  some  of  the  items  found  in  these  school  regula- 
tions : 

Persons  Excluded.  A  good  many  of  the  laws  simply  exclude  infected 
"  children  "  or  "  pupils,"  but  many  exclude  "  persons  "  and  some  men- 
tion "  teachers  "  and  "  parents,"  and  in  Fall  River  "  janitors  "  are  named 
in  the  order.  In  Cambridge  "  No  person  shall  attend  or  visit  "  a  school 
if  living  in  a  house  with  a  communicable  disease. 

Persons  who  are  actually  sick  with  communicable  disease  are  invari- 
ably excluded  from  school  and  a  number  of  diseases  are  at  times  thus 
treated  which  do  not  require  notification  and  which  receive  no  other 
attention  from  sanitary  authorities.  Thus  measles  and  whooping  cough 
are  frequently  not  reported,  but  they  invariably  are  excluded  from 
school;  mumps  and  German  measles  are  rarely  reported  but  they  are 
to  be  excluded  by  rules  of  the  Iowa  state  board  of  health.  Ring-worm 
and  itch  which  are  never  reported  are  excluded  in  Boston,  Providence, 
and  doubtless  in  other  places.  In  Fitchburg  purulent  ophthalmia  is  not 
reported  but  is  to  be  excluded,  and  in  Bridgeport  the  same  is  true  of 
"  consumption." 

As  it  is  possible  for  conscienceless  lawyers  to  raise  the  quibbling 
point  that  a  person  who  is  up  and  about,  but  who  is  yet  desquamating 
from  smallpox  or  who  has  diphtheria  bacilli  in  the  throat  is  not  "  sick  " 
or  "  suffering  from  "  or  "  affected  with  "  a  communicable  disease,  the 
Indiana1  state  board  of  health  rule  excludes  any  one  who  "  has  recently 
been  affected  "  with  the  specified  disease.  A  similar  provision  is  found 
in  Minnesota,2  Albany,  Rochester,  and  in  Maine3  "  persons  recovering 
from  communicable  disease  must  have  a  permit  before  leaving  the  house. 

Not  only  is  the  sick  person  excluded  but  also  the  other  members  of 
the  family.  This  is  required  by  rule  in  smallpox,  diphtheria,  scarlet 
fever,  and  the  rarer  severe  diseases  in  many  states4  and  cities,  and  even 
where  there  is  no  law  on  the  subject  it  is  almost  universally  the  prac- 
tice. In  New  York  City  in  tenement  houses  the  rule  is  extended  to  all 
the  families  on  the  floor. 

The  rules  in  other  states  and  cities  require  the  exclusion  from  school 


to  prevent  the  spread  of  such  contagious  disease,  prohibit  the  attendance  of  any 
teacher  or  scholar  upon  any  school  under  their  control,  and  may  specify  the  time 
during  which  such  teacher  or  scholar  shall  remain  away  from  such  school." 

Indiana,  State  Board  of  Health  Rules,  19  February,  1891. 

-Minnesota,  Statutes  (1804),  Sec.  7045. 

;  Maine,  Chapter  123  of  1887  as  amended  by  Chapter  139  of  1895,  Sec.  15. 

••Delaware,  Iowa,  Kentucky,  Massachusetts,  North  Carolina,  Vermont,  Atlanta, 
Baltimore,  Brookline,  Mass.,  Concord,  Fitchburg,  Framingham,  Mass.,  Lowell, 
Macon,  Newton,  Mass.,  New  York  City,  Philadelphia,  Spokane,  St.  Louis,  and 
Syracuse. 


(  OMMUNIL  ABLE   D I  SEA  SES.  465 

of  all  children  living  in  the  house.1  An  inquiry  sent  out  by  the  Min- 
nesota state  board  of  health2  showed  that  there  was  only  one  local 
board  of  health  in  that  state  which  did  not  exclude  from  school  all 
children  in  the  infected  houses.  In  Fitchburg  a  house  is  defined  as 
follows : 

"  In  excluding  pupils  from  any  house  in  which  smallpox,  scarlet  fever,  diphtheria, 
and  membranous  croup  exists,  two  or  more  buildings  must  be  considered  as  one 
house  if  there  is  any  direct  communication  between  them;  or  if  it  is  possible  to 
enter  or  leave  the  two  residences  by  means  of  the  same  hall,  stairway,  or  door."3 

As  most  of  these  rules  exclude  the  person  unless  or  until  a  permit 
is  given  by  the  health  authorities,  it  is  impossible  to  determine  from  the 
rules  alone  how  strictly  the  exclusion  is  extended  to  the  whole  family  or 
house.  It  is  believed,  however,  that  the  permit  under  the  above-men- 
tioned rules  is  rarely  given  to  any  children  living  in  the  house  and  almost 
never  in  the  case  of  members  of  the  family.  In  Providence  all  children 
living  in  the  infected  house  are  excluded  whenever  it  appears  to  the 
inspector  that  the  families  cannot  be  trusted  to  keep  isolated  from  one 
another.  This  is  in  about  twenty-five  per  cent,  of  the  cases.  In  other 
eases  persons  living  in  the  house  but  not  in  the  family  are  allowed  to  go  to 
school,  in  scarlet  fever  after  one  week,  and  in  diphtheria  after  a  negative 
culture  has  been  obtained  from  the  throat.  Out  of  210  families  where 
such  permits  were  given  in  only  one  did  the  disease  subsequently  appear, 
whieh  would  indicate  that  the  isolation  which  the  department  relied  upon 
was  well  maintained.  ( 'hildren  living  in  the  house  would  be  more  likely 
to  contract  the  disease  than  to  carry  it  to  others,  and  of  540  susceptible 
children  in  these  houses  only  one  became  sick.  This  would  indicate  that 
when  there  was  reasonably  good  isolation  children  in  other  families  in 
the  house  may  with  a  fair  degree  of  safet\  attend  school.  Cambridge 
also  follows  the  Providence  plan.  In  BrookHne,  Mass.,  children  from  a 
family  where  there  is  whooping  cough  may  attend  school  only  when 
the\  have  previously  had  the  disease. 

Of  course,  when  the  rules  are  so  stringent,  parents  who  have  siok- 
ness  in  their  families  or  house  and  who  wish  to  send  their  well  children 
to  school,  send  their  children  away  to  board.  In  such  cases  in  Provi- 
dence a  written    permit    is   given,   but    only   after   the   Lapse  of  a  week 

in  scarlet    fever,  if    the  child    has  not    had   the  disease.       If    the  child  has 

bad  it,  the  permit  is  given  at  once.  In  diphtheria  a  negative  cult- 
ure is  required,  and  then  the   perinil    is   given    at    once.      See  Appendix 

'Indiana  Minnesota,  Ohio,  Pennsylvania,  South  Dakota.  Tennessee,  ami  in 
Bridgeport,  Camden,  Denver,  Fall  River,  Hartford,  Jersey  City,  Louisville,  Newark. 
\>w  [Iaven,  New  Orleans,  Providence,  Rochester,  Sail  Lake  City,  Worcester,  and 
STonkers. 

Minnesota,  State  Board  "i    Health  Report  (1895  B),  p.  K)5. 

Fitchburg,  Rules  of  Board  of  Health  (1807),  Rule  18. 


466  COMMUNICABLE   DISEASES. 

68.  This  permit  is  of  a  different  color  from  that  used  after  the  card 
is  removed.  In  Denver  as  in  Providence  the  period  of  exclusion  is 
one  week  after  removal  from  scarlet  fever.  In  Philadelphia  it  is  two 
weeks.  In  Providence  those  exposed  to  diphtheria  may  attend  school 
after  a  single  negative  culture  from  the  throat,  but  in  Denver  a  week 
must  elapse  and  a  negative  culture  be  secured.  In  the  City  of  New 
York  children  in  institutions  are  kept  out  of  school  for  ten  days 
after  exposure. 

In  many  cities  persons  exposed  must  not  be  admitted  to  school. 
In  Concord  such  child  is  to  be  excluded  until  a  certificate  has  been 
granted  by  the  board  of  health  that  the  period  of  incubation  belonging 
to  the  disease  to  which  he  has  been  exposed  is  passed.  Brookline, 
Mass.,  Cambridge,  Fall  River,  Fitchburg,  Minneapolis,  New  Haven, 
Paterson,  and  Somerville  do  not  allow  children  in  school  for  two  weeks 
if  they  have  visited  a  house  where  there  is  communicable  disease.1  In 
Fitchburg  and  other  cities  it  is  also  directed  that  pupils  are  not  to  be 
sent  to  the  house  when  communicable  diseases  are  believed  to  exist  in 
the  household  of  absent  pupils.  A  similar  provision  in  the  Iowa  rules 
applies  to  teachers.' 

Responsibility  for  Exclusion.  A  considerable  number  of  the  regula- 
tions place  the  responsibility  for  exclusion  upon  the  teacher,  who  is  not 
to  permit  the  child  to  attend  school.  This  is  by  far  the  easiest  way  to 
enforce  the  law,  for  the  teachers  are  public  officials  and  are  therefore 
more  easily  controlled,  provided,  of  course,  the  school  authorities  are  in 
sympathy  with  the  sanitary  officials.  Other  rules  place  the  responsi- 
bility upon  the  parent  who  is  not  to  send  the  child  to  school.  Others 
still  make  both  parties  responsible.  The  ordinance  from  Rochester  is 
perhaps  as  explicit  as  any  one  rule.2 

1  Fitchburg,  Rules  and  Regulations  of  Board  of  Health  (1897),  Rule  16: 
"  The  principal  of  any  school  upon  the  receipt  of  information  satisfactory  to  him 
that  any  pupil  attending  school  under  his  charge  has  visited  a  household  where,  at 
the  time  of  such  visit,  smallpox,  diphtheria,  membranous  croup,  or  scarlet  fever 
existed,  is  authorized  to  suspend  such  pupil  from  school  for  a  period  of  two  weeks 
next  following  such  visit."' 

-  Rochester,  Ordinances  of  the  Board  of  Health  (1895),  Xo.  11,  Sec.  1: 
"  Xo  principal,  superintendent,  teacher  or  person  acting  for  or  representing  any 
such  principal,  superintendent  or  teacher  of  any  school,  and  no  parent,  master, 
guardian,  or  custodian  of  any  minor  child  shall  permit  any  such  child,  having 
scarlet  fever,  diphtheria,  membranous  croup,  smallpox,  measles,  whooping  cough, 
or  any  other  dangerous,  infectious  disease,  or  any  child  residing  in  any  house  in 
which  any  such  disease  exists  or  has  recently  existed,  to  attend  any  public  or  private 
school,  until  he  or  she  shall  have  obtained  from  this  board  permission  to  attend  such 
school.  Xor  shall  any  such  principal,  superintendent,  teacher  or  person  acting  for 
or  representing  any  such  principal,  superintendent  or  teacher,  permit  any  such  child 
to  be  unnecessarily  exposed  or  to  heedlessly  expose  any  other  person  to  the  taking 
or  to  the  infection  of  any  contagious  disease.1' 


C OJIML  Wit  A BLE    DISEA  SES.  467 

In  New  Orleans  parents  must  notify  teachers  of  communicable 
diseases.  Atlanta  lias  a  unique  provision  that  physicians  must  notify 
the  superintendent  of  schools,  but  in  most  cities  this  is  left  to  the  health 
officer.  Sometimes,  as  in  New  Orleans,1  Oklahoma,2  and  St.  Louis,3- 
teachers  arc  explicitly  directed  to  send  out  all  cases  of  communicable 
diseases  found  in  the  school. 

In  Worcester,4  and  doubtless  in  many  other  cities,  teachers  are 
requested  to  send  away  from  school  any  children  suspected  of  having 
communicable  disease,  and  in  Worcester  cases  of  sore  throat  are  to  be 
excluded. 

Schools  included  in  the  Rules.  Many  of  the  regulations  forbid 
attendance  at  any  school.  A  few  simply  apply  to  public  schools. 
Private  schools  are  named  in  the  regulations  in  Indiana,  Ohio,  and  in 
Buffalo,  Lowell,  the  City  of  New  York,  and  Providence:  parochial 
schools  in  Indiana,  Ohio,  and  Providence:  Sunday  schools  in  Buffalo, 
Cincinnati,  the  District  of  Columbia,  Philadelphia,  and  Providence; 
night  schools  in  Minneapolis:  colleges  in  Cincinnati  and  the  District  of 
Columbia;  seminaries  in  the  District  of  Columbia;  and  "any  educa- 
tional institution'"  in  Providence. 

Duration  of  Exclusion.  Of  cour.se  children  and  other  persons  are 
not  allowed  to  return  to  school  before  the  termination  of  the  isolation 
at  home  as  shown  on  page  457,  that  is  before  the  house  is  disinfected 
and  the  warning  sign  removed.  Exclusion  will  be  at  least  as  long  as 
isolation  at  home  and  sometimes  longer.  Some  of  the  regulations  as 
those  of  Illinois,  Buffalo,  Concord,  Denver,  Louisville,  New  Haven. 
Paterson,  Rochester,  and  Vonkers  prescribe  definitely  the  time  during 
which  the  exclusion  must  continue.  In  the  cities  above  mentioned,  the 
period  of  exclusion  from  school  is  somewhat  lunger  than  the  isolation  at 

1  New  Orleans.  Ordinance,  Council  Series  N'<>.  2777,  Sec.  6: 

"Thai  every  principal,  teacher  or  assistant  teacher  of  any  ami  every  private  or 
public  school,  "ii  observing  that  any  child  <>r  children,  pupils  of  said  school,  presenl 
symptoms  of  any  contagious,  infectious  or  pestilential  disease,  shall  send  said  child 
or  pupil  to  Baid  pupil's  or  child's  domicile  and  residence,  with  instructions  to  the 
parent  or  parents,  tutor,  guardian  or  other  person  in  charge  of  said  pupil,  child  or 
children,  to  have  the  said  pupil  <>r  child,  or  pupils  or  children  examined  by  the 
family  physician,  and  said  instructions  shall  be  in  writing,  and  in  oo  case  shall  said 
child  or  children,  pupil  or  pupils,  so  sent  home,  be  allowed  to  attend  said  school 
thereafter  until  there  shall  be  produced  and  filed  with  said  principal,  teacher  or 
assistant  teacher,  a  certificate  from  a  licensed  physician  that  said  child  or  children, 
pupil  or  pupils,  are  nol  Buffering  from  any  contagious,  infectious  or  pestilential 
diseases.11 

'Oklahoma,  Rules  of  Territorial  Hoard  "f  Health.  Sec.  I. 
St.  Louis,  Ordinances  i\^>j>.  <  bapter  14,  Sec. 

1  Worcester.   Report  of  Hoard  of  Health  (1895). 


468  COMMUNICABLE   DISEASES. 

home,  usually  about  two  weeks,  though  in  Buffalo  it  is  three  weeks  and 
in  Louisville  twenty  days.  The  laws  of  Iowa,  Massachusetts,  North 
Carolina,  and  Tennessee  require  exclusion  for  two  weeks  after  recovery, 
(three  days  after  measles  in  Massachusetts)  ;  those  of  Pennsylvania, 
thirty  days  after  recovery.  In  Utah  exclusion  is  maintained  three 
weeks  after  the  card  is  off  in  scarlet  fever,  and  two  weeks  after  in 
diphtheria. 

Regulations  which  allow  a  permit  a  certain  time  after  "  recovery  '" 
are  not  definite,  as  it  is  impossible  to  determine  exactly  when  recovery 
takes  place,  and  practically  leave  the  matter  to  be  decided  by  the 
person  who  gives  the  permit  to  return.  A  number  of  cities  among 
which  are  Paterson,  Providence,  and  St.  Paul,  allow  children  to  return 
to  school  as  soon  as  the  warning  card  is  removed  from  the  house. 

Return  Permits.  Most  regulations  provide  that  persons  may  not 
enter  school  after  communicable  disease  without  a  permit.  There  is, 
however,  some  difference  of  practice  in  regard  to  who  shall  issue  the 
permit.  In  some  places  the  permit  is  to  be  issued  by  the  health  departs 
ment,  in  others  by  the  attending  physician,  and  in  some  by  both. 

The  health  department  is  to  issue  the  permit  in  Minnesota,  Penn- 
sylvania, South  Dakota,  Albany,  Asbury  Park,  Baltimore,  Bridgeport, 
Cambridge,  Camden,  Concord,  Denver,  Elmira,  Macon,  Newburgh,  New 
Haven,  New  York  City,  Paterson,  Providence,  San  Francisco,  and  in 
St.  Louis,  in  smallpox,  scarlet  fever,  and  diphtheria. 

The  form  of  permit  used  in  Minneapolis  is  shown  in  Appendix  09. 
It  has  a  stub  for  record.  Providence  has  a  simpler  form  and  the  date  of 
granting  the  permit  instead  of  being  noted  on  a  stub,  is  stamped  on  the 
slip  on  which  a  record  of  the  case  is  kept.     See  Appendix  70. 

In  North  Carolina,  Ohio,  Augusta,  Charleston,  Newark,  New  Orleans, 
Boston,  and  in  St.  Louis  (in  whooping  cough,  measles,  and  chicken 
pox),  a  certificate  from  the  attending  physician  suffices.  In  Cleveland, 
Cincinnati,  Fall  River,  Fitchburg,  Jersey  City,  Newton,  Mass.,  Buffalo, 
and  Rochester,  certificates  from  both  physician  and  health  department 
are  required.     The  form  used  in  Rochester  is  shown   in   Appendix   71. 

In  Chicago  a  postal  card  is  sent  by  the  health  department  to  the 
principal  of  the  school  giving  notice  that  the  children  may  return  to 
school.  This  is  printed  in  red,  while  the  exclusion  notices  are  in  black. 
In  Milwaukee  a  certificate  is  issued  by  the  health  department  which 
may  be  sliOAvn  at  the  school  or  library  or  elsewhere. 

In  Delaware  the  law  requires  the  school  officers  to  issue  the  per- 
mit to  return  to  school;  in  Iowa  the  mayor  or  town  clerk;  and  in  Mas- 
sachusetts, North  Carolina,  Vermont,  Louisville,  and  Spokane,  it  may  be 
either  the  board  of  health  or  the  attending  physician. 


( 'OMMUmC.  VBLE   DIHE.  1 S ES.  469 

In  order  that  children  may  understand  the  rules  in  regard  to  com- 
municable diseases  it  is  required  in  Scranton  that  the  rules  be  posted 
in  the  schoolroom.1  In  Montclair,  X.  J.,  a  card  stating  the  period  of 
exclusion  is  given  to  the  family  in  each  case. 

In  Michigan,2  teachers  are  required  to  teach  the  methods  of  prevent- 
ing the  spread  of  communicable  diseases.  Circulars  have  been  issued 
by  the  state  board  of  health  to  guide  the  teachers  in  their  instruction, 
and  since  1898  a  teachers'  monthly  bulletin  has  been  sent  to  all  the 
teachers  in  the  state.  A  number  of  the  boards  of  health  in  other  states 
where  it  is  not  required  by  law,  nevertheless  send  monthly  bulletins  to 
teachers.  It  is  to  be  feared  that  some  of  these  bulletins  need  more 
careful  editing. 

Closure  of  S,-]m<>ls.  The  question  of  closing  schools  to  prevent  the 
spread  of  communicable  disease  has  caused  a  great  deal  of  discussion. 
If  all  the  cases  of  communicable  disease  could  be  reported  and  isolated, 
there  would  of  course,  be  no  need  of  closing  schools  ;  but  unfortunately 
this  is  not  done,  and  sometimes  one  or  more  cases  continue  in  school 
unrecognized  perhaps  by  any  one.  The  chance  of  this  is  very  much 
diminished  by  careful  medical  supervision;  but  sometimes  cases  will 
elude  even  the  most  careful  inspection,  and  in  such  cases  when  it  is  ap- 
parent that  there  is  an  unrecognized  case  attending  the  school  and  in- 
n,  ting  the  other  pupils,  the  only  thing  to  do  is  to  close  the  school. 

Several  states,  among  which  may  be  named  New  Jersey,  Kentucky, 
Ohio,  and  South  Carolina,  provide  by  statute  for  the  closing  of  schools  to 
prevent  the  spread  of  communicable  disease.  In  Ohio3  the  board  of  health 
may,  "during  an  epidemic  or  threatened  epidemic  close  any  school." 
In  New  Jersey4  the  law  does  not  give  control  of  public  schools  to  the 
board  of  health,  but  to  the  board  of  education. 


1  Scranton,  Rules  and  Regulations  of  Hoard  of  Health  (1893),  Sec.  44: 

■■  .      .      .      And    it    shall  be   the   dutj    of   tin-   I >•  >:i i < t  to  have  this  section  printed  on 

r;nd>  mentioning  the  names  of  diseases  declared  communicable  and  dangerous  to 
the  public  health  in  this  rule,  and    posted  in  every  schoolroom   in   this  city;  ami    it 

shall    he    the   dnt\    of   each    teacher   to    read    the   section  to  the  SCl 1  at   least  once  a 

month  and  whenever  any  epidemic  shall  appear.     And  it  shall  he  the  duty  of  the 
board  of  health  to  have  this  section  printed  on  cards  and  furnished  t<,  every  private 

school,  academy,  seminary,  kindergarten  and  Sunday  scl 1   in  this  city,  and   to 

request  tie-  person  or  persons  in  charge  of  such  private  institutions  to  post  such 

Bards  in  conspicuous  places,  and  read  t  his  sect  ion  to  the  school  at   least  once  a  month, 
and  whenever  an}  epidemic  shall  prevail." 

-  Michigan,  Chapter  146  of  1895. 
Ohio,  Ajuiotated  statutes  (U ).  Sec.  2186. 

•  New  Jersey,  General  statutes  (1896),  p.  1689, Sec.  21: 

"That   t  he  board  of  health  of  any  township,  or  an\   City,  borough,  town  or  other 

local  municipal  government  in   this  state  shall    have   the  righl   to  declare  any  epi- 
demic or  cause  of  ill  health  to  he  so  injurious  or  hazardous  as  to  make  ii  necessary 


470  COMMUNICABLE   DISEASES. 

In  South  Carolina1  the  order  of  a  board  of  health  to  close  schools, 
must  be  approved  by  the  city  or  town  council.  The  closing  of  schools 
for  communicable  disease  is,  however,  usually  done  by  the  board  of 
health  under  its  general  grant  of  authority.  Often,  too,  it  is  done  by 
the  school  officers  simply  at  the  request  of  the  sanitary  officers,  and 
sometimes  it  is  done  by  the  school  authorities  of  their  own  volition. 
When  a  medical  inspection  of  schools  is  maintained,  it  is  said  that 
closure  is  not  so  often  necessary. 

Disposal  of  Bodies  of  Persons  Dead  of  Communicable  Diseases. 
Doubless  the  danger  to  be  apprehended  from  such  bodies  has  been  much 
exaggerated.  If  it  were  not  for  the  reprehensible  practice  of  kissing 
the  corpse,  which  strange  to  say,  is  not  uncommon,  the  danger  from  the 
body  itself  would  be  very  slight.  If  this  could  be  prevented,  the 
danger  would  be  from  exposure  to  the  members  of  the  family  and  in- 
fected articles  in  the  house  ;  but  there  is  a  popular  fear  of  danger  from 
this  source,  and  very  stringent  regulations  regarding  the  methods  of  dis- 
posing of  such  dead  bodies  and  of  conducting  funerals  are  commonly 
found.  Such  regulations  are  found  in  the  statutes  of  Colorado,  Connecti- 
cut, Maine,  Minnesota,  Missouri,  New  Mexico,  Pennsylvania,  Vermont, 
and  the  state  board  of  health  rules  of  Iowa,  Indiana,  North  Carolina, 
North  Dakota,  Ohio,  and  South  Dakota,  and  in  the  local  rules  of  nearly 
all  cities. 

Report  by  Undertaker.  A  good  many  cities  require  that  under- 
takers shall  immediately  report  all  deaths  from  communicable  diseases. 
In  Rochester  the  undertaker  is  to  give  immediate  notice  only  when 
there  is  no  physician  in  attendance.  For  some  reason  unknown  to  the 
writer,  the  board  of  health  in  Lowell  refuses  to  receive  such  notice  over 
the  telephone. 

Disinfection  of  the  Body.  In  nearly  all  city  and  state  rules  the 
undertaker  is  required  to  disinfect  the  body.  In  Pennsylvania2  it  is 
simply  stated  that  "  it  shall  be  the  duty  of  the  undertaker  or  other  per- 
son or  persons  having  the  body  in  charge  to  thoroughly  disinfect  the 
body."  In  Connecticut  it  must  be  disinfected  as  required  by  the  state 
board  of  health.3     In  most  of  the  rules  it  is  ordered  that  the  body  be 


to  close  any  or  all  of  the  public  or  private  schools  in  the  limits  of  such  township,  or 
of  such  city,  borough,  town  or  other  local  municipal  government;  but  in  case  of 
public  schools,  the  same  shall  not  be  closed  except  by  the  direction  of  the  board  of 
education,  school  trustees,  or  other  body  having  the  control  or  direction  thereof; 
any  such  board  of  education,  school  trustees,  or  other  body  having  control  of  pub- 
lic schools  may  in  such  case  cause  any  or  all  of  the  schools  under  their  control  to  be 
closed,  if  in  their  judgment,  such  closing  be  necessary  for  sanitary  purposes. 

1  South  Carolina,  Act  of  5  January,  1895. 

2  Pennsylvania,  Chapter  124  of  1895,  Sec.  4. 

3  Connecticut,  Chapter  100  of  1893,  Sec.  1. 


COMMUNICABLE   DISEASES.  471 

wrapped   in   a  sheet  wet  with   a  prescribed  disinfecting  solution.     In 
Connecticut1  the  rule  reads  : 

"  That  the  body  of  any  person  who  died  of  one  of  the  diseases  mentioned  in  the 
amendment  to  section  104,  of  the  General  Statutes,  shall  be  prepared  for  burial  by 
the  person  having  it  in  charge,  by  wrapping  it  in  several  thicknesses  of  cloth,  wrung 
out  of  solution  made  by  dissolving  sixty  grains  of  Corrosive  Sublimate  and  two  table- 
spoonfuls  of  Common  Salt  in  one  gallon  of  hot  water,  or,  out  of  a  solution  made  by  dis- 
solving six  ounces  of  pure  Carbolic  Acid  [not  the  commercial,  colored,  impure  Acid), 
in  a  gallon  of  hot  water.''' 

In  Lynn,  Holvoke,  Cambridge  (see  page  472)  and  Somerville,  it  is 
prescribed  that  the  whole  body  including  the  face  be  so  wrapped. 

Various  disinfectants  are  ordered  as:  Bichloride  of  mercury,  1  to  50 
in  Vermont;  1  to  100  in  Denver:  1  to  125  in  South  Dakota,  Youngs- 
town,  and  Detroit :  1  to  150  in  Colorado  Springs  ;  1  to  200  in  Portland 
Ore.:  1  to  500  in  North  Dakota,  Boston.  Buffalo,  and  Cambridge:  1  to 
1,000  in  Connecticut  and  Philadelphia.  Carbolic  acid  5  per  cent,  in 
Connecticut,  District  of  Columbia,  and  Philadelphia.  Chloride  of  zinc 
10  per  cent,  in  Holyoke  and  Lynn.  Chloride  of  lime,  4  per  cent,  in 
Philadelphia.  Sulphate  of  zinc,  one-half  pound  to  one  gallon  in  Ver- 
mont. More  explicit  rules  still  in  regard  to  disinfection  are  found  in  a 
tew  cities  as  Chicago,  Detroit,2  and   Denver/1     In  Chicago: 

•  Before  the  body  is  moved  or  hauled  for  further  treatment,  the  orifices  of  the 
sose  and  throat,  ami  in  typhoid  fever  the  rectum  should  be  packed  with  absorbent 
cotton  saturated  with  an  approved  disinfectant,  or  thoroughly  cleansed  by  an  in- 
jection of  such  disinfectant;  after  which  it  may  be  bathed,  dressed  and  encoffined, 
either  wrapped  in  a  disinfectant  sheet  or  packed  in  absorbent  cotton  saturated  with 
the  disinfectant.     If  the  face  is  left  exposed,  it  should  be  freely  sprayed  with  the 

disinfectant."' 

Iii  Denver  the  body  must  be  embalmed  and  the  cavities  stopped  and 
filled  with  cotton  soaked  in  corrosive  sublimate  1  to  100. 

"Disinfection  of  the  Room  and  the  Undertaker.  It  is  not  usualh  re- 
quired that  the  room  shall  be  disinfected  before  the  funeral,  but  in 
( Jhicago : 

••  The  entire  apartment  and  its  belongings  arc  to  he  thoroughly  sprayed  with  an 
approved  disinfectant,  also  before  removal  from  the  death  room  the  exterior  of  the 
coffin  should  he  sprayed  or  sponged  with  the  disinfectant.  It  may  then  he  removed 
to  a  room  previously  prepared  by  thorough  ventilation,  or,  if  accessary,  by  disin- 
fection and  from  which  all  unnecessary  furniture  and  other  articles  have  been  re- 
moved. As  soon  as  the  bod]  is  removed  from  the  death  chamber,  the  room  should 
he  locked  and  in.  ..he  allowed  to  enter,  excepl  the  disinfectors,  until  the  room  and 
its  belongings  have  been  properly  treated  and  made  safe.'' 


1  Connecticut,  Mate  Board  of  Health  Rule,  6  July,  1898. 
Detroit,  Ordinance  of  24  May,  L892,  Sec.  8. 
Denver,  « Ordinance  ■»»  of  1898,  s>  <■.  2f>. 


472  COMMUNICABLE    DISEASES. 

The  strictest  rules  for  the  undertaker's  care  of  himself  are  in  Detroit  r1 

"  .  .  .  Every  undertaker  having  in  charge  the  body  of  any  person  who  has 
died  of  either  of  the  above  mentioned  diseases  shall,  during  the  time  he  is  preparing 
such  body  for  burial,  wear  a  long  rubber  overcoat  buttoned  to  the  chin,  and  after 
he  has  properly  prepared  the  body,  shall  spray  his  hair,  beard,  hands  and  boots, 
especially  the  soles,  with  the  above  disinfectant  cologne,  and  shall  wear  his  rubber 
coat  when  carrying  or  arranging  said  coffin  or  casket  during  the  funeral.  After  said 
funeral  the  undertaker  shall  spray  his  hair,  beard,  hands,  shoes  or  boots  and  rubber 
coat  with  said  disinfecting  cologne  before  returning  home  or  walking  the  public 
streets." 

The  Coffin.  Almost  all  the  rules  require  that  the  body  shall  be  at 
once  placed  in  a  coffin  and  the  coffin  closed  and  not  again  opened.  In 
the  majority  of  rules  the  coffin  is  to  be  "  air-tight,"  in  others  it  is  to  be 
simply  "tight,"  in  others  "sealed,"  in  Boston  and  Buffalo,  "  absolutely 
tight,"  in  Minnesota  "  tightly  sealed,"  in  Pennsylvania  "  tightly  closed." 
It  is  not  generally  intended  by  these  rules  that  the  coffin  shall  be 
"  hermetically  sealed,"  though  this  is  required  in  Erie,  but  simpl}- 
securely  fastened  so  that  it  may  not  be  easily  opened.  In  the  City  of 
New  York  the  casket  is  to  be  "properly  sealed  immediately  and  per- 
manently." In  the  District  of  Columbia  the  coffin  is  to  be  "  clamped." 
In  Chicago : 

"  The  coffin  used  in  such  cases  should  be  absolutely  water  and  air-tight  so  as  to 
prevent  leakage  of  poisonous  or  offensive  fluids  or  gases  during  the  conduct  of  the 
burial.  All  disinfectants  used  in  such  cases  should  be  proven  bacterially  and 
chemically  proficient." 

In  Philadelphia  :2 

"...  the  entire  inner  surface  of  which  (lid  and  all)  shall  be  thoroughly  and 
completely  lined  with  a  layer  of  raw  cotton  of  a  thickness  of  not  less  than  one  inch; 
and  said  coffin  or  casket  shall  be  tightly  closed  with  screws  or  clamps,  and  n  main  sfl 
closed,  or  the  body,  wrapped  as  above,  shall  be  encased  in  a  coffin  or  casket  of  metal, 
with  all  joints  and  seams  closely  soldered." 

The  Cambridge  and  Somerville  rule  requires  the  casket  to  be  sealed 
with  wax,3  and  in  Portland,  Ore.,4  it  must  be  made  air  tight  with  putty. 

i  Detroit,  Ordinance  of  24  May,  1892,  Sec.  8. 

2  Philadelphia,  Hules  of  the  Board  of  Health  (1895),  Sec.  205. 

3  Cambridge,  Rules  of  Board  of  Health  (1897),  Sec.  7: 

"  In  all  cases  of  death  from  diphtheria,  membranous  croup,  scarlet  fever,  typhoid 
fever,  typhus  fever,  smallpox  or  cholera,  the  undertaker  shall  wrap  the  entire  body, 
including  face,  in  a  sheet  saturated  with  a  solution  of  one-fifth  of  one  per  cent,  of 
bichloride  of  mercury,  and  then  place  it  in  a  tight  coffin  or  casket,  and  seal  the  lid  in 
two  places  with  sealing  wax,  and  shall  furnish  the  board  with  his  sworn  statement 
that  the  foregoing  requirements  have  been  complied  with." 

4  Portland,  Ore.,  Ordinance  10359,  Sec.  14: 

"...  the  undertaker  shall  .  .  .  immediately  place  the  said  body  in  a 
coffin  and  seal  the  same  as  follows:  All  joints  shall  be  closed  with  putty,  and  the 
same  material  shall  be  used  around  the  top  and  bottom  of  said  coffin,  making  the 
same  air  tight." 


COMMUNICABLE    DISEASES.  473 

Most  of  the  rules  require  the  bod}r  to  he  put  in  the  casket  "  im- 
mediately,'" "  at  once '"  or  "  as  soon  as  possible.*'  In  Cleveland  how- 
ever,  six  hours'  time  is  given,  and  in  Pennsylvania  and  Louisville  six 
hours  if  the  undertaker  is  summoned  between  five  a.  m.,  and  eleven 
!•.  M.,  otherwise  twelve  hours.  In  Youngstown,  <  >.,  it  is  five  hours,  in 
Cambridge  eight  hours,  and  in  Erie  twelve  hours. 

In  Buffalo,1  District  of  Columbia,  and  Philadelphia,  the  body  must 
not  be  placed  in  an  ice  box. 

Time,  of  Burial.  It  is  generally  conceded  that  the  sooner  the  body 
of  a  person  dead  of  communicable  disease  is  disposed  of,  the  better  it  is. 
Many  rules  specify  the  time  within  which  the  burial  or  the  funeral 
must  take  place.  Often  it  is  provided  that  the  health  officer  may  by 
express  permit  extend  the  time.  The  Iowa  rule  requires  that  the  body 
shall  be  buried  immediately,  in  Florida  within  six  bonis.  In  Indiana 
anil  South  Dakota  the  time  allowed  is  twelve  hours  :  in  Minnesota, 
Ohio,  Albany,  Asbury  Park,  Bridgeport,  Buffalo,  Fall  River,  Fitchburg, 
Haverhill,  Lawrence,  Newark,  San  Francisco,  Spokane,  and  New 
Orleans  (in  the  summer),  twenty-four  hours;  in  Wilmington,  thirty 
hours,  and  in  the  District  of  Columbia,  Elmira,  Louisville,  Penn- 
sylvania, Rochester  and  New  Orleans  (in  the  winter),  thirty-six  hours. 
In  New  Bedford  the  body  must  be  buried  the  same  day  or  the  next  day. 

Privacy  of  Funeral.  Almost  all  cities  require  that  the  funerals  of 
persons  who  have  died  of  communicable  disease  shall  be  "private." 
Other  terms  are  also  used,  as  it  shall  be  ••  strictly  private,"  "  there  shall 
not  be  a  public  funeral"  or  a  "church"  funeral,  and  in  Indiana  and 
Iowa  no  "school  funeral."  It  is  also  required  that  the  attendance  at 
the  funeral  shall  be  limited  to  "as  few  as  possible,"  or  that  no  one  shall 
he  present  ••  whose  attendance  is  unnecessary,  or  to  whom  there  is 
danger  of  contagion  thereby." 

The  interpretation  of  such  general  expressions  is  of  course  doubtful 
and    musl    be    left    to    the    health    officer,  and    in    the    la.-^t    resort    to  the 

courts.     Iii  Albany  the  ordinance  requires  the  health  officer  to  ti\   the 
limit  of  attendance;  but  in   man\  of  the  rules  it  has  been  deemed  besl 

to  define  re  clearly  what   is  meant    by  a  private  funeral  and   who  may 

attend  it.     In  Pennsylvania2  the  attendance  i>  limited  --to  the  imme- 
diate adult  relatives  of  the  deceased,  and  the  necessary  number  of  adult 

pall  bearers."      There  ma\    he    -no   child    pall    bearers   or  carriers."      In 

Iowa,3  and  in  Milwaukee1  there  can  be  ••  no  pall  bearer  under  twenty 

1  Buffalo,  Ordinances  (1898),  Chapter  25,  Sec.  ">7. 

Pennsylvania,  Chapter  L24  ox  i*'.'">.  Sec.  8. 

Lowa,  Regulations  <>i  State  Board  .>t  Health  (1899),  Si  c.  27. 
1  Milwaukee,  Report  oi  Health  Commissioner  for  year  ending  April.  1891,  p.  21. 


474  COMMUNICABLE   DISEASES. 

years  of  age,"  and  only  adults  in  Providence.  In  Cleveland1  and 
Youngstown  no  children  may  attend  the  funeral.  In  Holyoke,  Lowell, 
and  Lynn  the  attendance  is  limited  to  the  "  immediate  adult  relatives," 
in  Lawrence  to  the  "  adult  family  in  the  house,"  in  Youngstown,  O.,  to  the 
adult  members  of  the  family.  Only  the  "near  relatives"  and  other 
adult  persons  not  exceeding  six  in  number  as  may  be  provided  by  rules 
of  the  director  of  police  are  allowed  to  be  present  in  Cleveland.2  In 
Newark  the  "  immediate  household,"  in  San  Francisco  and  Somerville 
the  "  immediate  family,"  and  in  Providence  the  "  immediate  relatives  " 
only  are  permitted  to  be  present."  In  Minneapolis  and  Fitchburg  the 
"  immediate  family  "  is  still  further  limited  to  those  "  who  are  resident 
at  the  place  of  death."  In  Milwaukee  only  persons  who  have  been 
already  exposed  may  be  present.  It  is,  of  course,  necessary,  if  there  is 
any  funeral  at  all,  that  both  undertaker  and  clergyman  shall  be  present, 
but  their  presence  is  expressly  permitted  in  only  a  few  of  the  rules,  as 
those  in  Indiana,  Lynn,  Milwaukee,  Minneapolis,  and  Providence.  In 
San  Francisco  the  health  officer  may  be  present,  and  in  Somerville  "  those 
whose  business  calls  them  there,"  which  is  doubtless  intended  to  include 
the  undertaker  and  clergyman.  In  Milwaukee  "  the  clergymen  must 
take  all  precautions  they  can  command  to  prevent  spreading  the  con- 
tagion/'' As  nearly  all  the  rules  allow  the  health  officer  to  grant  per- 
mits for  other  persons,  he  can  readily  cause  the  presence  of  the  clergy- 
man to  conform  to  the  law.  Most  of  these  rules  refer  to  funerals,  but 
there  may  be  other  gatherings  at  the  house  and  there  may  be  individual 
visitors.  Hence  in  Providence  and  Utiea  the  persons  in  charge  of  the 
body  shall  not  permit  "  any  assemblage  or  gathering."  In  Haverhill 
"  no  person  shall  be  allowed  to  enter  the  premises  where  the  body  is  or 
view  the  body.''  In  Vermont3  the  funeral  must  be  conducted  with  as 
little  publicity  as  possible. 

( 'arriages  at  Funerals. 
In  Pennsylvania:4 

"  No  undertaker,  or  other  person  or  persons  having  charge  of  the  funeral  or 
burial  of  the  body  of  a  person  who  has  died  of  any  of  the  diseases  mentioned  in  sec- 
tion four  of  this  act,  shall  in  any  case  furnish,  or  provide  for  such  funeral,  more 
than  the  necessary  number  of  conveyances  for  said  adult  relatives  and  pall-bearers, 
and  all  such  conveyances  which  may  have  been  used  or  occupied  by  any  person  or 
persons  who  have  been  residing  in  the  same  family,  or  house,  with  the  deceased, 
shall  be  fumigated  and  disinfected  at  such  time  and  in  such  manner  as  may  be 
directed  and  required  by  the  health  authorities." 

1  Cleveland,  Ordinances,  Chapter  30,  Sec.  471. 

2  Cleveland,  Ordinances,  Chapter  30,  Sec.  465. 

3  Vermont,  Statutes  (1894),  Sec.  4687. 

4  Pennsylvania,  Chapter  124  of  1895,  Sec,  8. 


COJEVCXICABZE    DISEASES.  475 


In  Detroit,1 


"•No  public  or  private  hack,  carriage  or  conveyance  used  or  held  for  hire  shall 
be  hired  or  used  to  attend  funerals  of  persons  dying  of  any  of  the  above  mentioned 
diseases  without  a  permit  for  such  use  of  said  carriage  first  obtained  from  the  health 
officer." 

In  Erie  only  three  carriages  are  allowed,  and  in  Yonkers  only  two. 
In  Milwaukee2  "no  person  shall  be  allowed  to  occupy  the  same  carriage 
with  those  who  are  residing  in  the  infected  house."  The  kind  of  car- 
riage that  may  be  used  is  prescribed  in  Yonkers.3 

As  in  Pennsylvania  and  Yonkers  so  in  a  number  of  other  cities  it  is- 
required  that  carriages  used  at  funerals  must  be  disinfected. 

Place  of  Funeral.  Many  of  the  states  forbid  a  church  funeral  and 
sonic  few  a  school  funeral.4 

In  Milwaukee  and  San  Francisco  it  is  forbidden  to  have  any  funeral 
at  the  house  (services  at  the  grave  probably  being  permitted).  In  Prov- 
idence also  services  at  the  grave  alone  are  permitted  in  smallpox  and  in 
cases  of  scarlet  fever  and  diphtheria  that  die  at  the  hospital. 

Funeral  X<>tirt>.  It  is  important  that  the  funeral  notice  should  be 
so  worded  as  to  warn  persons  not  to  come,  instead  of  inviting  them.5    In 


1  Detroit,  Ordinance  of  24  May,  1892. 

-  .Milwaukee.  Report  of  Commissioner  of  Health,  ending  April,  1891,  p.  21. 

;  STonkers,  Sanitary  Code  (1897),  Sec.  38: 

" It  shall  be  unlawful  to  permit  more  than  two  carriages  at  any  such  funeral. 
The  carriage  or  carriages  used  to  convey  any  person  or  persons  from  any  infected 
house  to  the  cemetery  or  elsewhere  shall  he  upholstered  in  leather,  including  all 
parts  of  the  inside  of  said  carriage,  except  the  floor  and  other  parts  composed  of 
solid  wood.      The  undertaker  or  other  person  or  persons  furnishing  carriages  to 

persons  residing  in  or  entering  infected  1 m^  shall  immediately  fumigate  or  cause 

to  he  fumigated,  and  then  washed  with  a  disinfecting  solution,  every  such  carriage 

before  using  il   tor  other  purposes  under  the  direct  sn  pen  ision  <>t  an  ci  up  love  of  the 
lmard    of    health;   and    hereafter   only  such  carriages  shall  he  used  to  convey  persons 

•offering  from  contagious  diseases  to  the  Fonkers  city  hospital.     Any  violation  of 

this  sect  ion  will  subjeel  the  offender  to  one  handled  dollars  tine  and  imprisonment.11 

1  Iowa.  Mate  Board  of  Health  Regulations  (1899),  Rule  27: 
No  person,  company,  corporation,  or  association  having  charge  of  or  control  of 
any  schoolhouse  or  church,  or  of  any  building,  room  or  place  used  for  school  ox 
church  purposes,  or  for  anj  public  assembly,  shall  permit  the  bodj  of  any  person 
dead  from  anj  of  the  contagious  or  infectious  diseases  named  in  these  regulations, 
or  anj  other  dangerous  contagious  disease,  except  typhoid  fever,  to  be  taken  into 
lucb  schoolhouse,   church,  building,  room  or   place,  for  the   purpose   of   holding 

funeral  service  over  such  bodj  ." 

b  Buffalo  i  Ordinances  1 1898),  Chapter  25,  Sec.  89: 

u  Whenever  anj  person  shall  die  from  any  of  tin'  contagious  or  infectious  dis- 
eases na nied  in  seet  ion  1 1 ,  t  he  undertaker  having  charge  of  the  preparation  and  in- 
terment   of    the    remain8   shall    lie    il nlj    person  authorized    to    insert    the    public 


476  C  OMMUWICA  BLE    I)  I  SEA  SES. 

Albany  the  funeral  must  be  advertised  as  private,  but  the  statute  in 
Pennsylvania1  goes  further  and  requires  "  that  any  advertisement  of  such 
funeral  shall  state  the  cause  of  death  "  and  in  Cleveland2  the  undertaker 
shall  "publicly  notify  all  persons  attending  such  funeral  of  the  name 
and  contagious  character  of  the  disease  from  which  the  person  has  died." 
In  Philadelphia3  "  such  notice  shall  contain  only  the  residence,  name  of 
deceased,  cause  of  death,  and  date  of  death  and  the  words  '  no  funeral ' 
and,  if  desired,  the  names  of  the  parents." 

Transportation  of  Bodies.  It  is  in  most  regulations  forbidden  that 
the  body  of  a  person  dead  of  communicable  disease  shall  be  carried  in  a 
public  conveyance  or  hack,  or  else  it  is  required  that  it  be  carried  in  a 
hearse  or  undertaker's  wagon.4  In  Buffalo  the  undertaker  with  the 
body  must  "  proceed  direct  from  the  house  to  the  burial  ground." 

Disposal  of  the  Body.  Aery  many  of  the  rules  as  has  been  shown 
require  that  the  body  shall  be  permanently  disposed  of  by  burial  within 
a  limited  number  of  hours.  Occasionally  it  is  stipulated  that  it  shall 
not  be  placed  in  a  receiving  tomb,  and  in  Iowa  and  Minneapolis  it  must 
not  be  so  placed  unless  it  is  in  an  hermetically  sealed  casket. 

Disinfection  of  Draperies,  Etc  The  materials  used  by  undertakers 
about  the  death  room  should  be  disinfected.  The  Boston  rule  is  given 
below.5 

Conditions  Requiring  Enforcement  of  Bide*.     Many  of  the  rules  in 

notice  of  death,  and  shall  state  the  cause  of  death  in  such  notice  for  which  he  shall 
he  held  responsible. 

"  No  person  shall  invite  to  funerals  or  any  services  connected  therewith,  any  per- 
son whose  attendance  is  not  necessary,  or  to  whom,  or  through  whom  there  is  dan- 
ger of  contagion  being  communicated  or  spread." 

1  Pennsylvania,  Chapter  124  of  1895,  Sec.  0. 
Cleveland,  Ordinances,  Chapter  30,  Sec.  473. 

3  Philadelphia,  Pules  Board  of  Health  (1895),  Sec.  205  K. 

4  Pennsylvania,  Chapter  124  of  1895,  Sec.  9: 

l'  The  body  of  a  person  who  has  died  of  any  of  the  diseases  mentioned  in  section 
4  of  this  Act,  shall  not  be  conveyed  to  or  from  any  dwelling  or  other  building  or 
place  to  any  cemetery  or  other  point  or  place  within  or  through  any  of  said  munici- 
palities except  in  a  hearse  or  other  vehicle  used  for  the  purpose  of  conveying  corpses 
only,  or  in  such  vehicle  as  shall  be  satisfactory  to  the  health  authorities,  and  under 
such  regulations  as  they  may  in  any  case  adopt.  The  undertaker  and  the  person  or 
persons  having  charge  of  the  funeral  or  transportation  of  such  body  shall  be  respon- 
sible for  any  violation  of  the  provision  of  this  section.'1 

5 Boston,  Manual  of  Health  Department  (1890),  page  33: 

"  Draperies  (so  called)  and  all  articles  which  have  been  used  about  the  body  of 
any  person  who  has  died  of  smallpox,  diphtheria  (including  membranous  croup, 
so-called),  scarlet  fever,  typhus  fever,  typhoid  fever,  yellow  fever,  or  cholera,  or 
which  have  been  used  in  the  room  where  such  person  has  died,  shall,  before  being 
removed  from  the  house,  be  destroyed  by  fire,  or  disinfected  to  the  satisfaction  of 
the  Board  of  Health. 


COMMUNICABLE   DISEASES.  477 

regard  to  funerals  and  burials  refer  to  persons  dead  of  "  contagious  or 
infectious  diseases."  Others  either  with  or  without  retaining  such  general 
terras  refer  to  special  diseases,  usually  smallpox,  scarlet  fever,  diphtheria, 
croup,  and  perhaps  cholera,  typhus,  and  yellow  fever.  Measles  are 
added  in  Charleston,  Lowell,  Minneapolis,  Xewburgh,  New  York  City, 
Rochester,  Providence,  Scranton,  cerebro-spinal-meningitis  in  Philadel- 
phia and  Vonkers,  and  whooping  cough  in  Minnesota.  Public  funerals 
in  tuberculosis  also  are  forbidden  in  Minneapolis.1 

It  is  not  sufficient  to  control  the  funerals  of  those  who  have  died  of 
the  diseases  mentioned.  Other  members  of  the  family  where  the  com- 
municable disease  is,  may  die  of  non-communicable  disease  ;  but  public 
funerals  in  such  cases  would  be  dangerous,  hence  in  Providence  "  the 
funeral  of  any  person  who  has  died  while  any  member  of  the  family  is 
sick  with  smallpox,  scarlet  fever,  measles,  diphtheria,  and  membranous 
croup  shall  be  private." 

Responsibility  for  Violation  of  Rules.  The  responsibility  for  the 
violation  of  funeral  rules  may  be  placed  upon  the  relatives  of  the 
deceased  or  upon  the  undertaker,  or  as  in  Providence  upon  the  clergy- 
man. Usually  the  responsibility  of  a  private  funeral  is  placed  upon 
both  the  family  and  the  undertaker  as  in  the  Pennsylvania  law  in 
Appendix  72.  For  illegal  acts  connected  with  the  immediate  care  of  the 
body,  the  disinfection  and  closing  of  the  coffin,  etc.,  the  undertaker  alone 
is  usually  held  responsible,  while  for  the  use  of  a  church  the  sexton  or 
person  in  charge  is  at  fault,  and  for  the  improper  use  of  carriages  the 
owner  or  driver.  Sometimes  the  persons  attending  the  funeral  are 
liable  as  in  Somerville.  In  some  cities  as  Fall  River  the  undertaker  is 
required  to  notify  the  family  in  regard  to  the  rules  governing  the 
funeral.  The  penalty  for  violation  of  these  rules  is  often  quite  high  as 
■-•:<hi  in  Denver-  and  §250  in   Milwaukee.3 

Anyone  interested  in  this  subject  should  study  the  entire  set  of 
funeral  regulations  contained  in  the  Pennsylvania  law  and  shown  in 
Appendix  72. 

Transportation  by  Common  Carrier.  Much  attention  has  of  late 
been  given  to  the  transportation  of  bodies  by  common  carriers,  particu- 
larly the  transportation  of  bodies  of  persons  dead  of  communicable 
diseases.     This  matter  has  been  frequently  discussed  at  the  conferences 

of  the  state  boards  of  health  and  has  also  been  considered  by  the  bag- 
gage agents  and  the  undertakers.  The  state  officials  have  been  par- 
ticularly anxious  to  guard  against  the  earn  ins  of  communicable  disease 


'Minneapolis,  Ordinance  of  25  June,  1897,  Sec.  20. 

-  Denver,  <  >rdinanc<  '  oapter  1 1.  Sec.  26. 

-  Milwaukee,  Report  -f  Health  <  '< nissioner,  year  ending  April.   1801,  page  21. 


478  COMMUNICABLE   DISEASES. 

from  one  state  to  another,  and  the  railroad  officials  have  sought  to  pro- 
tect their  employees  and  patrons.  The  rules  known  as  the  Nashville 
Rules  were  adopted  at  a  conference  of  the  state  boards  of  health,  the 
National  Funeral  Directors'  Association,  and  the  American  Association 
of  General  Baggage  Agents.  These  rules  are  given  in  Appendix  73. 
They  have  been  adopted  in  substantially  their  present  form  by  the  rail- 
roads represented  by  the  baggage  association  and  by  a  considerable 
number  of  states.1 

In  most  cases  these  have  been  adopted  as  rules  of  the  state  board 
of  health. 

Some  states  also  have  other  rules  on  this  subject.  In  Vermont  the 
transportation  of  bodies  dead  of  smallpox,  cholera,  typhus  fever,  yellow 
fever,  diphtheria,  and  scarlet  fever  is  forbidden.  In  California  and 
Maine  bodies  of  persons  dead  of  communicable  disease  are  to  be  trans- 
ported only  with  the  permit  of  the  state  board  of  health,  and  in  Massa- 
chusetts only  with  a  permit  from  the  local  board  without  other  restric- 
tions. In  Arkansas,  Connecticut,  Florida,  New  Jersey,  and  New  York 
such  bodies  may  be  transported  only  when  disinfected  and  in  her- 
metically sealed  caskets.  In  Ohio,  Tennessee,  Virginia,  and  West  Vir- 
ginia a  similar  rule  is  in  force,  but  the  method  of  disinfection  is  pre- 
scribed, and  it  is  also  required  for  bodies  dead  of  other  diseases  if  the 
time  to  the  point  of  destination  is  over  eighteen  hours.  The  form  of 
permit  used  under  these  rules  in  many  states  is  very  large  and  cumber- 
some and  is  printed  on  yellow  paper,  while  permits  for  non-communicable 
diseases  are  printed  on  white  paper. 

Statutes   Consulted   in   the   Preparation   of   the    Chapters   on  Communi- 
cable Diseases. 

Alabama.     General,  and  quarantine,  Code  (1896),  Sees.   2392-3,  2403-7,  2429,  2436, 
2439. 

Quarantine,  Code   (1896),  Sees.  245-51,  2001-8,  2395-2400,  2409-2427.     Act  of  23 
February,  1899. 
Arizona.     General,  Penal  Code  (1887),  Sees.  633,640;  Chapter  29  of  1899. 
California.     General,  quarantine,  Political  Code  (1886),  Sees.   2798-3063,    Penal 
Code  (1886),  Sees.  220,  373. 

Vaccination,  Political  Code  (1886),  Sees.  2993-4;  Chapter  24  of  1899. 

Antitoxin,  Chapter  39  of  1895. 
Colorado.     General,  quarantine,  vaccination,  Act  of  17  April,  1893. 
Connecticut,  General,  General  Statutes  (1888),  Sees.  2603,  2606. 

Notification,  Chapters  77  of  1895,  146  and  242  of  1897. 

Funerals,  Chapter  155  of  1893,  (also  rules  of  state  board  of  health.) 

Quarantine,  General  Statutes  (1888),  Sees.  2594-2602. 

Vaccination,  General  Statutes  (1888),  Sees.  1747,  2137,  2607. 

Antitoxin,  Chapter  252  of  1895. 

1  Alabama,  Colorado,  Delaware,  Illinois,  Indiana,  Iowa,  Louisiana,  Maryland, 
Michigan,  Minnesota,  Mississippi,  Montana,  New  Hampshire,  North  Carolina,  North 
Dakota,  Ohio,  Oklahoma,  Pennsylvania,  and  South  Dakota. 


COMMUNICABLE   DISEASE s.  479 

Delaware.     School  attendance,  vaccination,  Act  of  21,  March,  1883. 

General,  Revised  Code  (1893),  p.  298,  (Laws  of  Delaware,  Vol.  16,  Chapter  345). 
Quarantine,  Revised  Code  (1893),  p.  362,  (Laws  of  Delaware,  Chapter  46). 
District  of  Columbia.     General,  Act  of  3  March,  1897. 
Florida,  General,  quarantine,  Revised  Statutes  (1892),  Sees.  764-72;  Chapter  34  of 

1899. 
Georgia.     General,  quarantine,  Code  (1882),  1375  to  1393. 

Vaccination,  Act  of  20  December,  1897. 
Idaho.     Revised  Statutes  (1887),  Sec.  1153;  Act  of  13  March,  1899. 
Illinois.     Powers  of  cities,  Annotated  Statutes  (1896),  Chapter  24,  Sec.  63,  seventy- 
eight. 
Indiana.     Act  of  28  April,  1899. 
low  a.     Code  (1897),  Sees.  2564-75. 
Kansas.     Inoculation,  General  Statutes  (1897),  Chapter  100,  Sec.  321. 

Quarantine,  General  Statutes  (1897),  Chapter  75,  Sec.  17. 
Kentucky.     Legislation,  Statutes  (1894),  Sees.  2044,  2055,  2059. 
Quarantine,  Statutes  (1894),  Sec.  2049,  2056,  2062. 
Vaccination,  Statutes  (1894),  Sees.  4608-14. 
Louisiana.     Chapter  192  of  1898. 
Vaccination,  Chapter  8U  of  1S77. 
Warning  sign,  Chapter  115  of  1882. 
Quarantine,  Revised  Laws  (1884),  Sees.  3022-62. 
Maim:.     General,    quarantine,    Revised  Statutes   (1883),    Chapter  14;   Supplement 
Laws  (1885-95),  Chapter  14. 
Vaccination,  Revised  Statutes  (1883),  Chapter  11,  Sec.  87,  VIII;  Chapter  213  of 
1889,  and  172  of  1893. 
Maryland.     General,  Public  General  Laws  (1888),  Art.  43,  Sees.  8,  14-34;  Chapter 
346  of  1898. 
Quarantine,  Public  General  Laws  (1888),  Art.  41,  Sec.  71. 
Massachusetts.      General,    Public   Statutes   (1882),   Chapter  80,  Sec.  39  et   seq. 
Chapters  '.'s  of  188^  102  of  1890,   188  of  1891,  138  of  1885,  101  of  1886,  302  of 

1893,  198  of  1885,  4> f  1895,  211  of  18s:,,  and  120  of  1891. 

Vaccination,  Public  Statutes  (1882),  Chapter  17.  Sec.  9,  and  Chapter  80,  Sees.  51 

and  53;  Chapters  515  of  1894,  and  496  of  1898. 
Quarantine,  Public  Statutes  (1882),  Chapter  80,  Sec.  62  et  seq.;  Chapter  79  of 
is:.::. 
MICHIGAN.     General,    vaccination,  quarantine,   Compiled    Laws   <ls<i7).   Sees.   4412. 

Il-Jl  -54,  1460,  (171-83. 
Minnesota.     I  leneral,  vaccination,  quarantine,  statutes  (1894).  Sees.  Toe  79;  chap- 
ter 176  ol  L898. 
Warning  sign,  Chapter  L33  of  L897. 
Mississippi.     Annotated  Code  (1892),  Sees.  1008-9.  1405  6,  2278. 
Quarantine,  Chapter  79  of  1898. 
Vaccination,  Chapter  69  of  L896. 
Missouri.     Revised   statutes   (1899),   Sees.   5281,   5457,   5508,  5961,  5962,  7618-29, 

9764. 
Mom  w  \.     Penal  Code  1 L895),  Sees.  874,  694. 

Ni.u    Hampshire.      General,    vaccination,    Public    statutes   (1891),   Chapter   110, 
Chapters  80  of  1898,  and  100  of  L899. 
Vaccination,  Public  Statutes  (1891),  Chapter  1 10,  See.  1 ;  Chapter  93,  Sec.  2. 
Quarantine,  Public  statutes  (1891 1,  Chapter  111;  Chapter  80  of  L898. 
\i;u  Jersey.    General,  General  Statutes  (1895),   p.   L644,   Sec.  19,   Ml..    XIII.,  p. 
L645,  Sees.  52  .".7;  p.  L675,  Sees.  221  26. 
Vaccination,  General  statutes  (1895),  p.  1639,  Sees.  21  26. 
Antitoxin,  General  Statutes  (1895),  p.  1649,  Sec.  -1. 


480  COMMUNICABLE   DISEASES. 

New  Jersey,  continued. 

Notification,  General  Statutes  (1895),  p.  1677,  Sees.  236^10;  p.  1676,  Sees.  227-31. 

Quarantine,  General  Statutes  (1895),  p.  1671,  Sees.  205-215;  Chapter  107  of  1897. 
New  Mexico.     Compiled  Laws  (1897),  Sees.  3708,  3713-4. 

Vaccination,  Compiled  Laws  (1897),  Sees.  3704-5. 
New  York.     General,  vaccination,  Revised  Statutes  (1896),  p.  2418  (Public  Health 
Law,  Sees.  24,  200-1). 

Quarantine,  Revised  Statutes  (1896),  p.  2418  (Public  Health  Law,  Sees.  80-131g). 
Nevada.     Compiled  Laws  (1900),  Sees.  4983-6. 
North  Carolina.     Act  of  1  March,  1893. 

Quarantine,  Code  (1883),  Sees.  2893-2922. 
North  Dakota.     Political  Code  (1895),  Sees.  195,  201,  263-5,  271-4. 
Ohio.     General,  Annotated  Statutes  (1900),  Sees.  409 (-25)  (-28),  2115-6,  2118,  2135-6, 

2142-48. 
Oregon.     Quarantine,  Annotated  Laws  (1887),  Sees.  2537-39. 
Pennsylvania.     General,  Chapters  124  of  1895,  and  95  of  1897. 

Quarantine,  Brightly's  Purdoivs  Digest  (1894),  pp.  1712-24. 
Rhode  Island.     General,  quarantine,  vaccination,  General  Statutes   (1896),  Chap- 
ter 94. 

Quarantine,  General  Statutes  (1896),  Chapters  94  and  95. 

Vaccination,  General  Statutes  (1896),  Chapter  65,  Sec.  14. 
South  Carolina.     General,  Revised  Statutes  (1893),  Act  of  5  January,  1895,  Sees. 
965-8. 

Vaccination,  Chapter  78  of  1899. 

Quarantine,  Revised  Statutes  (1893),  Sees.  992-1031. 
South  Dakota.     Act  of  6  March,  1895. 
Tennessee.     Code  (1896),  Sees.  302-16,  3080-100,  3101-11. 
Texas.     General,   quarantine,   Revised  Statutes   (1895),   Sees.  538,   541,  543,   4327- 

4342a. 
Utah.     Chapter  45  of  1899. 

Quarantine,  Revised  Statutes  (1898),  Sec.  1110. 
Vermont.     General,  vaccination,  quarantine,  Statutes  (1894),  Sees.  4673,  4680-89. 
Virginia.     General,    vaccination,    quarantine,    Code    (1887),    Sees.    1496,    1719-28; 
Chapters  612  of  1895-6,  and  1146  of  1899-1900. 

Quarantine,  Code  (1887),  Sees.  1733-41;  Acts  of  30  April,  1877,  and  16  January, 
1896. 
Washington.     General,  quarantine,  Codes  (1899),  Sees.  739,  1238-42,  2972-3009 

Notification  of  Tuberculosis,  Chapter  71  of  1899. 
West  Virginia.     Code  (1899),  Chapter  150. 
Wisconsin.     Statutes  (1898),  Sees.  1408,  1412a-1416,  4602,  4608d. 
Wyoming.     Chapter  76  of  1899. 


' 


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CHAPTER  X. 

COMMUNICABLE   DISEASES 

(continued). 

Administrative    Work. 

IF  the  community  intends  to  do  anything  in  the  way  of  official  control 
of  communicable  disease  it  is  necessary  for  a  sanitary  officer  to  visit 
the  infected  premises  to  leave  directions  for  the  management  of  the  case 
and  to  see  that  whatever  is  required  is  done.  In  small  communities 
this  work  of  course  falls  upon  the  health  officer  and  is  indeed  his  first 
and  most  important  duty.  In  cities  in  which  the  health  department  is 
of  sufficient  importance  to  warrant  the  employment  of  subordinate  offi- 
cials to  assist  the  health  officer,  the  work  of  medical  inspection  as  it  is 
properly  called  is  placed  upon  an  officer  especially  employed  for  that 
purpose,  called  a  medical  inspector,  or  in  some  cases  these  duties  may 
be  performed  incidentally  by  other  subordinate  officers.  The  following 
shows  the  number  of  medical  inspectors  in  some  of  our  larger  cities  and 
what  salaries  they  receive  : 

Number  of  Annual 

City.  inspectors.  Salary. 

Boston 1   medical  inspector 2,200 

1  medical  inspector 1,400 

Brooklyn  (Borough  of)   1  chief  medical  inspector 2,500 

2  diagnosl  icians 1,800 

•_'  diagnosl  icians 1,200 

IT  medical  inspectors 1,200 

Buffalo 1   medical  inspector 1,000 

Cambridge 1   medical  inspector 3,000 

Chicago 1  chief  medical  inspector 2,000 

i"  medical  inspectors 900 

10  medical  inspectors  (in  winter) ... .  900 

Denver 2  medical  inspectors 900 

District  of  <  '"liiinl>i;i 1   medical  inspector 1,500 

Hartford 1   medical  inspector 600 

Milwaukee 5  assistant   health  commissioners . . .  900 

Minneapolis. :;  assistant  health  commissioners  1. 

New  Bedford 1   medical  inspector 500 

Newark I   medical  inspector.          1,000 

81 


482  COMMUNICABLE   DISEASES. 

Number  of  Annual 

City.  Inspectors.  Salary. 

New  York  (Borough  of  Manhattan) . .    1  chief  medical  inspector $2,500 

2  diagnosticians 1,800 

1  diagnostician 1,500 

1  diagnostician 1,200 

IT  medical  inspectors 1,200 

Omaha 1  medical  inspector 1,200 

Philadelphia 1  chief  medical  inspector 2,300 

4  assistant  medical  inspectors 1,200 

Pittsburgh 1  medical  inspector 2,400 

Providence 1  medical  inspector 1,500 

Rochester 1   medical  inspector 1,000 

St.   Paul 1   medical  inspector 720 

Salt  Lake  City 1   medical  inspector 720 


As  eases  of  communicable  disease  are  likely  to  come  to  light  at  any 
time  of  the  day  or  night,  the  health  department  is  kept  open  during  the 
whole  twenty-four  hours  of  every  day  in  the  year  in  the  great  cities,  and 
even  in  such  cities  as  Detroit  and  Pittsburgh.  In  smaller  places  night 
calls  are  so  rare,  and  the  medical  inspector  or  similar  officer  so  well 
known,  that  in  emergencies  it  is  expected  that  he  will  be  sought  at  his 
home. 

When  a  report  of  communicable  disease  is  received  at  the  health 
department  it  should  be  placed  in  the  hands  of  the  medical  inspector  as 
soon  as  possible.  There  is  some  advantage  in  allowing  the  inspector  to 
take  with  him  the  original  report  sent  in  by  the  physician.  By  so  doing 
he  may  be  better  able  to  correct  errors  in  the  name  or  address  which  are 
likely  to  occur  and  thus  save  valuable  time.  This  is  done  in  St.  Paul. 
If  it  is  done  of  course  the  report  should  first  be  recorded  in  the  office. 
It  may  be  at  once  entered  on  the  permanent  record  which  should  be 
kept  by  every  health  department  of  all  cases  of  communicable  disease 
reported.  If  the  inspector  comes  regularly  to  the  office  he  of  course 
gets  his  report  then.  In  Xew  York  the  inspector  calls  at  the  office 
twice  a  week  only,  and  the  reports  in  the  morning's  mail  are  delivered 
to  him  before  nine  A.  M.  by  the  police.  In  Boston  a  mimeograph  list  of 
the  names  and  addresses  of  the  sick  is  sent  out  daily  at  noon  so  that  it 
is  received  by  the  inspectors  at  about  two  P.  m.  The  reports  received 
later  are  sent  to  the  inspectors  by  mail. 

In  many  cities  the  original  returns  are  at  once  filed  and  a  blank  form 
or  report  containing  the  name  and  address  of  the  patient  is  given  to  the 
inspector.  In  many  cases  the  blank  carried  by  the  inspector  is  the  one 
that  shall  serve  as  a  full  report  or  perhaps  a  permanent  record  of  the 
cases  as  will  be  referred  to  below.  Sometimes,  as  in  San  Francisco  and 
Buffalo,  a  simple  slip  is  given  him  on  which  he  is  to  make  a  report  stat- 


t  OMMlTJSm  - 1 BLE    DISE,  1  S  E  \  483 

ing  briefly  what  action  he  took,  and  giving  the  name,  age,  and  address 

the  patient  and  the  name  of  the  physician. 

In  almost  all  eases  the  health  officials  accept  the  diagnosis  of  the 
attending  physician  who  reports  the  ease,  though  in  Seattle  the  health 
officer  visits  and  confirms  the  diagnosis  in  every  ease  reported.1  In 
Cambridge  the  medical  inspector  sees  each  case,  but  keeps  his  opinion 
to  himself  unless  called  upon  by  the  attending  physician.  Even  when 
the  case  is  discovered  in  other  ways,  if  there  is  a  physician  in  attendance 
it  is  usually  considered  good  policy  to  consult  him  in  regard  to  the  diagno- 

ind  not  attempt  to  officially  investigate  the  case. 

.More  trouble  occurs  from  diphtheria  than  any  other  disease.  In 
diphtheria  health  officers  from  the  attention  that  they  have  given 
to  the  subject  and  theii  familiarity  with  the  evidence,  recognize  the 
diagnostic  significance  of  the  diphtheria  bacillus.  Practicing  physicians, 
on  account  of  a  more  limited  observation  ami  because  of  an  occasional 
failure  of  the  method,  frequently  do  not  consider  that  this  organism  is  a 
safe,  or  perhaps  even  useful  aid  to  diagnosis.  Sanitary  officials  have 
therefore  generally  come  to  think  that  whenever  diphtheria  bacilli  are 
found  in  the  throat  or  QOSe  of  a  person,  that  person  should,  so  far  as  his 
relation  with  the  public  is  concerned,  he  treated  as  if  having  diphtheria, 
ami  it  is  the  usual  custom  to  treat  the  cast-  in  this  way  no  matter  what 
the  opinion  of  the  physician  may  have  been,  ami  no  matter  if  he  adheres 
to  it  after  the  culture  has  been  taken.  On  the  other  hand  the  health 
officer  is  perfectly  ready  to  treat  the  rase  as  diphtheria  when  the  attend- 
ing physician  reports  it  as  such,  when  no  culture  has  been  taken,  or 
even  if  when  a  culture  has  he, -II  taken  no  diphtheria  bacilli  ate  found. 
I  is  well  known  that  through  errors  of  technique  or  from  other 
causes  the  bacillus  is  not  found  on  the  first  culture  in  ten  per  cent,  or 
more  of  tin-  cases  of  true  diphtheria  this  position  of  the  health  officer  is 
perfectly  logical.  Sometimes  those  physicians  who  have  no  confidence 
in  bacteriolog}  are  very  ready  to  tike  advantage  of  the  situation  when 
the  bacilli  do  not  happen  to  he  found  at  first,  even  if  they  really  believe 
the  case  to  be  diphtheria,  and  refuse  to  take  another  culture,  saying  thai 

the  "  health     department     has    decided    that    it    was  not  diphtheria,"  and 

that  therefore  they  will  not  report  it  as  such.  The  writer  takes  every 
sion  to  urge  a  second  and  perhaps  a  third  culture  in  such  cases,  and 
usually  if  the  ease  w  a  ria  n  t  s  i  I  lhe\  ale  taken.  Personally  the  writer 
ha-  never  seen  a  case  of  what  he  believed  to  !><■  true  diphtheria  which 
did  not  show  diphtheria  bacilli  on  tin-  third  culture,  and  probablj  three 
negative  cultures  ma}  he  very  safety    relied  upon. 

While  it  is  unwise  for  the  health  officer,  except  when  sine  of  error 

'  Letter  it Health  I  ►fficer,  1895. 


484  COMMUNICABLE   DISEASES. 

or  deceit  on  the  part  of  the  attending  physician,  to  personally  investi- 
gate the  case,  yet  it  is  sometimes  necessary.  Moreover,  cases  are  con- 
stantly occuring  in  which  communicable  disease  is  suspected  when  there 
is  no  physician  attending.  It  has  been  deemed  wise  therefor  to  give 
the  sanitary  officers  authority  to  investigate  such  cases.  On  page  112 
reference  was  made  to  statutes  which  confer  authority  to  enter  private 
property  to  investigate  nuisances,  and  some  of  these  are  so  worded  as 
to  permit  the  exercise  of  the  same  right  for  the  investigation  of  com- 
municable diseases.  The  Massachusetts  law  has  been  copied  by  other 
states  and  probably  allows  and  requires  the  exercise  of  this  power.1 

Other  states,  among  which  may  be  mentioned  Indiana,  Maryland, 
New  Hampshire,  New  Jersey,  North  Dakota,  Ohio,  South  Carolina, 
Texas,  Virginia,  and  West  Virginia,  have  either  by  statute  or  by  rule  of 
the  state  board  of  health  authorized  local  boards  to  examine  into  cases 
of  suspected  communicable  disease.2  In  Texas  permission  must  first  be 
asked  before  the  forcible  entrance  is  made.  In  West  Virginia  the 
officers  may  not  enter  at  night  for  this  purpose.  The  rules  of  the  In- 
diana state  board  of  health  grant  the  right  of  examination  only  when 
there  is  no  physician  in  attendance  or  when  the  physician  fails  to 
report.  The  North  Dakota  rules  add  that  the  health  officer  must  "  in 
no  way  interfere  with  the  treatment  of  the  case."  The  charter  of  New 
York  City  authorizes  the  inspection   of  cases   for  diagnosis.15     In  New 

1  Massachusetts,  Public  Statutes  (1882),  Chapter  80,  Sec.  28: 

"  The  board  shall  examine  into  all  nuisances,  sources  of  hith  and  causes  of  sick- 
ness." 

2  New  Jersey,  General  Statutes  (1895),  p.  1645,  Sec.  45: 

"  That  all  police  justices,  recorders,  justices  of  the  peace  and  all  other  magis" 
trates  are  hereby  authorized  on  complaint  founded  on  information  and  belief,  sup- 
ported by  oath  or  affirmation  of  any  officer  or  agent  of  the  state  board  of  health  or 
of  any  local  board  of  health  that  there  is  in  any  dwelling  house,  store,  stable  or  any 
building  of  any  kind  whatsoever  any  nuisance  affecting  health  or  any  person  sick  of 
any  contagious  or  infectious  disease,  or  any  condition  of  contagion  or  infection 
which  may  have  been  caused  by  any  one  recently  sick  of  any  such  disease  in  such 
dwelling  house,  store,  stable  or  any  other  building,  to  issue  a  warrant  directed  to 
the  sheriff  of  the  county  within  which  such  complaint  shall  be  made,  or  to  any  con- 
stable, marshal,  police  officer  or  to  any  officer  or  agent  of  such  board  of  health 
directing  him,  them  or  any  of  them  to  search  in  such  dwelling  house,  store,  stable 
or  other  building  for  such  nuisance  affecting  health;  or  for  any  person  sick  of  any 
contagious  or  infectious  disease,  or  for  any  condition  of  contagion  or  infection  which 
may  have  been  caused  by  anyone  recently  sick  of  any  such  disease  in  such  dwelling 
house  or  other  place  as  aforesaid,  and  if  such  nuisance  be  found,  to  abate  the  same; 
and  if  such  sick  person  be  found,  to  deal  with  him  according  to  law  and  the  ordi- 
nances of  such  board  of  health;  and  if  such  condition  of  contagion  or  infection  be 
found  to  exist,  to  destroy  the  same  by  means  of  proper  disinfection. 

3  New  York,  Chapter  378  of  1897,  Sec.  1184: 

"  The  sanitary  superintendent,  the  assistant  sanitary  superintendents,  the  sani- 
tary inspectors  and  the  officers  of  said  department  may  visit  all  sick  persons,  who 


COMMUNICABLE   DISEASES.  485 

Hampshire  the  authority  to  enter  private  premises  is  granted  only  to 
inspectors  appointed  by  the  state  board  of  health.  A  number  of  cities 
have  similar  provisions  in  their  ordinances.  In  Maryland  the  state 
board  of  health  is  to  decide  questions  of  diagnosis.1 

While  in  ordinary  cases  the  diagnosis  of  the  attending  physician  is 
usually  accepted,  it  is  by  no  means  so  with  hospital  cases.  If  the  city 
officials  an-  to  remove  a  case  of  communicable  disease  to  a  hospital  it 
is  [tiudent  for  them  to  be  as  sure  as  possible  that  the  ease  is  sent  to  the 
right  ward.  It  is  unfortunate  to  send  a  scarlet  fever  case  to  a  diph- 
theria ward  or  chicken  pox  to  the  smallpox  hospital.  Therefore  in 
hospital  cases  the  patient  is  usually  examined  by  the  medical  inspector 
before  being  placed  in  the  department  ambulance.  In  New  York 
special  medical  inspectors  are  detailed  for  this  and  are  called  diagnosti- 
cians. 

In  all  cases  it  is  necessary  for  the  medical  inspector  to  exercise  the 
utmost  care  and  judgment  so  as  not  to  irritate  in  any  way  the  family  of 
the  patient,  or  the  attending  physician. 

In  the  District  of  Columbia  and  Philadelphia  penalties  are  imposed 
tor  the  obstruction  of  an  officer  while  discharging  the  duties  above 
referred  to,  and  in  Philadelphia  if  an  aggrieved  person  after  recovery 
assaults  an  officer  he  is  to  lie  fined  and  imprisoned.2 

The  first  thing  to  be  done  by  the  medical  inspector  on  making  his 
visit  is  to  enquire  as  to  the  facts  of  the  illness,  its  duration,  origin,  etc., 
the  age  and  other  items  concerning  the  patient  that  it  is  desirable  to 
record,  and  also  to  note  whatever  is  necessary  in  regard  to  the  other 
members  of  the  family.  As  the  laws  concerning  the  disease  are  often 
applicable  to  nil  members  of  the  family  and  to  all  children  living  in  the 
house,  enquiries  must  be  made  of  the  other  families  living  in  the  house. 
It  is  wise  to  visit  the  other  families  first  if  this  is  possible,  but  if  not. 
its  is  perhaps  usually  the  case,  the  inspector  should  not  enter  the  in- 
fected apartments  80  that  he  may  not  be  obliged  to  go  directly  from  an 
infected  to  an  uninfected  family.  It  is  possible  (  t  hough  improbable  ) 
that     he    might     thus    convey   the    disease,   but    it    is  chiefly   for    the   moral 


shall  be  reported  t<>  tin'  department  of  health  as  sick  of  anj  contagious,  pestilential 
or  infectious  disease  ami  report  i"  the  department  "f  health,  in  writing,  Ins  or  their 
opinion  "l  t  lieir  sickness." 

Maryland,  Chapter  346  of  1898,  Sec.  34E: 
"All  questions  of  doubl  concerning  the  cause  or  nature  of  any  sickness  believed 
<>r  suspected  to  lie  « . r  an  infectious  or  contagious  character,  shall  he  referred  i"  the 
Btate  board  <>f  health;  ami  the  said  hoard  shall  he  authorized  to  emploj  a  competent 
bacteriologist  t"  conduct  inquiries  into  the  nature,  source  and  vehicles  of  infectious 
disease/1 

Pennsylvania,   \<-t  of  20  January,  1859,  Sec.  28. 


486  COMMUNICABLE   DISEASES. 

effect  that  he  should  thus  respect  isolation.  The  data  needed  for 
record  and  as  a  basis  for  giving  directions  for  management  may  lie 
taken  on  a  special  slip  from  which  they  may  be  copied  on  to  a  record 
book,  or  they  may  be  taken  down  upon  a  printed  form  which  shall  serve 
as  the  permanent  record. 

After  thoroughly  examining  into  the  necessary  facts  the  medical 
inspector  gives  directions  as  to  isolation  and  disinfection.  To  aid  in 
this  most  health  departments  furnish  printed  circulars  which  the  in- 
spector may  leave  with  the  infected  family  and  perhaps  with  other 
families  in  the  house  and  neighborhood,  as  in  Detroit  and  Heading.  In 
Louisville  circulars  are  not  distributed  at  all.  As  such  circulars  of 
directions  may  well  be  uniform  for  all  communities,  and  as  small  com- 
munities could  not  well  afford  to  print  them,  they  are  furnished  by 
many  state  boards  of  health.1 

Sometimes,  as  in  Connecticut,  a  card  is  furnished  to  be  hung  in  the 
sick  room  on  which  are  printed  in  large  type  the  more  important  regu- 
lations. In  cities  with  a  large  foreign  population  circulars  are  often 
printed  in  different  languages.  Sometimes  a  polyglot  circular  is  issued 
and  sometimes  a  separate  circular  in  each  language.  Examples  of  such 
circulars  are  given  in  Appendices  74-80. 

Besides  leaving  circulars  which  contain  general  directions,  it  is  of 
course  the  duty  of  the  medical  inspector  to  give  specific  directions  for 
the  isolation  and  general  management  of  the  case  in  question.  The 
varying  regulations  of  different  states  and  cities  for  the  control  of  the 
patient,  the  family,  and  persons  living  in  the  house,  have  already  been 
considered.  It  is  the  duty  of  the  inspector  to  explain  all  these  matters. 
and  to  see  that  they  are  thoroughly  understood.  He  must  also  make 
it  understood  that  the  rules  are  to  be  obeyed.  Usually  these  directions 
are  given  verbally,  but  the  rules  of  the  Iowa  and  Vermont  state  boards 
of  health  require  that  they  shall  be  in  writing.  In  Iowa  the  notice  is 
to  be  in  the  name  of  the  mayor  or  township  clerk  and  is  to  be  served 
upon  the  family.  In  Vermont  the  notice  is  issued  over  the  signature 
of  the  health  officer  and  is  served  upon  the  head  of  the  family.  See 
Appendix  81. 

Sometimes  while  no  formal  order  for  isolation  is  served,  a  printed 
notice  in  regard  to  school  attendance  is  left  at  the  house.  This  is  done 
in  Reading,  Vonkers,  and  Charleston.      See  Appendix  82. 

In  Providence  it  has  been  the  custom  for  the  police  to  call  on  the 
day  following  the  visit  of  the  medical  inspector  and  further  insist  upon 


1  California.  Colorado,  Connecticut,  Illinois,  Indiana,  Iowa,  Maine.  Maryland, 
Michigan,  Minnesota,  New  Hampshire,  New  York,  North  Carolina,  Rhode  Island, 
Tennessee,  Virginia,  and  Wisconsin. 


I  ■  0  MMl  Wfl  ■.  i  11 LE    1>  is EA  S  E  v  4  £  7 

the  measures  of  isolation  ordered.     It  is  believed  that  the  duty  of  obedi- 
ence is  thus  more  forcibly  inculcated. 

Occasionally  a  short  printed  notice  of  some  one  regulation  maybe 
left  when  it  is  desired  to  issue  a  special  warning  or  when  the  regulation 
lias  been  markedly  disregarded.  Such  singling  out  of  a  flagrant  act  is 
more  effectual  than  to  trust  to  the  warning  of  a  general  circular  of 
direction-. 

It  was  formerly  the  almost  universal  custom  of  medical  inspectors 
to  make  quite  a  thorough  "sanitary  survey'"  of  the  infected  house  and 
note  all  nuisances,  defective  plumbing  and  drainage  and  filthy  con- 
ditions in  or  about  the  premises!  This  was  done  as  a  result  of  the 
teaching  of  the  early  European  sanitarians  that  the  infectious  diseases 
were  largely  tilth  diseases.  These  inspections  carried  on  systematic  all) 
have  only  served  to  prove  that  these  teachings  were  not  correct.  At 
present  very  many  health  officials  have  discontinued  all  enquiries  into 
"unsanitary  conditions "  because  it  is  feared  that  if  emphasis  is  laid 
upon  such  defects  the  family  will  feel  that  the  disease  is  not  due  to 
contagion  purely,  and  will  he  only  too  ready  to  attribute  its  presence  to 
the  parsimony  of  the  landlord,  rather  than  failure  on  their  part  or  their 
neighbors  to  maintain  isolation.  The  health  officer  wishes  to  have 
nothing  weaken  tin-  belief  that  the  contagious  diseases  are  contagious. 
Inspection  of  the  house  is  very  generally  omitted  in  scarlet  fever, 
diphtheria,  smallpox,  and  measles,  hut  it  is  very  generally  made  in  ty- 
phoid, for  the  mode  of  transmission  of  this  disease  is  not  yet  fully 
understood  and  it  is  very  possible  that  " unsanitary  conditions "  may 
sometimes  he  a  factor  in  its  spread.  Indeed  it  is  known  that  the  con- 
tamination of  drinking  water  with  sewage  is  sometimes  a  factor.  In 
some  cities  the  inspection  of  the  premises  where  there  is  communicable 
disease  is  not  made  by  the  medical  inspector  bul  by  the  sanitary  in- 
spector, as  in  Chicago,  Indianapolis  and  St.  Louis,  and  a  sample  of  the 
form  \\<i-i\  by  the  inspector  in  Indianapolis  is  shown  in  Appendix  3 
In  other  cases  the  form  used  for  this  purpose  also  includes  that  portion 
of  the  history  of  the  case  which  it  is  necessary  to  record.  It  is  then 
made  out  by  the  medical  inspector  in  lull  and  returned  to  the  office 
where  the  returns  lor  the  year  ma\  he  bound  together  or  otherwise 
tiled.  In  Appendices  83  I  may  be  found  a  sample  of  the  style  of  report 
which  requires  a  very  full  examination  of  the  premises. 

In  cities  where  \er\  strict  isolation  is  maintained  and  the  wage 
earners  are  kept  from  work,  it  is  necessarj  for  the  city  to  support  the 
famil\  when  the\  are  without  means.  This  is  don.'  more  in  Detroit 
than  perhaps  any  other  city,  and  there  the  inspector  is  required  to  make 
a  report   as  to  the  financial  condition  of  the  infected   family. 


488  COMMUNICABLE   DISEASES. 

After  the  medical  inspector  has  left  his  circulars  and  given  his 
directions  and  obtained  the  data  for  his  report,  he  may  put  up  the  warn- 
ing sign.  This  however,  is  sometimes  done  by  sanitary  inspectors  or 
by  the  police,  or  by  a  man  appointed  especially  for  that  purpose  as  in 
St.  Louis.  In  Chicago,  Cambridge,  Minneapolis  and  St.  Paul  the  cards 
are  put  up  by  the  sanitary  inspectors,  in  Pittsburgh  and  Detroit  by  the 
sanitaiy  police. 

When  the  inspector  visits  a  case  of  diphtheria  he  should  be  pre- 
pared to  take  cultures  from  the  throat  or  nose.  Very  often  the  attend- 
ing physician  requests  that  the  inspector  take  a  culture  from  the 
patient.  In  Philadelphia  the  board  of  health  advertises  to  take  cultures 
on  request.  In  Providence,  children  living  in  the  house  are  not  per- 
mitted to  go  to  school  until  negative  cultures  have  been  obtained  from 
them,  and  persons  living  in  the  family  with  the  case  are  not  allowed  to 
go  to  work  until  this  has  been  done.  Then,  too,  the  inspector  is  likely 
to  hear  of  suspicious  cases  of  sore  throat  in  the  neighborhood  which  are 
unattended  by  a  physician,  and  which  he  should  examine.  He  should 
therefore  carry  a  number  of  culture  outfits  with  him.  Several  ordinary 
culture  boxes  may  be  carried  in  the  pockets,  but  if  many  cultures  are 
to  be  taken,  it  is  important  to  decrease  the  burden  as  much  as  possible- 
Hence  swabs  alone  are  sometimes  carried  in  place  of  the  complete  out- 
fit. If  many  tubes  are  to  be  carried,  it  is  necessary  to  use  a  box  or  bag. 
When  smallpox  is  prevalent,  the  medical  inspector  should  be  prepared 
to  vaccinate  as  he  may  come  across  persons  whom  it  is  safest  to  vaccin- 
ate at  once  lest  they  escape  from  observation. 

After  his  return  to  the  office  it  is  necessary  for  the  inspector  to  send 
out  various  notices  or  to  see  that  it  is  done  by  the  proper  clerk.  The 
first  and  most  important  notice  is  that  to  the  schools.  Many  of  the 
state  regulations,  as  those  of  Colorado,  Maryland,  North  Carolina,  Penn- 
sylvania,1 Tennessee,  and  Vermont,  require  the  health  department  to 
notify  the  school  department,  and  such  a  requirement  is  still  more  often 
found  in  municipal  regulations.  The  efficient  health  officer  would  send 
such  a  notice  even  if  he  was  not  formally  directed  so  to  do,  and  this  is 
probably  the  reason  why  the  requirement  is  not  universal. 


1  Pennsylvania,  Chapter  124  of  1895,  Sec.  14: 

"  It  shall  be  the  duty  of  the  health  authorities  in  the  several  municipalities  as 
aforesaid,  to  furnish  daily,  by  mail  or  otherwise,  to  principals  or  other  persons  in 
charge  of  said  schools,  a  printed  or  written  bulletin,  containing  the  name,  location 
and  disease  of  all  persons  suffering  from  cholera,  smallpox  (variola  or  varioloid), 
scarlet  fever,  typhus  fever,  yellow  fever,  relapsing  fever,  diphtheria,  diphtheritic 
croup,  membranous  croup  or  leprosy,  upon  receipt  by  them  of  reports  of  such  cases 
from  physicians  as  recpaired  in  section  one  of  this  act:  Provided,  That  the  health 
authorities  of  any  municipality  may,  in  lieu  of  the  daily  bulletin  herein  required, 


( ■  OMMUNICABL  E    UlsEA  SES.  4  8  9 

As  a  matter  of  fact  various  methods  are  taken  to  notify  the  schools. 
Usually  whatever  method  is  taken,  the  notices  are  sent  daily,  but  some- 
times as  in  Baltimore  they  are  only  sent  twice  a  week.  In  Newark 
notices  are  sent  to  private  schools  three  times  a  week.  In  some  cases 
they  are  sent  to  the  board  of  education  as  is  required  by  the  laws  of 
Maryland,  Tennessee  (to  the  county  superintendent  if  not  in  a  town), 
and  North  Carolina.  In  Massachusetts  the  statute  requires  notices  to  be 
sent  to  the  school  committee.  In  several  cities  where  it  is  not  prescribed 
by  law  this  method  is  followed,  as  in  Bridgeport,  Denver.  Detroit.  Fall 
River,  Fitchburg,  Newark,  and  Youngstown,  O. 

Notice  reaches  the  teacher  who  is  to  enforce  the  law  sooner  if  it  is 
sent  directly  to  the  school  where  the  pupils  attend,  and  this  can  be 
readily  done  if  the  medical  inspector  obtains  the  facts  at  the  time  of  his 
visit.  This  method  of  sending  the  notice  directly  to  the  school  is  prob- 
ably the  one  generally  followed.1  When  notice  is  sent  to  the  school 
department  of  course  a  complete  list  of  all  cases  is  sent  as  in  Detroit : 
but  sometimes  even  then  a  separate  slip  is  sent  for  each  case  as  in  Fitch- 
burg. Sometimes  when  it  is  sent  to  the  schools  direct  a  complete  list 
of  all  cases  reduplicated  on  the  mimeograph  or  hektograph  is  sent  as  in 
Boston  and  Baltimore.  When  notice  is  sent  only  to  the  school  where 
the  pupils  attend,  usually  only  the  names  of  the  children  there  attending 
are  sent.  Sometimes  the  Christian  names  of  all  the  children  are  sent, 
but  more  often  only  the  family  name  and  the  address.  The  form  of 
eard  used  in  the  District  of  Columbia  is  shown  in  Appendix  85.  In 
Bridgeport  what  is  practically  a  copy  of  the  physician's  report  is  sent  to 
the  school.  Only  the  family  name  is  used  in  Chicago,  as  shown  in 
Appendix  86.  This  card  is  a  double  reply  card  and  the  reply  card  is 
Used  by  the  principal  of  the  school  to  report  to  the  health  department  that 
the  not  ice  was  duly  received.      Sometimes  a  copy  of  the  law  is  printed  on 

the  card.  In  Providence  for  scarlet  fever  the  letters  are  in  red,  for 
diphtheria  black,  and  still  another  style  of  card  is  wsvd  for  measles. 
Notices  are  sent   to  parochial,  private,  and  other  secular  schools  in  the 

same  manner.     Notices  are  frequeatly  sent   to  Snndax  schools  but  this  is 

by  no  means  universal.     In    Providence   the  Sunday  school  notices  arc 

sent   to  the  pastors  of   the   churches.      In    that    citj    they   are  sent  daily, 

but  in  Newark  they  arc  sent  on   Friday  of  each   week.     In  some  cities 


I  no  viile  thai  ;»  not  ire  shall  be  given  to  the  school  ors<  Inn.  is  attended  by  the  children 
in  whose  borne  or  residence  any  of  the  diseases  mentioned  in  this  section  exist,  and 
prescribe  the  form  of  said  notice." 

1  It  certainly   is   in   Albany,  Boston,  Cambridge,  Chicago,    District  of  Columbia, 
Minneapolis,  New  Fork, Philadelphia,    Providence,    (leading,  Rochester,    st.  Louis, 

San   I  ran'  is.  ...  :nnl    Y..nk«Ts. 


400  COMMUNICABLE    DISEASES. 

they  are  sent  to  the  superintendents  of  the  Sunday  schools.  The 
medical  inspector  also  sends  notices  to  the  public  and  other  libraries, 
and  in  those  cities  where  wage  earners  are  kept  from  work,  notices  must 
be  sent  to  the  employers.  In  Detroit  the  post  office  authorities  are  noti- 
fied of  cases  of  communicable  disease.  In  Providence  notices  are  sent 
to  the  da}^  nurseries,  in  Chicago  to  milkmen,  and  to  fresh  air  societies 
in  New  York.  In  Boston  where  the  medical  inspector  does  not  visit 
the  office  each  day  a  card  is  sent  by  him  to  the  office  recommending 
whether  the  patient  should  be  removed  to  the  hospital  or  kept  at  home. 
In  case  the  latter  is  decided  upon,  the  notice  shown  below1  is  sent  to 
the  attending  physician. 

After  the  infected  house  has  been  visited  and  the  clerical  work  con- 
nected with  the  various  notices  has  been  done,  it  is  necessary  to  make  a 
record  of  the  case,  or  at  least  to  begin  such  a  record  which  of  course 
can  be  completed  only  with  the  termination  of  the  case.  The  import- 
ance of  keeping  a  good  record  of  all  cases  of  communicable  disease  can- 
not be  overestimated.  There  are  a  great  number  of  unsolved  problems 
connected  with  the  management  of  communicable  diseases  and  a  vast 
number  of  observations  of  the  natural  history  of  these  diseases  must  be 
made  before  satisfactory  solutions  can  be  reached.  The  importance  of 
keeping  such  records  has  been  recognized  in  the  statute  law  of  several 
states  and  it  is  required  in  Maryland,2  Massachusetts,  North  Carolina, 
New  Jersey,  and  South  Dakota. 


1  Office  of  Board  of  Health, 

Boston,. ]S9 

Doctor 

I  have  just  now    made    an   official    visit    at  the  house   of    your   patient 
at for  the 


Board  of  Health.  It  will  be  my  duty  to  cooperate  with  you  in  main- 
taining the  necessary  isolation  of  the  patient,  and,  on  notice  from  you  or 
the  family  of  the  termination  of  the  disease,  to  see  the  patient  and  certify  the 
facts  required  by  the  Board  of  Health  for  its  action. 

Respectfully, 


Agent,  Board  of  Health. 

-  Maryland,  Chapter  M46  of  1898,  Sec.  34C: 

"  The  Boards  of  Health  in  the  several  cities,  towns,  and  counties  shall  cause 
a  record  to  be  kept  of  all  reports  received  in  pursuance  of  the  preceding  sec- 
tions and  such  record  shall  contain  the  names  of  all  persons  who  are  sick  with  infec- 
tious or  contagious  diseases,  the  localities  in  which  they  live,  the  disease  with  which 
they  are  affected,  together  with  the  date  and  names  of  the  persons  reporting  any 
such  cases,  and  the  record  of  quarantine,  disinfection  and  other  preventive  meas- 
ures.'" 


COMMUNICABLE    DISEASES.  491 

In  Massachusetts  the  record  is  to  he  in  hunks  furnished  by  the  secre- 
tary of  state.  In  New  York  City  a  similar  book  is  used.  Two  books 
are  used  so  that  inspectors  may  not  he  delayed  and  the  records  are 
entered  twice  a  week  when  the  inspectors  call  at  the  office  and  are 
signed  by  them.  Another  honk  which  is  practically  a  street  index  also 
has  all  the  cases  entered  in  it.  A  separate  book  is  used  for  the  cases 
which  go  to  the  hospital. 

Another  form  of  record  consists  of  the  report  of  the  inspector  upon 
a  sheet  which  is  tiled,  and  perhaps  hound,  and  thus  serves  as  a  perma- 
nent record.  These  may  he  indexed  by  streets  or  names,  or  both,  or  ar- 
ranged according  to  one  method  and  indexed  by  the  other.  Such  forms 
are  used  in  cities  where  the  sanitary  inspection  of  the  infected  house 
is  made  a  feature  of  the  work.  Examples  of  these  forms  are  shown 
in  Appendices  83-4. 

A  very  convenient  form  of  record  is  the  card  record.  These  cards 
may  he  arranged    according  to   streets  or  by  names,  or  there  may  he  a 

arranged  each  way.  In  Providence  experience  has  shown  that 
there  is  little  need  for  any  other  that  a  street  index.  The  form  used 
in  Milwaukee  is  shown  in  Appendix  87,  blue  for  diphtheria,  red  for 
scarlet  fever,  buff  for  typhoid,  and  white  for  measles  and  other  disi 
Of  course  the  items  diffei  somewhat  in  the  different  diseases.  The 
record  is  compact  and  there  is  a  considerable  number  of  items,  more 
than  there  is  room  lor  mi  most  of  the  hook  records,  but  not  as  many  as 
it  is  well  to  record. 

In  Providence  a  compromise  form  of  record  is  used.  It  is  used 
like  a  card  in  that  the  sheets  are  arranged  alphabetically  by  streets. 
They  are  kepi  in  a  drawer  with  a  hoard  upon  them  to  keep  them  flat  : 
hut  as  they  arc  of  the  thickness  of  ordinary  paper  they  can  he  easily 
folded  and  carried  in  the  pocket.  The  medical  inspector  takes  blank 
ones  with  him  and  (ills  them  out  as  fully  as  possible,  and  he  also  takes 
them  with  him  when  he  makes  any  subsequent  visits.  All  the  cases  oi 
all  diseases  under  observation  are  kepi  in  a  pile  together,  arranged  by 
streets.     When  a  case  has  terminated  the  slips  for  each  disease  are  kepi 

Separate.  At  the  end  of  the  year  thej  are  assorted  and  arranged  in 
various  ways  for  ease  in  making  up  tables  and  are  finally  bound.  The 
form  used  in  diphtheria  is  shown  in  Appendix  88.  The  scarlet  fever 
slips  are  white,  diphtheria  green,  mid  typhoid  blue. 

Another  useful  form  of  record  and  >  generally  used  in  conjunction 

with  book  or  card  records  is  the  map.  .Maps  are  hung  in  the  office 
and  on  these  are  noted  all  the  eases  of  communicable  diseases  thai  come 
to  the  notice  of  the  depart  men  t .     Sometimes  a  separate  map  is  used  for 

each  disease  and  sometimes  all  are  marked  on  one    map.  different    colors 


4112  C  OMMXTNICABLE   BIsEA  SEs. 

being  used  for  the  different  diseases.  Sometimes  one  map  lasts  for  a 
whole  year  or  for  several  years  as  the  phthisis  map  at  Rochester.  Some- 
times a  new  ma})  is  used  for  each  month  as  in  Baltimore,  and  in  Provi- 
dence a  new  one  on  which  are  marked  all  diseases,  is  set  up  every  six 
months.  In  Providence  the  map  is  mounted  over  cork  and  is  pasted 
only  around  the  edges  so  that  it  may  be  easily  cut  off  and  filed  away. 
Cases  may  be  designated  by  spots  of  ink  or  pins  or  both.  The  most 
common  way  is  to  stick  in  a  red  headed  pin  for  scarlet  fever  as  near 
the  location  of  the  case  as  may  be,  a  black  pin  for  diphtheria  and  a 
white  pin  for  typhoid.  In  Providence  where  the  locations'  are  marked 
by  both  ink  and  pins  the  scarlet  fever  and  diphtheria  pins  are  taken  out 
when  the  cards  are  removed  and  a  spot  of  the  corresponding  color  is 
left  on  the  map.  The  typhoid  pins  are  left  in  as  long  as  the  map  is  in 
use  and  their  location  is  marked  with  a  T.  In  Baltimore  a  separate 
wafer  of  brown  is  stuck  on  the  pins  for  every  case  in  the  house.  As  a 
new  map  is  used  for  each  month,  the  cases  carried  over  from  the  pre- 
ceding month  are  designated  by  a  red  wafer.  When  disinfected  the 
place  of  the  pin  is  marked  in  blue.  Pin  maps  are  exceedingly  useful 
and  show  local  outbreaks  better  than  any  other  method.  Such  maps 
are  used  in  Asbury  Park,  Baltimore,  Cambridge,  Denver,  Montclair, 
N.  J.,  New  Bedford,  Providence,  Rochester,  and  doubtless  in  man}*  other 
places. 

To  post  a  placard  and  exclude  children  from  school  may  and  doubt- 
less does  accomplish  much  :  but  unless  something  more  is  done,  the 
patient  and  perhaps  other  members  of  the  family  may  pay  little  heed 
to  isolation.  The  laws  almost  invariably  require  that  the  patient  and 
other  members  of  the  family  stay  in  the  house.  This  they  will  rarely 
d<  >.  particularly  members  of  the  family  who  are  well,  unless  there  is 
some  supervision,  and  unless  this  supervision  is  constant  it  is  scarcely 
possible  to  believe  that  our  state  and  municipal  laws  are  at  all  well  en- 
forced ;  and  constant  supervision  is  rare  in  American  cities. 

Even  if  there  is  only  one  other  visit,  a  final  one,  before  the  card  is 
taken  down,  it  may  do  some  good,  for  there  may  be  a  fear  that  viola- 
tions of  the  law  will  be  discovered:  but  this  is  often  omitted  even  in 
such  cities  as  Cleveland,  St.  Paul,  Chicago,  and  Cincinnati.  In  Hart- 
ford also,  only  one  visit  is  made  at  the  beginning,  but  when  the  attend- 
ing physician  reports  that  the  case  is  well  the  patient  comes  to  the 
office  of  the  medical  inspector  to  show  that  desquamation  has  ceased  or 
to  have  a  culture  taken. 

In  most  cities  at  least  two  official  visits  are  made  to  the  infected 
premises,  one  when  the  case  is  reported  and  one  when  the  warning  sign 
is  to  be  removed.     In  scarlet  fever  the  object  of  the   visit  is  to  deter- 


COMMUNICABLE    DISEASES.  493 

mine  whether  desquamation  has  ceased,  and  in  diphtheria  to  take  a 
culture  from  the  throat.  Of  course,  if  the  patient  is  not  through 
desquamating  or  diphtheria  bacilli  are  found,  several  visits  may  be  re- 
quired. Usually  the  first  of  these  "final"  visits  is  not  made  until  a 
notice  is  received  from  the  family  or  from  the  physician  that  the  case  is 
well  and  that  in  scarlet  fever  desquamation  has  ceased;  but  in  Roches- 
ter it  is  the  custom  for  the  medical  inspector  to  visit  all  cases  after  the 
expiration  of  twenty-one  days. 

In  some  cities  a  more  complete  supervision  of  the  cases  is  main- 
tained. In  Baltimore  frequent  visits  are  made,  and  the  same  is  true  of 
Newport,  R.  I.,  Paterson,  and  Pittsburgh.  A  still  better  supervision  is 
secured  by  daily  visits.  This  is  done  in  Wilmington,  Del.,  where  the 
sanitary  inspectors  (executive  officers),  do  this  work  though  they  are 
aided  by  the  police.  In  Detroit,  where  a  stricter  isolation  is  kept  up  in 
scarlet  fever  and  diphtheria  than  in  most  cities,  the  inspector  is  sent  to 
the  house  within  three  hours  after  the  case  is  reported  and  then  visits 
the  house  daily.  He  also  makes  a  daily  report  to  the  central  office  as 
shown  on  page  497. 

The  only  certain  means  of  knowing  that  isolation  is  maintained  as 
directed  is  to  guard  the  premises  day  and  night.  This  is  rarely  done 
in  scarlet  fever  ami  diphtheria,  though  it  is  reported  that  in  Pittsburgh 
it  i-  done  in  perhaps  live  peT  cent  of  the  cases  :  and  it  has  been  done  in 
special  outbreaks  as  in  Salem,  Mass.,1  in  diphtheria  in  1896,  and  Colum- 
bus, IikL-  in  diphtheria  in  1897.  In  Seattle  a  guard  is  placed  day  and 
night  in  diphtheria  and  occasionally  in  scarlel  fever.3  In  the  more 
feared  diseases,  as  smallpox,  typhus  lever  and  yellow  fever,  it  would 
doubtless  ofterier  be  done  if  it  were  not  that  most  cases  of  these  dis- 
a  are  taken  to  the  hospital.  Occasionally,  however,  it  is  impossible 
to  provide  hospital  care  owing  to  lack  of  facilities,  and  it  is  then  quite 
common  to  set  guards  about  the  premises.  Tliis  method  of  isolation  is 
Bpecifically  provided  for  in  man\  state  laws  and  was  referred  to  on 
page  148.     A  similar  authority  is  given  by  statute  in    Alabama  and   in 

Pennsylvania  cities  of  the  sec I  (lass.     When   guards   are   employed 

the\  have  to  be  kept  on  duty  day  and   night  and    frequently  more  than 
one  side  of  the  house  has  to  be  guarded. 

In  Providence  when  it  has  been  necessary  to  care  for  smallpox  in  a 
dwelling,  a  nurse  has  been  furnished  by  the  city  and  no  other  guard  has 
ever  been  required,  though  it  might  be  with  certain  classes  of  people. 
A  similar  practice  is  sometimes  followed  in  Montclair,  N.  J.,  in  eases  ol 

Salem    Report  ol  Board  ol  B<  alth,  I 
-  Indiana  Medical  Journal,  June,  181*7. 
1..  it,. 1  from  Health  <  (fficer,  LI 


494  GO  MMl  WIC L 1 BL E    DISE.  I  8  ES. 

diphtheria  and  scarlet  fever  among  the  poor.  Not  only  are  cases  of 
smallpox  thus  kept  under  control,  but  in  some  cities  all  exposed  to  that 
disease  are  confined  as  in  Cleveland,  the  District  of  Columbia,  and  Pitts- 
1  >uxgh.  In  other  cities  as  Newark  and  Providence,  this  is  not  done,  though 
of  course  the  exposed  persons  are  kept  under  daily  observation  and  are 
thoroughly  vaccinated.  It  is  believed  in  those  cities  that  harsher 
methods  only  result  in  concealment  and  sometimes  in  the  escape  of  the 
persons  under  suspicion. 

For  all  this  work  of  controlling  isolation  the  regular  police  can  be 
of  great  assistance  to  the  health  department.  The  officer  on  the  beat 
frequently  passes  the  infected  premises,  is  often  acquainted  with  the 
inmates  of  the  house,  and  is  very  likely  to  detect  any  violations  of  the 
law  and  can  report  them  promptly  to  the  health  department,  In  many 
cities  the  police  are  required  by  ordinance  to  co-operate  with  the  health 
department.1  In  order  to  secure  this  co-operation  on  the  part  of  the 
police  in  Providence,  a  slip  naming  the  persons  who  are  not  to  leave  the 
house  is  sent  through  the  chief  to  the  officer  on  the  beat,  a  green  slip 
being  used  for  diphtheria  and  a  white  one  for  scarlet  fever.  On  receipt 
of  the  slip  the  officer  visits  the  house  and  supplements  the  directions  of 
the  medical  inspector  with  the  authority  of  the  law. 

When  a  death  occurs  from  communicable  disease  most  regulations 
require  that  the  funeral  shall  be  private.  The  funeral  can  very  gen- 
erally be  controlled  through  the  undertaker,  who  is  usually  licensed  by 
the  municipality.  If  his  license  is  issued  by  the  health  department  his 
co-operation  is  likely  to  be  all  the  more  hearty.  Some  cities,  however, 
do  not  rely  on  this  alone,  but  have  one  or  more  inspectors  attend  the 
funeral.  In  Detroit,  Lowell,  Milwaukee,  Newark,  and  Worcester,  a 
single  inspector  is  present,  and  in  Toledo  two  inspectors.  In  Detroit  a 
special  "funeral  inspector"  is  employed,  and  he  assists  in  disinfection. 
In  Providence,  when  it  is  suspected  that  there  is  an  intention  to  violate 
the  rules,  two  policemen  are  detailed  for  this  purpose.  The  undertaker 
usually  reports  if  he  suspects  a  violation  of  rules  is  intended. 

When  the  time  approaches  for  the  removal  of  the  warning  sign  or 
the  "raising  of  quarantine."  as  it  is  popularly  called,  it  is  necessary 
that  a  notice  should  be  sent  to  the  health  department  by  the  family  or 
the  attending  physician.  <  )f  course,  in  the  rare  instances  where  inspec- 
tion by  the  health  officials  is  made  frequently,  such  notice  is  not  neces- 
sary :   but  in  most  cities  this  is  not  done,  and  when  it  is  not  it  is  very 


1  Providence,  Resolution  of  the  Board  of  Aldermen,  16  February,  1893: 

"  The  chief  of  police  be  and   he  is  hereby  directed  to  furnish  upon  call  of  the 

superintendent  of  health,  such  police  service  in  the  care  of  contagious  disease  as 

the  said  superintendent  of  health  may  require." 


COMMUNICABLE    DISEASES.  495 

generally  the  custom  to  leave  a  postal  card  with  the  family  or  with  the 
physician,  on  which  notice  may  lie  sent.  In  Cambridge  a  postal  printed 
for  this  [impose  and  addressed  to  the  health  department  is  left  at  the 
house  by  the  medical  inspector  on  his  first  visit.  In  Cleveland  a  slip 
is  left  with  the  family  of  the  patient,  but  the  doctor's  signature  must  he 
secured  before  it  will  he  recognized  by  the  health  department.  See 
Appendix  89. 

In  most  cities  the  report  of  recovery  is  to  he  sent  in  by  the  physi- 
cian instead  of  the  family.  In  some  cities,  as  St.  Louis  and  Chicago, 
a  formal  request  i>  made  to  the  attending  physician  to  send  in  bis 
report.  In  the  latter  city  a  reply  postal  is  used.  See  Appendix  !»<>.  In 
the  District  of  Columbia  postal  cards  of  different  colors  are  used  for 
different  diseases  and  in  diphtheria  the  physician  is  to  give  the  date 
when  the  membrane  disappeared,  and  in  scarlet  fever  when  desquama- 
tion ceased.  In  Boston  the  physician  reports  to  the  medical  inspector 
who  visits  the  case  to  confirm  the  facts  and  report  to  the  hoard  of 
health. 

As  in  most  cities  negative  cultures  from  the  throat  are  required 
before  the  release  from  isolation  is  given,  it  has  gradually  come  about 
that  the  Labor  of  taking  these  cultures  has  fallen  chiefly  upon  the  medi- 
cal inspectors.  When  the  attending  physician  chooses  to  take  the  final 
cultures  he  is  permitted  and  sometimes  encouraged  to  do  so.  but  per- 
haps in  the  majority  of  cases  he  notifies  the  health  department  that  he  is 

through  with  the  case  and  expect  the  department  to  take  the  cultures. 
This  taking  of  cultures  has  become  so  important  a  part  of  sanitary  work 
that  in  Baltimore  a  special  '-throat  inspector"  has  been  appointed  for 
this,  and  in  Rochester  an  "inspector  of  diphtheria."  In  Columbus,  <  '.. 
the  medical  inspector  Leaves  the  culture  outfit  at  the  house  for  the 
physician  and  calls  for  it  the  next  day.  In  order  to  prevent  too  fre- 
<  I  lien  t  calls  for  cultures  from  persons  anxious  to  terminate  isolation, 
sonic  officers  refuse  to  take  a  second  culture  within  a  week  if  the  first 
shows  that  diphtheria  bacilli  are  present.  Some  officers  feel  thai  cul- 
tures are  called  for  too  early  and  would  fix  a  minimum  time  before 
which  they  will  noi  be  taken  by  the  medical  inspector.  Sometimes  in 
Long  standing  cases  the  virulence  of  the  bacillus  is  tested  upon  guinea 
pigs  and  the  patient  released  from  isolation  if  the  bacillus  appeal-  to 
have  lost  its  virulence.  This  is  the  custom  in  Brookline,  Mass..  but  it 
is  nut  often  done,  except  in  prolonged  cases,  for  a  negative  culture 
is  usually  obtained  before  the  animal  test  is  completed.  Furthermore, 
there  is  very  grave  doubt  as  to  whether  this  test  is  of  much  value  in 
indicating  whether  the  bacillus  is  virulent  to  man. 

in  most  cases  the  health  departmenl  orders  the  "release  ol  quaran- 


490  COMMUNICABLE    DISEASES. 

tine,"  but  in  Iowa1  it  must  be  by  order  of  the  mayor  or  township  clerk, 
but  only  after  disinfection  and  on  the  approval  of  the  attending 
physician.  It  is  usually  the  custom  for  the  disinfector  to  remove  the 
warning  sign  when  lie  has  completed  his  work,  but  in  cities  and  towns 
where  disinfection  is  not  compulsory,  or  is  not  done  by  the  officials,  the 
householder  is  directed  by  the  health  officer  to  remove  the  placard. 

The  medical  inspector  is  not  only  required  to  keep  a  record  of  the 
cases  visited  by  him  but  he  is  obliged  in  some  of  the  larger  cities  to 
make  daily  or  weekly  reports  to  the  department  of  the  work  done  by 
him.  In  Buffalo  and  San  Francisco  a  separate  slip  is  turned  in  by  the 
inspector  for  each  case.  In  Philadelphia  where  a  half  letter  sheet  is 
used  by  the  physician  for  reporting,  there  is  a  space  on  the  back  for  the 
report  of  the  medical  inspector.  A  more  elaborate  form  of  daily  report 
is  used  in  the  District  of  Columbia  stating  the  number  of  houses  visited 
and  placarded  and  the  number  of  cultures  taken.  In  Minneapolis  a 
somewhat  similar  report  is  made  weekly. 

When  isolation  in  communicable  disease  is  maintained  by  the  sani- 
tary officials  with  such  rigor  as  to  interfere  with  the  work  of  the  wage 
earners,  the  support  of  the  family  must  be  provided  in  other  ways,  and 
it  should  of  course  properly  be  provided  by  the  municipality.  Assist- 
ance may  be  and  frequently  is  furnished  by  the  poor  department,  but 
it  is  not  usually  done  unless  the  family  are  at  other  times  recipients. 
It  appears  to  many  much  better  for  the  health  department  to  furnish 
assistance,  and  there  are  good  reasons  for  not  being  too  niggardly  about 
it.  If  the  family  in  which  there  is  communicable  disease  is  to  be  sub- 
jected to  too  great  hardships  on  account  of  it,  many  such  cases  will 
surely  be  concealed.  On  the  other  hand,  they  should  not  be  encouraged 
to  expect  too  much  from  the  community,  and  it  is  not  easy  to  hit  upon 
a  happy  mean. 

Various  states,  as  Massachusetts,-  Michigan,  North  Dakota,  and  Vir- 
ginia, have  provided  that  the  payment  for  the  care  of  communicable 
disease  shall  be  a  charge  upon  the  person  siek  or  his  parents  or  guar- 
dians, and  that  it  shall  not  be  a  charge  upon  the  city  or  state  unless  the 
patient  is  without  property.     The  tendency  of  these  laws  is  to  treat  the 


1  Iowa,  Rules  of  State  Board  of  Health,  24  February,  1899,  Rule  12. 
-Massachusetts,  Public  Statutes  (1882),  Chapter  so,  Sec.  S3: 

"  All  reasonable  expenses  which  have  been  heretofore  or  may  hereafter  be  in- 
curred by  the  board  of  health  of  a  city  or  town,  in  making  the  provision  required  by 
law  for  a  person  infected  by  the  smallpox  or  other  disease  dangerous  to  the  public 
health,  shall  be  paid  by  the  person  himself,  his  parents,  or  master,  if  able;  other- 
wise by  the  town  in  which  he  has  a  legal  settlement;  and  if  he  has  no  settlement,  by 
the  Commonwealth,  in  which  case  the  bills  therefor  shall  be  approved  by  the  state 
board  of  lunacy  and  charity." 


( '  OMMl  XI<  \  J  B  L  E    1>  I S  h\  I  S  EJS.  4 <j 7 

patients  to  whom  aid  is  given  as  if  they  were  paupers.  It  is  questioned 
by  many  whether  this  is  a  wise  course.  If  a  family  is  by  action  of  the 
community  deprived  of  the  support  furnished  by  its  wage  earners  should 
not  the  family  he  helped  with  some  degree  of  liberality,  and  in  such  a 
way  as  to  make  them  feel  that  they    are  not    the    recipients  of   charity'/ 

In  Providence  when  a  family  lias  to  he  helped  in  this  way.  owing  to 
Loss  of  wages,  the  amount  given  is  paid  ••  for  services  in  the  care  of 
communicable  disease."  The  theory  is  that  if  the  patient  was  removed 
to  the  hospital,  the  city  would  have  to  pay  for  the  care,  in  thai  city 
fifteen  dollars  per  week.  If  by  the  wage  earner  remaining  at  home 
strict  isolation  can  he  maintained,  the  family  receives  a  certain  sum  for 
exercising  this  rare.  The  amount  paid  is  seven  dollars  per  week,  or  if 
the  wages  lost  are  less  than  that,  the  amount  of  the  wages  is  paid.  As 
this  plan  is  less  expensive  than  sending  to  the  hospital,  the  taxpayers 
ought  not  to  complain.  In  1  900  seventeen  cases  received  *1  ->1  in  this  way. 
Dining  the  same  period  147  patients  at    the    hospital    cost  $6,943.61; 

If  absolute  isolation  is  not  maintained  in  these  cases,  the  money  is 
withheld  by  the  health  department  and  the  family  becomes  dependent  upon 
the  poo)' department.  In  Detroit  where  stricter  isolation  is  maintained 
than  in  most  cities,  tor  the  year  ending  30  June,  1899,  support  was  fur- 
nished iii  189  families  at  a  cost  of  $4,617,  in  60  of  which  $597.35  was 
for  fuel.  During  the  year  there  were  331  houses  placarded  for  dipth- 
theria  and  251  for  scarlet  fever.  In  that  city  the  quarantine  inspectors, 
of  winch  there  are  two,  visit  infected  houses  each  day 

■•in  find  the  necessities  of  each  case,  which  an-  telephoned  to  the  clerk.  Prom 
the  number  in  the  family  ami  age  of  the  occupants,  the  amount  of  each  article  ordered 
is  determined.  Each  order  received  is  carefully  compared  with  the  previous  order  in 
order  thai  the-  city  may  not  he  imposed  upon  by  over-stocking  with  things  which  are 
m»t  needed.  Everj  order  is  copied  in  duplicate,  one  going  to  the  concern  furnishing 
tin-  goods,  thence  to  the  party  receiving  the  goods,  ami  one  being  retained  in  the 
office.  Tin-  duplicate  sent  with  the  order  is  returned  after  ailing  and  compared  with 
the  original,  width  is  then  used  in  checking  the  hill  rendered  by  the  contractor  at 
t  he  end  of  each  i n  h." 

On  the  first  visit,  the  financial  condition  of  the  family  .is  reported  on 
blank-  furnished  for  the  purpose.  In  Seattle,  where  also  absolute 
isolation  i-  maintained,  in  1899  onlj  $200  was  expended  in  supplies  for 
t  he  poor,  alt  hough  there  were  in  that  city  *  I  eases  of  diphtheria  mid  1  12 
of  scarlel  fever. 

\'-u  Hampshire  has  recentlj  recognized  the  justice  of  assisting  per- 
sons confined  o\\  Lng  to  communicable  disease  :' 

••  Whenever  anj  person  or  family  is  placed  in  quarantine  bj  a  hoard  of  health  to 
protect  the  public  against  smallpox,  scarlet  fever,  diphtheria,  or  other  dangerous, 
Infectious,  or  contagious  disease,  it  shall   he  the  duty  oi   said  board  to  asMsi  such 

\.n\  Hampshire.  Chapter  II i    189D    Sec.  I. 


498  00  MM  I  XI CABLE    DISEA  SES. 

person  or  family   while  in  quarantine  in  such  mannner  as   in  the  judgment  of  the 
board  may  be  deemed  wise  or  necessary." 

The  expense  is  to  be  charged  to  the  health  department  and  not  to  the 
poor  department  unless  the  persons  are  already  paupers. 

In  Minnesota1  the  board  of  health  while  maintaining  isolation  may 
"  provide  necessaries  for  persons  in  poverty." 

Epidemics. 

In  the  opinion  of  the  writer  the  word  epidemic  should  be  rarely 
used  as  applied  to  an  outbreak  of  communicable  disease  ;  the  latter  term 
is  in  most  cases  much  to  be  preferred.  The  word  is  a  popular  one  and 
as  ordinarily  used  implies  a  condition  of  great  and  unusual  danger.  As 
that  is  undoubtedly  its  meaning,  it  cannot  be  accurately  defined  and  the 
attempts  to  do  so  have  been  futile.  The  use  of  a  word  like  this  which 
is  not  capable  of  close  definition  should  be  discouraged  by  health  officers 
and  scientific  men.  It  is  used  in  this  connection  because  it  is  here  in- 
tended to  refer  to  just  those  indefinite  conditions  of  popular  fear  covered 
by  the  word. 

To  one  who  is  conversant  with  sanitary  laws  it  may  appear  that  the 
authority  to  control  persons  and  property  which  is  conferred  upon  sani- 
tary officers  is  very  great,  and  is  sufficient  to  meet  any  emergency. 
Nevertheless,  the  harm  done  by  a  great  epidemic  is  so  great  both  to  the 
lives  and  business  of  a  community,  that  it  is  often  felt  that  very  drastic- 
measures  may  be  permitted  to  prevent  or  check  it.  Impending  pesti- 
lence is  to  be  feared  as  is  an  invading  army,  and  as  in  war  a  community 
is  put  under  martial  law,  so  in  times  of  pestilence  the  sanitary  author- 
ities are  sometimes  given  extraordinary  powers  in  order  the  more  suc- 
cessfully to  fight  the  disease. 

Sometimes  these  extraordinary  powers  are  conferred  upon  the  state 
board  of  health  as  in  Indiana,2  New  Jersej^,3  Nebraska,4  Maryland,5 
Minnesota,6  Missouri,7  Ohio,8  and  Wisconsin.9  In  Maryland  the  state 
board  of  health  "  shall  cause  all  needful  sanitary  measures  and  pre- 
cautions to  be  taken  which  the  emergency  calls  for   and  which   may  be 


1  Minnesota,  Statutes  (1894),  Sec.  7072. 

2  Indiana,  Act  of  4  March,  1893. 

3  New  Jersey,  General  Statutes  (1895),  p.  1636,  Sec.  8. 

4  Nebraska,  Chapter  51  of  1899. 

5  Maryland,  Public  General  Laws  (1888),  Art.  43,  Sec.  8. 

6  Minnesota,  Statutes  (1894),  Sec.  7045. 
Missouri,  Revised  Statutes  (1899),  Sec.  7522. 

*  Ohio,  Annotated  Statutes  (1900),  Sec.  2143. 
9  Wisconsin,  Chapter  24  of  1899. 


COMMUNIL  ABLE    DISE,  1  SES.  499 

consistent  with  law  ";  and  there  is  an  epidemic  fund  of  *10,000  to  be 
drawn  upon  with  the  approval  of  the  governor.  In  AViseonsin  and  In- 
diana the  amount  available  is  $50,000.  In  New  Jersey  the  state  board 
of  health  may  spend  money  in  excess  of  the  appropriation  with  the  ap- 
proval of  the  governor,  the  treasurer  and  the  comptroller. 

The  greatest  [towers  are  however  given  to  local  health  authorities 
rather  than  to  state  officials,  for  the  real  work  of  sanitary  administra- 
tion is  chiefly  in  the  hands  of  the  former,  and  they  are  conferred  by 
special  acts  rather  than  general  laws.  Examples  of  such  powers  are 
found  in  New  York  City,1  Buffalo,2  St.  Louis,3  Pennsylvania  cities  of 
the  second  class,4  and  New  Orleans. 

While  the  control  of  communicable  disease  is  usually  left  to  the 
local  authorities,  the  advice  and  help  of  state  and  federal  officials  is 
often  sought.  Most  state  boards  of  health  were  established  largely  for 
the  purpose  of  giving  such  advice.  In  the  largest  cities  the  health 
department  is  usually  so  well  organized  that  such  assistance  is  not  often 
necessary,  but  in  smaller  places  even  in  moderate  outbreaks  appeal  is 
made  to  the  state  board  of  health  for  advice,  and  it  is  often  asked  that 
a  state  official  be  sent  to  thoroughly  investigate  the  conditions  and  per- 
haps take  charge  of  the  outbreak.  In  Massachusetts  the  calls  upon  the 
state  board  are  so  numerous  that  a  special  bureau  in  charge  of  an  ex- 
perienced physician  has  been  established  to  look  after  this  work.  As 
has  been  elsewhere  shown,  state  boards  are  sometimes  authorized  to 
take  the  initiative  if  the  local  board  proves  inefficient  This  is  the  case 
in  Massachusetts,  but  in  that  state  it  is  very  rarely  found  necessary. 

The  federal  governmenl  also  through  the  marine  hospital  service 
sometimes  ;idvises  or  takes  charge  of  local  epidemics,  as  in  Brunswick, 
(.a.,  iii  1893,  Birmingham,  Ala.,  in    L898,  and    Hampton.  Va.,  in    L899. 

1  \ru  Xork,  Chapter  378  of  L897,  Sec.  1178: 

1 ' In  the  presence  of  great  and  imminent  peril  to  the  public  health  bj  reason  of 
impending  pestilence,  it  shall  be  the  duty  of  the  hoard  of  health,  having  firsl  taken 
and  filed  among  its  records  what  ii  shall  regard  a>  sufficient  proof  to  authorize  its 
declaration  of  such  peril,  and  having  duly  entered  the  same  in  its  records,  t"  tal<<< 
snrli  measures,  and  to  d"  and  order  and  cause  t"  he  done,  such  acts  and  make  such 
expenditures  (beyond  those  duly  estimated  tor  or  provided)  for  the  preservation  of 
the  public  health  (though  not  herein  elsewhere  or  otherwise  authorized)  as  ii  maj 

in  g !  faith  declare  the  pnblic  safety  and  health  demand,  and   the  mayor  shall  in 

writing  approve.  Bui  the  exercise  of  this  extraordinary  power  shall  also,  so  far  as 
it  involves  such  excessive  expenditures,  require  the  written  consent  of  at  least  three 
members  of  the  board  of  health,  and  the  approval  aforesaid  of  the  mayor.  Vml 
Buch  peril  shall  oot  be  deemed  to  exist  except  when,  and  for  such  period  of  time,  as 
the  hoard  ,,t  health  ami  mayor  shall  declan 
\,  w  fork,  Chapter  105  of  L801,  Sec.  -'::»'•. 

Miss,, mi.    I,V\  ise.l  .statutes  i  1899),   Sec.  •"')•">". 

1  Pennsylvania,  Chapter 258  •■)  1895,  Sec.  28. 


500  C OMM I  XI<  \  I II L  E    hisK.  [  s ES. 

This  service  is  authorized  by  an  act  of  Congress  approved  15  February, 
1893^  which  directs  the  supervising'  surgeon  general  to  aid  and  co- 
operate with  local  boards  in  preventing  the  spread  of  communicable 
diseases  from  one  state  to  another.  Of  course  the  federal  officers  can- 
not take  entire  charge  of  an  outbreak  in  all  its  details  without  a  request 
from  the  local  authorities.  Such  request  is  sometimes  made  and  it  is  a 
little  curious  that  it  has  hitherto  been  from  communities  in  the  southern 
states,  where  sentiment  is  supposed  to  be  the  strongest  against  federal 
interference. 

Smallpox. 

It  does  not  require  many  cases  of  smallpox  to  make  an  epidemic. 
The  number  of  cases  of  scarlet  fever  or  diphtheria  which  will  be  suffered 
in  a  community  without  producing  the  notion  of  an  epidemic  is  very 
considerable,  but  if  one-tenth  as  many  cases  of  smallpox  should  appear, 
the  place  would  be  thrown  into  a  panic  at  once.  It  is  true  that  small- 
pox is  usually  a  more  serious  disease  than  diphtheria,  but  there  is  no 
such  difference  as  popular  notion  would  indicate.  Even  a  single  case 
of  smallpox  in  many  small  communities  creates  that  state  of  mind 
which  is  characteristic  of  an  epidemic,  and  renders  it  necessary  to  do 
most  of  the  things  which  are  required  in  an  outbreak  of  real  magnitude. 

In  Public  Health  Reports,  20  October,  1890,  page  1765,  may  be  found 
a  very  good  account  of  methods  which  it  is  desirable  to  follow  in  out- 
breaks of  smallpox.  It  is  an  account  of  what  is  attempted  by  the 
officers  of  the  marine  hospital  service  when  they  are  called  to  take 
charge  of  an  epidemic. 

Discovery  of  Oases.  As  has  been  shown,  physicians'  reports  are  the 
chief  source  of  official  knowledge  of  communicable  disease.  Reliance 
upon  such,  however,  is  wTell  known  to  be  very  unsafe.  A  study  of  out- 
breaks of  smallpox  and  yellow  fever  will  show  that  they  almost  always 
proceed  from  unrecognized  or  unreported  cases.  In  many  mild  cases 
no  physician  is  called  and  in  such  cases  often  no  one  is  at  fault.  In 
other  mild  and  doubtful  cases  when  a  physician  is  called,  the  report  to 
the  authorities  is  not  made  because  the  physician  fails  to  make  a  cor- 
rect diagnosis,  or  in  rarer  cases  because  he  deliberately  conceals  the 
case.  Sometimes  even  severe  cases  are  concealed  by  the  friends  of  the 
patient.  Failure  to  diagnose  seems  to  be  almost  as  criminal  on  the 
part  of  the  attending  physician  as  deliberate  concealment.  It  can 
rarely  be  that  a  suspicion  of  the  true  condition  does  not  cross  the  phy- 
sician's mind,  and  if  it  does  it  is  his  duty  to  immediately  notify  the 
health  authorities  of  it,  and  let  them  assume  the  responsibility  of  the 
decision.  When  the  courts  will  hold  the  physician  to  this  responsi- 
bility there  will  be  fewer  outbreaks. 


COMMUNICABLE    DISEASES.  :,Ul 

In  mild  outbreaks  great  trouble  is  experienced  from  the  unwilling- 
ness of  the  public  and  often  of  the  physicians  to  acknowledge  the  dis- 
ease; the  smallpox  of  1899  as  also  the  yellow  fever  of  L898  afford 
many  examples  of  this.  In  Muncie,  Ind.,1  in  1893  photographs  of  the 
serious  hospital  cases  were  exposed  in  public  to  prove  the  diagnosis. 
but  they  were  of  little  avail.  In  Warwick  County,  Ya.-  (in  which  is 
situated  Newport  News),  in  1899  one  of  the  county  supervisors  declared 
that  the  disease  was  not  smallpox  and  that  vaccination  made  it  worse, 
and  the  board  of  supervisors  declared  that  they  would  take  no  action  at 
all.  One  of  these  supervisors  had  smallpox  and  tended  his  grocery 
store  during  the  whole  course  of  the  disease.  In  Alexandria  in  the 
same  year  the  city  council  refused  to  vaccinate  the  people,  and  the 
mayor  advised  the  sick  to  eject  disinfectors  from  the  house. 

In  Boston,  Columbus,  < )..  and  doubtless  in  other  cities  it  is  required 
that  all  cases  of  chicken  pox  he  reported  during  smallpox  outbreaks  in 
older  that  the  health  officers  may  make  the 'diagnosis.  Even  when  this 
is  not  the  law  it  is  the  custom  during  the  prevalence  of  smallpox  to 
call  the  attention  of  the  hoard  of  health  to  all  cases  not  typically  chicken 
pox.  In  one  year  in  Chicago  350  cases  of  suspected  smallpox,  which 
proved  not  t<>  he  that  disease,  were  reported  to  the  board  of  health.  In 
Brooklyn  in  1894  of  913  suspected  cases  reported  460  were  not  small- 
pox. During  an  epidemic  man}  suspected  cases  are  reported  by  the 
laity  and  sometimes  on  good  grounds.  Three  out  of  five  cases  of  small- 
pox which  came  to  the  writer's  notice  last  spring  were  reported  hv  Lay- 
men. Medical  inspection  of  schools  will  in  most  American  cities  do 
little  to  discover  smallpox,  as  the  school  population  is  so  well  protected 
by  vaccination  that  a  relatively  small  proportion  of  cases  are  found  in 
it.  Iloiisi-  to  house  inspection  is  the  only  method  during  an  outbreak 
by  which  concealed  or  unrecognized  cases  can  he  discovered.  Such 
inspection  should  be  repeated  after  a  shorl  interval.  A  partial  inspec- 
tion is  sometimes  carried  on  in  conjunction  with  vaccination,  particu- 
larly in  t  he  immediate  neighborhood  of  the  infection.    Thorough  house  to 

house  inspection  is  rarely  adopted  excepl  when  an  outbreak  has  reached 

alarming  proportions,  and  often  noi  even  then.  Such  an  inspection  was 
carried  out  in  Birmingham,8  Ala.,  in  L898,  h\  the  marine  hospital 
service,  the   inspectors   visiting  everj    room   in   ever}    house,  and   as  a 

result    forty-five  Cases  of  smallpox   were  discovered. 

Isolation.  In  smallpox  it  is  the  universal  custom  to  remove  all 
patients  to  the  hospital  or  else  | nit  guards  aboul  the  houses.      The  former 

1  Indiana,  Report  ol  State  Board  of   Health  (1893),  \>.  108,  ei  »eq. 
*  Public  Health  Reports,  Marine  Hospital  Service  (1899),  p.  624. 
'Public  Health  Reports,  Mann.'  Hospital  Service  (1898),  p.  247,  et  seq. 


502  COMMUNICABLE   DISEASES. 

method  is  almost  always  to  be  preferred.  In  Brooklyn,  Chicago,  New 
Orleans,  and  Providence  it  has  not  alwa}rs  been  insisted  on  if  01113-  one 
family  occupied  the  house.  In  Providence  in  such  cases  the  health 
department  furnishes  the  nurse  who  does  not  leave  the  house  and  acts 
as  guard.  In  Muncie  domiciliary  isolation  was  at  first  attempted,  but 
the  disease  continued  to  spread  until  all  cases  were  removed  to  the  hos- 
pital, when  it  at  once  ceased,  but  perhaps  the  extension  of  vaccination 
had  something  to  do  with  this  result.  Sometimes  it  is  impossible  on 
account  of  insufficient  hospital  facilities,  and  more  rarely  it  is  impos- 
sible on  account  of  the  forcible  resistance  of  the  friends  of  'the  patient. 
In  Chicago  in  1894  in  one  district,  122  cases  were  treated  at  home 
because  of  lack  of  hospital  accommodations.  The  objection  to  removal 
to  the  hospital  is  in  some  cases  not  without  reason,  for  the  "pest 
houses  "  provided  axe  sometimes  a  disgrace  and  not  fit  for  the  care  of 
the  sick.  The  removal  of  patients  is  sometimes  accompanied  with  dan- 
ger to  the  officials.  In  Muncie,  Intl.,  in  1893  the  ambulance  attendants 
were  twice  tired  upon  and  one  was  shot  in  the  arm.  In  Milwaukee  in 
1894  such  violent  demonstrations  were  made  that  the  removal  had  to 
be  given  up.  The  following  is  from  the  report  of  the  Wisconsin  Board 
of  Health  1893-4,  p.  56: 

"On  Saturday  evening,  August  25th,  between  four  and  five  o'clock,  one  of  the 
officers  of  the  health  department  was  sent  to  remove  a  patient,  a  child,  from  "jiil 
Fifteenth  Avenue,  in  the  rear.  The  party  of  this  place,  undoubtedly  led  to  do  as 
he  did  by  the  influence  above  mentioned,  had  notified  the  quarantine  officers  that 
any  person  coming  there  to  remove  the  child  would  be  shot,  and  he  procured  a 
revolver  and  lay  in  wait  for  the  health  officer.  A  mob  congregated,  and  when  the 
ambulance  drove  up  with  a  squad  of  twelve  policemen  violent  demonstrations  began, 
stones  were  thrown,  the  horses  struck  with  the  missiles,  and  a  general  melee  com- 
menced. The  official  in  charge  of  the  police  stated  to  the  health  officer  that  he  had 
not  sufficient  force  to  disperse  the  mob  and  he  would  not  undertake  to  do  so.  The 
mob  was  armed  with  clubs  and  missiles,  the  horses  were  being  constantly  struck, 
the  health  officials  resisted,  and  it  was  therefore  impossible  in  the  absence  of  a  suffi- 
cient number  of  police  to  remove  the  patient.  Xot  only  is  the  health  department 
prevented  from  removing  the  patient,  but  in  the  houses  which  have  been  quaran- 
tined, and  from  which  patients  have  been  removed,  we  are  experiencing  great 
trouble.  Last  night  a  mob,  numbering  in  the  neighborhood  of  two  hundred  people, 
congregated  in  front  of  972  Orchard  St. ,  and  avowed  their  determination  to  take 
away  from  the  house  the  people  who  were  there  quarantined,  and  the  guards  on 
duty  at  that  house,  who  are  quiet,  reserved,  and  respectable  men,  state  this  morning 
that  they  do  not  consider  their  lives  safe  unless  some  action  is  taken  to  protect  them 
in  the  duties  which  they  are  called  upon  to  perform.  This  same  condition  of  affairs 
is  a  feature  at  several  other  houses  on  the  south  side.11 

When  it  is  not  possible  to  remove  patients  to  the  hospital,  a  guard 
should  be  placed  at  the  house  and  kept  there  day  and  night.  Usually 
two  guards  are  necessary,  one  at  the  front  and  one  at  the  rear.  It  is 
difficult  to  get  reliable  guards  if  many  are  required,  and   this  is  one  of 


(  OMMUNIt  A  BL  E    l>lsE.  1  8E8.  503 

the  causes  of  the  failure  of  this  method  of  management.  Some  guards 
are  liable  to  be  negligent  or  bribable.  The  guarding  should  be  begun 
promptly  or  it  is  of  little  use.  In  Chicago  and  Brooklyn  in  1894, 
whenever  a  report  of  smallpox  reached  the  health  department,  an  officer 
was  detailed  with  the  medical  inspector.  In  Muncie  a  guard-house  was 
established  in  the  centre  of  the  infected  district,  telephone  connection 
made,  a  captain  of  guards  appointed,  and  all  the  guards  were  boarded 
and  lodged  at  the  guarddiouse,  as  was  also  the  attending  physician. 
While  it  is  usually  considered  necessary  to  isolate  suspects  in  smallpox 
in  some  places  this  is  not  done.  The  laws  of  a  number  of  stales,  as 
those  of  Alabama,  Indiana.  Mississippi,  Missouri,  and  Smith  Dakota, 
require  the  isolation  of  all  persons  exposed  to  smallpox,  and  the  time 
specified  is  fourteen  days.  This  practice  is  also  followed  in  a  number 
of  cities  outside  of  these  states.  The  suspects  may  be  either  removed 
to  a  detention  hospital  or  (after  the  removal  of  the  sick)  be  guarded  at 
home.  In  Alabama  it  is  not  permitted  to  remove  a  suspect  to  the  hos- 
pital if  he  is  willing  to  pay  for  guards  around  his  house.  In  Detroit, 
.Milwaukee,  and  Rochester,  unless  the  number  of  suspects  is  too  great, 
they  are  generally  removed  to  a  hospital.  In  the  District  of  Columbia 
a  block  of  tenements  near*the  smallpox  hospital  has  been  hired  for  this 
purpose.  Among  other  cities  whose  recent  reports  show  the  isolation 
of  suspects  at  home  are  Cleveland.  Lowell,  Minneapolis,  New  Bedford, 
Omaha.  Pittsburgh,  and  St.  Paul.  Other  cities,  as  Boston,  Brooklyn, 
Chicago,  Cincinnati,  Newark,  and  Providence,  simply  keep  the  suspeets 
under  observation  without  placing  guards,  but  of  course  the}  are  first 
vaccinated.  In  Chicago  they  are  revacqinated  every  four  days  until  it 
takes  or  until  the  time  for  probation  has  passed,  and  the  house  is  pla- 
carded, except  in  the  " better  class  "  of  families.  The  duration  of  the 
observation  of  suspects  is  fourteen  days  in  Alabama.  Indiana.  Missis- 
sippi. Miss  rnri,  South  Dakota.  Boston,  Chicago,  Minneapolis.  Rochester, 
and  St.  Paul;  seventeen  days  in  Pittsburgh  and  Providence;  twenty- 
one  days  iii  Brooklyn  and  Cleveland.  Of  course,  when  absolute  isola- 
tion is  maintained,  it  is  necessarj  to  furnish  food,  fuel  and  other  neces- 
saries to  those  confined.  In  Newark1  in  189J  a  room  was  hired  for  a 
general  store  ami  goods  were  bought  ;it  wholesale.  A  horse  and  wagon 
and  two  men  were  employed  in  making  daily  deliveries.  Medical 
attendance  must  also  be  supplied,  and  in  an  epidemic  special  physicians 
are  usually  employed  whodonol  visit  other  persons,  but  in  Newark  the 
regular  physicians  to  the  poor  assisted  in  this.  In  Muncie  the  physi- 
cian won-  rubber  coat,  cap,  and   boots,  and  disinfected   himself  w  ith  cor- 

Newark,  Report  of  Department  ol  Public  Health  (1894),  p.  20. 


5()4  COMMUNICABLE    DISEASES, 

rosive  sublimate  solution  after  each  visit.     In  Providence  a  linen  duster 
or  perhaps  a  suit  of  overalls  and  rubbers  are  worn. 

The  problem  of  furnishing  hospital  accommodations  is  often  a  diffi- 
cult one.  Every  town  of  25,000  inhabitants  should  have  a  good  per- 
manent hospital,  but  there  are  many  larger  than  this  without  any.  Even 
a  hospital  of  reasonable  capacity  may  suddenly  become  overcrowded  so 
that  more  room  has  to  be  secured  on  short  notice.  In  some  states,  as 
Massachusetts1  and  Michigan,  local  health  authorities  may  seize  build- 
ings to  be  used  as  hospitals,  and  it  would  be  well  if  this  right  was  gen- 
erally granted.  In  the  summer  time  tents  can  usually  be  procured  and 
rapidly  set  up,  but  in  the  winter  something  more  substantial  is  required. 
"  Portable  hospitals  "  are  advertised  which  can  be  put  up  in  a  hurry  but 
are  rarely  used.  One  ward  of  this  kind  was  set  up  at  the  Municipal 
Hospital  in  Philadelphia,  but  cost  more,  took  longer  to  set  up  and  was 
not  so  satisfactory  as  a  similar  ward  constructed  in  the  usual  way.  In 
some  cities  portable  polling  booths  are  used,  and  these  in  an  emergeney 
have  been  utilized  as  hospitals.  Efficient  men  can  however,  construct  a 
serviceable  ward  in  a  remarkably  short  time  if  only  a  site  can  be  se- 
cured, and  often  the  city  owns  land  which  can  be  used  for  the  purpose 
temporarily.     For  examples  of  smallpox  hospitals  see  Chapter  XII. 

There  is  sometimes  considerable  difficulty  in  guarding  these  hospi- 
tals. In  Birmingham  the  plan  was  adopted  "  of  surrounding  the  camp 
with  a  high  barbed-wire  fence  :  thirty  feet  within  this  fence  a  single  wire 
was  drawn  to  mark  the  dead  line,  beyond  which  no  patient  was  allowed 
to  pass,  and  in  this  space  between  dead  line  and  fence  the  guards  were 
stationed.  At  night  the  entire  picket  line  was  lighted  by  large  gasoline 
torches,  thereby  enabling  a  small  number  of  guards  to  effectually  pre- 
vent the  escape  of  convalescents." 

In  order  to  prevent  the  mingling  of  infected  persons  with  the  well, 
schools  are  sometimes  closed,  and  in  Muncie,  in  1898,  the  authorities 
went  so  far  as  to  issue  the  proclamation  given  below2  and  the  public 
library  gave  out  no  books. 

Vaccination.  Vaccination  is  without  doubt  a  most  valuable  means 
of  preventing  or  stopping  an  outbreak  of  smallpox.      If  every  person  in 

i  Massachusetts,  Public  States  (1882),  Chapter  80,  Sec.  4;',. 

-  Indiana,  Report  of  State  Board  of  Health  (1893),  page  109: 

•  Xo  public  meeting  of  any  sort  should  be  held.  No  exercises  should  be  held  in 
any  church,  lodge,  opera  house,  ball  ground  or  any  place  of  like  character  Billiard 
and  pool  rooms  should  not  be  opened  to  the  public. 

"  The  people  generally  should  remain  at  their  homes  as  much  as  possible.  Con- 
gregations of  persons  on  the  street  should  be  avoided.  The  police  have  been 
directed  by  the  police  commissioners  to  see  that  no  crowds  collect  on  the  streets. 
Loitering  or  loafing  will  subject  parties  to  arrest.1' 


<  •  OMMZ  Wl (  A  II L  E    DIjS K,  IJSJKJS.  50  5 

a  city  should  be  properly  vaccinated,  there  is  little  doubt  that  the  out- 
break would  promptly  come  to  a  close  :  but  in  the  present  state  of  public 
opinion,  assiduously  cultivated  as  it  has  been  by  anti-vaceinationists,  a 
satisfactory  general  vaccination  is  impossible  except  when  the  public  is 
thoroughly  alarmed,  and  even  then  it  is  accomplished  with  difficulty. 
Ordinarily  all  that  can  be  done  is  to  vaccinate  the  inmates  of  the  in- 
fected house  and  perhaps  those  in  the  neighborhood,  and  those  in  whose 
company  the  infected  person  worked.  All  this  should  be  promptly 
done  after  every  case  of  smallpox.  If  the  outbreak  is  severe  enough  to 
warrant  general  vaccination,  effort  should  be  made  to  have  this  done  as 
rapidly  as  possible.  Sometimes  advantage  can  be  taken  of  the  fear  pro- 
duced b\  epidemics  in  other  communities.  Thus  in  1885  when  the 
New  England  states  were  greatly  alarmed  over  smallpox  in  Montreal  a 
general  vaccination  was  undertaken  in  Providence.  Ten  physicians 
were  employed  who  visited  each  house  and  offered  free  vaccination. 
Vaccinations  were  also  done  in  all  the  large  manufactories  and  retail 
stores  and  among  railway  employees.  The  school  children  were  all  vac- 
cinated previously,  as  in  Providence  the  law  in  regard  to  this  is  strictly 
enforced.  The  papers  generally  urged  vaccination  and  circulars  were 
distributed  through  the  schools  or  posted  on  the  city's  billboards.  By 
these  efforts  only  about  16,000  persons  were  vaccinated  out  of  a  popu- 
lation of  118,070,  which  was  not  a  very  satisfactory  showing.  When 
smallpox  actually  exists  as  an  epidemic,  many  more  persons  can 
be  vaccinated  even  if  no  compulsion  is  used.  It  is  best  to  employ  as 
Large  a  number  of  vaccinators  as  possible  so  as  to  render  the  population 
immune  at  the  earliest  moment.  It  is  not  always  possible  to  obtain 
enough  medical  men,  and  in  Birmingham,  in  1898,  the  marine  hospital 
service  employed  as  vaccinators  second  course  medical  students  al  four 
dollars  per  day.  Thirtj  vaccinators  were  employed  for  a  population  oi 
about  50,000.  In  Chicago,  in  1894,  with  a  population  of  a  million  and 
a  half.  500  vaccinators  were  employed.  In  Birmingham  the  vaccinators 
made  a  house  to  house  canvass  visiting  every  room.  Each  inspector 
caiiied  a  note  book  in  which  was  recorded  the  name  and  address  ol 
ever)  person,  and  the  date  of  the  Lasl  vaccination  of  such  person,  mid 
whether  or  not  such  vaccination  was  successful.    He  was 

14  to  vaccinate  all  persons  who  had  nol  been  successful^  vaccinated  within  the 
hist  year,  as  evidenced  b]  an  examination  "I  the  scar  in  each  case.  .  .  .  N< 
certificate  of  vaccination  was  to  be  honored,  and  although  this,  al  Brsi  glance, 
ina\  appeal  an  unreasonable  and  arbitrary  ruling,  still,  when  the  facts  are  re 
called  that  in  all  large  towns  there  are  usually  some  physicians  who  will  ui\r  false 
certificates  for  a  small  fee;  thai  there  are  many  persons  who  will  forge  certificates 
that  certificates  issued  in  g I  faith  i>\  reliable  physicians  maj  be  given  i>.\  their  re- 
cipients i"  parties  who  bave  aever  been  vaccinated,  and,  anally,  thai  a  certiBcate  oi 


506  C  OMMUNKJABLE    DISBA  SMS. 

vaccination  is    no  evidence  that  such  vaccination   was  successful,  the  necessity  of 
the  above  measures  will  be  easily  apparent. 

"  The  inspectors  were  especially  directed  to  be  at  all  times  courteous  in  their  treat- 
ment of  persons  of  all  classes,  to  explain  to  those  who  objected,  the  necessity  of  the 
measure  and  report  to  me  daily  for  prosecution  by  civil  authorities,  the  names  and 
addresses  of  those  who  refused  to  be  vaccinated  or  to  permit  an  examination  of  their 
vaccination  marks.'"1 

Smallpox  had  prevailed  in  Birmingham  for  a  year  and  was  very  preva- 
lent when  the  marine  hospital  service  took  hold  in  January  1898. 
Many  persons  had  been  vaccinated  during  the  preceding  months  and 
by  the  time  the  house  to  house  canvas  was  complete  nearly  every  per- 
son in  the  city  had  been  vaccinated.  This,  together  with  the  removal 
of  all  patients  to  the  hospital,  resulted  in  the  immediate  cessation  of  the 
outbreak.  In  any  considerable  outbreak  it  is  usually  the  custom  not  to 
allow  the  physicians  who  visit  the  sick  to  vaccinate  except  in  the  in- 
fected houses.  In  Baltimore,  in  1899,  thirty  extra  vaccinators,  at  a 
cost  of  -11,500,  vaccinated  60,000  persons.  In  Nashville,  in  January 
1900,  thirty  inspectors  vaccinated  40,000  persons.  In  Lowell,  in  1894, 
26,685  vaccinations  cost  $3,686. 

Disinfection. 

Disinfection  of  both  persons  and  things  after  cases  of  smallpox 
is  usually  thoroughly  carried  out.  Those  persons  exposed  near  the 
patient  are  told  to  bathe,  and  are  usually  compelled  to  change  their 
clothes  and  leave  those  they  have  worn  to  be  disinfected.  In  Chicago 
the  clothing  they  wear  is  sponged  with  corrosive  sublimate  before  they 
leave  the  house.  As  smallpox  usually  occurs  among  the  poor  there  is 
much  material  such  as  mattresses,  comforters,  carpets,  and  clothing 
which  is  not  worth  disinfecting  and  which  is  burned.  Where  there  is 
no  steam  disinfecting  plant,  it  is  necessary  to  burn  all  of  this  material. 
In  some  cities,  as  shown  by  the  reports  of  Augusta,  Ga.,  Indianapolis, 
Louisville,  Detroit,  and  Providence,  such  goods  if  destroyed  are  paid  for 
by  the  city.  If  there  is  a  steam  plant,  goods  of  tins  character  if  of  any 
value  may  be  steamed,  In  New  Orleans  where  there  was  no  steam  in 
1895,  wash  goods  were  boiled  and  left  overnight  in  a  solution  of 
bichloride,  1  to  1,000.  This  can  be  done  in  all  cities,  but  if  steam  is 
available,  it  is  best  to  use  that.  There  is  considerable  clinical  evidence 
to  show  that  sulphur  dioxide  is  a  good  disinfectant  in  this  disease,  and 
though  it  has  been  very  generally  discarded  for  formaldehyde  it  is  still 
used  quite  often  in  smallpox,  as  recently  in  Atlanta,  Birmingham,  Cin- 
cinnati,   New  Orleans,  and    Rochester.     If  sulphur  is  employed,   large 


1  Asst.  Surg.  G.  M.  Magruder,  Public  Health  Reports  (1898),  p.  247. 


' '  OMMZTNIl '.  I BL  E    I)  I  SEA  SEs.  5  Q  7 

amounts  are  used  and  pains  are  taken  to  have  the  air  of  the  room  moist. 
Formaldehyde  also  is  used.  In  cheap  houses  poorly  built  from  which 
the  gas  quickly  escapes,  instead  of  gaseous  disinfection,  bichloride  in 
solution  maybe  applied  with  a  pump  such  as  is  used  for  spraying  trees. 
This  was  done  in  Birmingham,  New  Haven.  New  Orleans,  Muncie,  and 
Providence.  For  the  better  class  of  houses,  employees  are  sent  by  the 
health  department  in  Providence,  Muncie,  and  Rochester  to  wash  all 
floors,  woodwork,  furniture,  etc.,  and  to  wipe  the  walls  and  ceilings. 
Particular  attention  should  be  given  to  the  privy  or  water-closets,  and, 
perhaps,  as  was  done  in  Muncie,  to  the  pump  handle  and  the  gate.  In 
Augusta,  ( ia.,  houses  are  all  kept  closed  for  a  month  after  disinfec- 
tion. 

The  cost  of  outbreaks  of  smallpox  is  very  great.  Even  in  those 
where  the  eases  are  few  in  number  and  the  general  business  interest-  of 
the  community  are  not  affected,  the  amount  spent  is  usually  many 
times  greater  than  would  be  for  scarlet  fever  or  diphtheria.  Thus  in 
Atlanta  in  1  *(.»4  the  cost  of  sixty-nine  eases  was  810,108.7(3,  or  *147.37 
per  case:  in  Lowell  in  1894  for  six  eases  $4,164.17,  or  $694.03  per 
ease,  and  in  1899  for  one  case  *4(.M».4»i  :  in  Newark  in  1894  for  131 
eases  $24,572.69,  or  $187.58  per  ease:  in  Muncie  in  1893  for  150  eases 
$23,217,  or  $154.78  per  ease:  in  New  Bedford  in  18i>:'>  for  three  eases 
$1,178.29,  or  $392.76  per  ease:  in  Toledo  in  1897  for  eighteen  cases 
$3,456,  or  $192  per  ease;  in  Brooklyn  in  1894,  exclusive  of  hospital 
treatment,  for  153  cases  $27,041.14,  or  $59.69  per  ease:  in  Montclair, 
X.  .1..  in  1898  for  one  case  $263.50;  in  Providence  in  1899  for  live 
-7:i4.14  or  $146.83  per  case ;  in  Augusta,  Ga.,  in  1899  for  P."; 
eases  $4,000,  or  $20.41  per  ease:  in  Portland,  Ore.,  in  1899  for  ten 
eases  $815.89  or  $81.59  per  ease:  in  the  District  of  Columbia  in 
1898  99  for  ninety-eighl  eases  $25,785.70,  or  $262.08  per  case ;  in 
Columbus,  O., « in  I*'.1'-1  for  seventy-five  cases  $42,750.85,  or  $570.01 
pei'  ease.     The   iost  of    maintaining  the  elaborate  smallpox  hospital  in 

Chicago  in    1899  was  $16,560,  and  only  twenty-One  patients    were  eared 

for.  Bui  a  general  communicable  disease  ambulance  service  is  also 
maintained   at    the  stable   which   consumes   a   considerable  part  <>l   the 

expense. 

)  .  How  Fever. 
This  is  the  most  difficull  disease  that  public  health  officials   have  to 

deal  with.  Very  little  is  known  with  defmiteness  about  the  manner  in 
which  it    is  spread,  the  nature  or  Location  of    the  poison    or    the  duration 

of  infection  in  the  individual.     The  diagnosis  also   is  difficult.     Public 

alarm  is  so  meat   on  the  advent   of    the  disease,    and    business  so  greath 


508  COMMUNICABLE   DISEASES. 

injured,  that  there  is  more  temptation  to  conceal  this  than  any  other 
disease.  The  one  great  ally  of  the  health  officer  is  frost,  which  over 
almost  the  whole  of  the  United  States  aids  him  in  suppressing  this  as  it 
does  no  other  disease.  Popular  fear  of  this  disease  is  so  great  that  a 
single  case  occurring  in  any  community  in  the  United  States  may  fairly 
be  said  to  constitute  an  epidemic. 

The  writer  lias  had  ahsolutely  no  experience  in  the  management  of 
outbreaks  of  yellow  fever  and  hesitates  to  describe  the  methods  that 
have  been  adopted  to  meet  it.  What  is  here  noted  is  taken  largely 
from  the  reports  of  the  marine  hospital  service  setting  forth  what  has 
of  late  years  been  done  and  what  is  advised  by  that  service.  Officers 
of  this  service  were  detailed  to  assist  or  direct  the  outbreaks  at  Bruns- 
wick, Ga.,  in  1893,  Biloxi,  Miss.,  New  Orleans,  Memphis,  and  many 
smaller  places  in  1897  and  1898,  and  at  Hampton,  Va.,  in  1899. 

The  management  of  yellow  fever  in  an  infected  community  of 
course  consists  in  the  application  of  the  principles  of  isolation  and  dis- 
infection. Often  cases  can  be  discovered  only  by  house  to  house  in- 
spection which  may  have  to  be  repeated  as  in  Hampton,  Va.,  in  1899; 
Brunswick,  Ga.,  in  1893;  and  Memphis,  in  1897.  Colored  physicians 
are  said  to  be  extremely  useful  for  this  work  among  the  colored  popu- 
lation. Removal  to  a  hospital  is  desirable  as  in  all  other  communicable 
diseases,  but  can  be  less  often  practiced  in  yellow  fever  than  in  small- 
pox for  the  disease  pursues  a  rapid  course,  and  except  in  early  stages 
removal  is  more  dangerous  for  the  patient  than  in  the  exanthemata.  In 
Brunswick,  in  1893  there  was  no  hospital,  and  in  New  Orleans  in  1897, 
of  386  cases,  but  202  were  treated  in  the  hospital. 

If  the  patient  remains  at  home  all  persons  except  those  needed  to 
care  for  him  are  removed  to  the  detention  hospital,  the  house  is 
placarded  and  guards  usually  placed  around  it.  Guards  are  not 
allowed  to  go  freely  about  the  town  but  must  sleep  in  a  guard-house. 
They  are  if  possible  to  be  immune.  The  following  was  the  method 
employed  in  New  Orleans,  in  1897  :J 

"A  guard  was  stationed  to  watch  the  premises  by  day  and  by  night,  and  no  one 
was  allowed  to  enter  or  leave  without  a  permit,  and  no  such  permit  was  given  unless 
the  applicant  for  same  had  had  yellow  fever;  lie  must  have  taken  a  bichloride  bath, 
1-2000,  and  had  been  furnished  from  the  outside  with  an  uninfected  suit  of  clothing. 
If  the  suit  could  not  be  obtained  from  without,  the  clothing  of  anyone  about  to  leave 
the  infected  premises  had  to  be  exposed  to  formaldehyde  fumes  for  six  hours, 
using  about  one  gallon  of  the  standard  formaldehyde  solution  to  each  25,000 
cubic  feet  of  air  space.  When  practicable,  disinfection  of  clothing  by  immersion  in 
a  solution  of  bichloride  of  mercury  1  to  1,000,  followed  by  careful  drying  was  pre- 
ferred. 


1  Louisiana,  Report  of  State  Hoard  of  Health,  1896-7,  p.  TO. 


<  OMMUNK  '.  I  ll  LE    I>lsE.  1  ,s  /-;.*.  ;,i  ig 

"No  one  was  allowed  to  enter  the  infected  premises  except  physicians  and  nurses, 
and  minister  or  priest,  and  even  they  were  nut  allowed  to  come  and  go  at  will,  unless 
they  conformed  with  the  Board  of  Health  regulations." 

The  care  of  the  sick  is  usually  taken  in  hand  by  the  sanitary  offi- 
cials. In  Brunswick  i24~>  nurses  were  employed  and  thirteen  physicians. 
There  were  1070  cases  of  the  disease.  .Most  of  the  nurses  were  paid 
(1.50  per  day.  Near  of  kin  were  not  employed,  hut  usually  a  patient 
was  nursed  by  a  friend. 

In  any  extended  outbreak  of  yellow  fever  there  is  sure  to  be  much 
distress,  and  relief  must  he  furnished  to  those  in  need  of  food  and 
clothing.  This  relief  is  usually  in  the  hands  of  the  health  department, 
or  at  least  is  given  only  under  its  direction. 

After  the  recovery  or  death  of  the  patient  the  premises  must  he  dis- 
infected. For  bedding,  carpets,  ami  textiles  generally,  burning  is  very 
generally  practiced  unless  the  articles  are  of  considerable  value.  These 
articles  should  he  replaced  by  the  sanitary  authorities.  Indeed,  the 
practice  of  reimbursing  for  all  loss  or  injury  during  disinfection  was 
quite  generally  followed  during  the  last  yellow  fever  outbreaks.  Tex- 
tiles that  are  not  burned  should  of  course,  he  steamed.  The  house  is 
generally  treated  with  formaldehyde  or  sulphur  dioxide,  or  both,  hut  a 
more  satisfactory  method  is  to  drench  it  with  bichloride  solution.  Pro- 
longed airing  is  also  efficient,  ('heap  houses  are  often  destroyed.  The 
surrounding  ground  requires  special  treatment  in  yellow  fever:1 

"The  premises  outside  the  houses  must  he  made  clear  of  trash  —  chips, 
leaves,  pieces  of  hoard,  etc.,  rotting  wood  being  believed  to  in-  an  especially  had 
nidus  of  infection.  The  mere  wetting  of  these  things  as  t  hey  lay  with  bichloride 
solution  is  not  thorough  disinfection,  the  underside  seldom  being  reached  bj  the 
solution. 

••  It   is  an   injury  to  wet   leaves  of  living  plants  with  bichloride  of  mercury.     It 

kills  the    leaves,    etc..    and    after   a    rain    has    washed    the    bichloride    off    these   dead 

leaves  are  a  good  nidus  (culture  medium)  for  any  infect  ion  not  destroyed,  as  on  the 
underside  of  the  hat.  it  is  ict  reasonable  t<>  believe  that  the  living  leaf  would 
serve  such  an  end. 

••  I-'.,  'the  thorough  wetting  of  the  cleaned  ground,  ditches,  etc..  with  bichloride 
solution  or  covering  it  with  chloride  of  I  inn'  is  doubtless  efficient,  hut  unquestion- 
ably t  If  disinfection  of  the  outside  premises  by  lire  is  the  method  "t  election. 

•This  is  best  done  by  the  Barber  asphalt  furnace  as  used  bj  Farrar  in  New 
oilcans  in  1897,  which  is  fairly  manageable.11 

This  Latter  method  of  disinfection  has  hern  used  in  Now  Orleans 
and  will  he  described  in  the  pages  devoted  to  the  consideration  of  dis- 
infection. Of  course  vaults  and  dr. mis  musl  be  disinfected  also.  In 
Now  Orleans  in  1897  not  only  were  the  infected  premises,  hut  also  the 
whole  block  disinfected  in  the  manner  described  above,  1  1,120  premises 

1  Reporl  ol  Supervising  Surgeon  (ieneral,  Marine  Hospital  Service  (1898),  p.  •'■•"'T. 


510  C  OMML  Wit  A  BL  E    U I  SEA  sES. 

being  so  treated.     The  character  and  extent  of  the  disinfection  ma}'  be 
inferred  from  the  amount  and  kind  of  materials  used.1 

In  18992  the  board  of  health  not  only  disinfected  yellow  fever  prem- 
ises, but  also  advised  by  means  of  a  circular  that  all  houses  be  treated 
in  the  same  way  where  there  had  been  cases  of  fever  concerning  which 
there  had  been  any  suspicion.  It  was  advised  that  the  houses  be  freely 
opened  during  cold  weather. 

Typhoid  Fever. 

The  most  important  thing  to  do  in  outbreaks  of  typhoid  fever  is  to 
seek  out  the  cause  and  if  possible,  remove  it.  The  principal  recognized 
sources  of  typhoid  fever  are  contaminated  water,  milk,  and  occasionally 
other  kinds  of  food.  Too  often  when  the  source  of  the  infection  is  dis- 
covered all  the  harm  possible  has  been  done.  Sometimes  the  infection  is 
found  to  still  continue,  and  it  should,  if  possible,  be  stopped  or  the 
public  warned  against  continuing  the  use  of  the  contaminated  water  or 
food.  If  milk  or  other  food  is  found  to  be  the  source  of  the  trouble  it 
can  usually  be  protected  against  further  infection.  If  wells  or  springs 
are  infected  their  use  can  be  stopped.  In  the  case  of  a  contaminated 
water  supply  the  public  can  be  warned  to  boil  the  water  before  drink- 
ing it.  But  the  health  department  will  not  do  its  whole  duty  unless  it 
makes  every  effort  to  have  the  public  supply  put  in  the  best  possible 
condition.  Public  sentiment  should  be  aroused  to  demand  that  water 
should  be  filtered  or  the  source  changed  or  such  other  steps  taken  as 
may  be  needed  to  render  the  water  safe. 

Whenever  an  exceptional  amount  of  typhoid  occurs  the  health  officer 
should  be  alert  to  discover  its  cause  at  the  earliest  possible  moment. 
The  reports  of  many  cities  show  that  health  officers  have  often  success- 
fully investigated  outbreaks  of  this  disease.     Often   the  local   health 

1  Louisiana,  State  Board  of  Health  Report  (1896-7),  p.  82: 
Disinfectants   Used   During  the  Yellow   Fever  Epidemic  of  1897  in  New 

Orleans. 

Formaldehyde 6,7274  pounds 

Chloride  of  Calcium 924         ' ' 

Bi-chloride  of  Mercury 1,743         tl 

Muriate  of  Ammonia 1,743         " 

Muriatic  Acid 4,270 

Sulphur 550         " 

Lime 4,391     barrels 

Chloride  of  Lime 21,793    pounds 

Carbolic  Acid 16^       " 

Wood  Alcohol 106     gallons 

Copperas 260     barrels 

-  New  Orleans,  Report  of  Board  of  Health  (1899),  p.  17. 


COMMUNICABLE    DISEASES.  511 

officer  finds  it  advisable  to  call  in  the  assistance  of  state  officers  because 
they  may  have  more  experience  in  such  matters  or  because  it  is  neces- 
sary to  go  outside  the  municipality  t»>  seek  for  the  cause.  The  Massa- 
chusetts state  board  through  its  agent  Professor  William  T.  Sedgwick, 
has  been  very  successful  in  investigating  these  outbreaks,  and  perhaps 
the  methods  employed  can  be  best  indicated  by  narrating  the  incidents 
of  one  of  these  investigations.  The  example  taken  is  that  of  Spring- 
field, where  the  outbreak  was  studied  by  Professor  Sedgwick  and  the 
local  health  officer,  Dr.  W.  II.  Chapin.  The  account  is  from  the 
twenty-fourth  report  of  the  Massachusetts  state  board  of  health  (for 
L892),  page  715. 

During  August,  1892,  a  large  increase  in  typhoid  lever  was  noted 
in  Springfield,  and  it  was  also  noted  that  the  increase  was  confined  to 
mil'  district,  known  as  the  Mc Knight  district.  The  local  health  officer 
promptly  began  to  seek  out  the  cause  of  the  disease.  Various  theories 
were  advanced,  the  most  tenable  of  which  was  that  it  was  due  to  con- 
taminated milk.  The  health  officer  investigated  the  milk  supply,  but, 
misled  by  false  information,  found  out  nothing.  At  tliis  juncture  the 
assistance  of  the  state  board  of  health  was  asked  for.  A  detailed  inves- 
tigation of  the  history  of  each  case  was  then  begun  and  the  results 
recorded  od  the  blank  shown  in  Appendix  91.  In  such  investiga- 
tions Professor  Sedgwick  considers  "the  fixing  of  the  precise  time  of 
infection  is  of  supreme  importance  for  the  investigator,  and  this  may 
often  be  obtained  with  considerable  accuracy  by  the  date  of  the  physi- 
cian's first  visit  or  the  time  of  the  patient's  taking  to  bed.  The  former 
can  usually  be  got  from  the  attending  physician  :  the  latter,  in  a  sur- 
prising number  of  cases  with  tolerable  accuracy,  from  the  patient  or  his 
friends.     The   location   of   the   patient    when   attacked    is  also  highly 

important,  as  possibly  indicating  the  place  of  infection,  the  place  of 
work,  business  or  school,  giving  alternative  information  of  the  same 
nature.  The  symptoms  are  asked  for  partly  as  a  matter  of  routine. 
parti}    to  gel    the  patient  or    liis  friends  to  talk  and  so  disarm  suspicion. 

and  partly  for  use  when  it  is  denied  thai  the  epidemic  is  real." 

In  the  Springfield  outbreak,  after  nineteen  houses  in  the  infected 
district  had  been  visited  and  forty-sis  cases  examined,  it  became  clear 
thai  all  theories  hitherto  advanced  were  untenable,  excepl  the  milk 
theory.  The  cause  could  nol  be  the  city  water  Bupply,  for  the  outbreak 
was  localized  in  one  dist  rict.  and  it  could  not  be  due  to  open  sewer  man- 
holes in  the  streets  for  the  same  reason.  Theretwas  no  more  defective 
plumbing  in  the  houses  than  in  others  where  there  was  no  fever, 
considerable  number  of  the  patients  drank  no  well  water,  li  was  nol 
dm-  to  infected  fruit,  vegetables,  or  ice,  for  those  attacked  did  nol   have 


512  COMMUNICABLE    DISEASES. 

a  common  supply  of  these  materials.  The  only  common  bond  was  the 
milk  supply.  All  but  one  of  the  cases  took  milk  from  the  same  milk- 
man. This  rendered  it  probable  that  the  milk  was  the  source  of  the 
trouble.  A  map  was  prepared  on  which  were  shown  all  the  cases  of 
fever  and  also  all  the  customers  supplied  by  the  suspected  milkman. 
Of  the  150  cases  reported  101  certainly  had  his  milk,  and  35  may  have 
had  access  to  it.  There  were  a  few  cases  in  other  parts  of  the  city  and 
it  was  found  that  some  of  these  were  temporarily  supplied  by  this  man. 
The  fever  developed  in  about  forty  per  cent,  of  the  houses  served  by 
him.  The  immunity  of  some  was  perhaps  explained  by  the  fact  that 
he  did  not  obtain  all  his  milk  from  what  afterwards  proved  to  be  the 
infected  source.  To  assist  in  ferreting  out  the  origin  of  the  outbreak  a 
chart  was  made  to  show  graphically  on  what  days  the  cases  were  taken 
sick.  The  facts  brought  out  by  the  investigation  and  shown  graphically 
on  map  and  chart  conclusively  fixed  the  cause  of  the  outbreak  in  this 
man's  milk.  It  then  remained  to  discover  how  the  milk  became  in 
fected.  At  first  the  dealer  concealed  the  identity  of  one  of  the  pro- 
ducers from  whom  he  bought  milk,  but  after  much  labor  this  farm  was 
located  and  it  was  found  that  there  had  been  "bilious  typhoid  fever" 
there  early  in  the  spring  and  cases  of  slow  fever  later.  There  were  two 
possible  ways  discovered  by  which  the  milk  might  have  become  in- 
fected. The  contents  of  the  privy  were  spread  on  a  lot  near  the  well, 
and  the  men  walked  over  this  in  going  to  the  well,  and  their  boots  -were 
rinsed  off  on  the  planking  over  the  well  into  the  water  below.  In  this 
water  bacilli  coli  communis  were  found.  The  cans  of  milk  were 
cooled  in  this  well  and  it  was  found  that  the  water  leaked  into  the  cans. 
Another  chance  for  contamination  was  directly  from  the  infected  hands 
of  convalescents.  Owing  to  the  false  statements  of  the  dealer  it  was 
only  with  great  difficulty  that  it  was  determined  that  the  milk  from  this 
particular  farm  went  to  the  infected  district.  It  was  necessary  in  order 
to  show  this,  to  cross-question  his  assistants  and  to  examine  the  books 
of  the  farmers  who  supplied  him  and  the  books  of  the  Co-operative 
Milk  Association. 

Typhus  Fever. 

This  has  of  late  been  a  rare  disease,  the  only  notable  outbreak  for  a 

number  of  years  being  that  in  New  York  City  in  1892.      The  first  cases 

were    among    Jewish    immigrants   chiefly    in    lodging   houses.     During 

February  1<>  and    11,  sixty-seven  cases  were  discovered  in  these  houses 

and  removed  to  the  isolation  hospital  on  North  Brother  Island:1 

"All  other  immigrants  who  had  been  exposed  to  the  contagion  were  removed 
from  the  different  houses  already  named,  to  No.  5  Essex  street  and  Xo.  42  East 
Twelfth   street,  where  they  were   put  under  close   sanitary  surveillance.     For  this 

1  New  York,  Report  of  Health  Department  (1892),  p.  122. 


COMMUNICABLE   DISEASES.  513 

purpose  a  detail  of  policemen  from  the  sanitary  squad  was  made,  and  orders  given 
them  to  permit  no  person  to  enter  or  leave  either  building  without  a  permit  in  writ, 
ing  from  the  chief  inspector  of  the  division  of  contagious  diseases.  At  first  this  was 
effected  by  stationing  one  officer  at  each  house,  and  relieving  him  every  eight  hours. 
It  subsequently  became  necessary  to  double  this  force,  stationing  two  officers  at  a 
time,  and  it  was  deemed  wise  to  relieve  them  from  duty  at  four-hour  intervals.  The 
officers  were  warned  of  the  danger  of  contracting  the  disease,  and  were  instructed 
to  keep  outside  of  the  houses  except  in  case  of  necessity  requiring  their  presence 
within  the  buildings.  Notwithstanding  precautions  taken  to  prevent  it,  cases- 
occurred  almost  daily  in  both  these  houses.  As  the  occurrence  of  these  cases  con- 
tinued after  the  period  of  incubation,  dating  from  the  segregation  of  the  suspects  in 
these  two  houses  by  the  department  order,  it  was  deemed  wise  to  vacate  both 
houses  and  to  continue  sanitary  observation  of  their  occupants  on  North  Brother 
Island. 

"  The  first  case  occurring  among  the  residents  of  New  York,  presumably  from 
the  contagion  brought  here  by  the  Hebrews,  was  that  of  Max  Bnsch,  carpenter,  em- 
ployed in  the  Thalia  Theatre.  He  was  taken  sick  February  19th  at  No.  53  Bowery. 
a  lodging  house,  and  was  removed  to  Bellevue  Hospital. 

•After  this  secondary  cases  occurred  in  a  number  of  houses  scattered  in  various 
parts  of  the  city.  Three  cases  were  received  from  ships  in  quarantine.  The  follow- 
ing very  remarkable  fact  reflects  credit  on  the  efficiency  of  the  department:  the  total 
number  of  residents  who  contracted  typhus  fever  before  June  1st  was  seventy,  of 
tli is  number  ten  contracted  it  from  contagion  in  No.  53  Bowery  (lodging  house) 
three  cases  were  found  at  No.  39  Hester  Street  (a  tenement  house),  four  cases  were 
found  at  No.  '_'4<>  Cherry  Street  (a  tenement  house).  These  were  the  only  houses  in 
which  more  than  one  case  occurred.  The  remaining  fifty-three  cases  were  in  fifty- 
three  different  houses.  In  other  words,  in  only  three  of  fifty-six  houses  did  more 
than  one  case  occur.'1 

■A  description  of  the  means  taken  to  prevent  the  spread  of  typhus  fever  in  this 
outbreak  is  of  interest.  These  means  are  twofold,  and  while  they  seem  simple  and 
easy  of  application,  their  detail  is  exceedingly  minute  and  must  be  carried  out  to  a 
degree  of  perfection.     They  are  as  follows: 

1st.  Isolation  of  persons  sick  with  the  disease  and  those  who  have  been  exposed 
to  its  contagion. 

2d.     Thorough  disinfection  of  all  infected  rooms  and  materials. 

"The  first  means  was  accomplished,  as  has  already  been  described,  by  the  re- 
moval of  persons  sick  to  the  hospital  for  contagious  diseases,  and  by  t  lie  segrega!  ion 
of  the  so-called  "suspects'1  in  two  houses,  and  their  subsequeni  removal  to  North 
Brother  Island.  The  second  means  w;is  effected,  first,  by  thorough  fumigation  of 
infected  rooms  ami  materials  in  them  with  sulphur  burned  in  accordance  with  the 
rule,  of  the  American  Public  Health  Association.  The  sulphur  is  placed  in  iron 
receptacles,  which  are  suspended  in  water,  so  thai  the  heal  from  the  burning  sul- 
phur causes  a  certain  amounl  of  steam  to  be  evaporated  from  the  water,  and  this 
adds  moisture  to  the  fumes  given  off  '»>  the  ignited  sulphur.  In  addition  to  this. 
the  sulphur  is  ignited  by  means  of  alcohol   pound  over  it.     The  burning  of  the 

alcohol    adils  also  to  the  isture   given  off   by  the  steam.      The    amount    of   sulphur 

used   is  three  pounds  to  every  1,000  cubic  feel  of  air  space  to  be  fumigated.     After 

Fumigation,  the  infected  t us  were  thoroughly  aired,  and  the  walls,  ceilings,  and 

Boors  subjected  to  disinfection  with  a  solution  of  bichloride  of  mercury.  The 
Btrength  of  this  solution  was  one  pari  of  mercurj  per  live  hundred  of  water.  After 
this  i  real  meni   the  rooms  were  again  fumigated   in  the  manner  already  described, 

after  which  they  were  again  aired,  and    I  lie  walls,  ceilings,  and  floors  scrubbed    wiih 

soap  and   water.     All  portable  materials,  such  as  baggage,  bedding,  etc.,  were  then 


514  COMMUNICABLE   DISEASES. 

moved  by  means  of  the  department  wagon  to  the  disinfecting  depot  at  the  foot  of 
East  Sixteenth  street,  where  they  were  subjected  to  disinfection  by  means  of  dry 
and  moist  heat,  in  a  special  chamber  bnilt  for  the  purpose,  and  described  in  the 
annual  report  of  the  board  of  health  for  1890.  The  two  houses,  No.  42  East  Twelfth 
street  and  No.  5  Essex  street,  in  which  the  "suspects'1  were  segregated  while  in 
the  city  proper,  were  not  permitted  to  be  occupied  for  human  habitation  until  a 
period  of  fourteen  days  had  elapsed.  During  this  period  the  windows  were  kept 
open  so  as  to  permit  thorough  airing  of  the  dwelling." 

Two  cases  were  on  one  day  found  in  the  alcoholic  ward  of  Bellevue 
Hospital.  One  of  them  had  been  there  five  days.  During  this  time, 
seventy-four  persons  had  been  exposed  in  the  same  ward  and  had  been 
discharged.  Sixteen  left  the  city,  thirty-eight  could  not  be  found,  and 
only  twenty  were  found  by  the  inspectors,  who  endeavored  to  locate 
them  all.  No  case  developed  among  them  so  far  as  known.  On  another 
occasion  a  case  was  found  in  one  of  the  general  wards  of  the  same 
hospital.  "  No  visitors  were  allowed  in  the  ward  for  three  weeks,  and 
a  list  of  all  the  occupants  with  their  addresses  was  furnished  the  depart- 
ment, and  notice  given  by  the  warden  when  any  one  was  discharged 
from  the  ward.  An  inspector  was  then  sent  to  find  him,  if  possible, 
and  keep  him  under  observation." 

Scarlet  Fever  and  Diphtheria. 

Usually  about  the  same  procedure  is  followed  in  extended  as  in 
mild  outbreaks  of  these  two  diseases.  It  is  very  seldom  that  the  pub- 
lic evinces  alarm  and  demands  or  permits  the  adoption  of  unusual 
methods.  Isolation  and  disinfection  are  the  remedies  that  are  relied  on. 
It  is  true  that  in  diphtheria  antitoxin  is  a  valuable  prophylactic;  but 
unfortunately  it  is  expensive,  not  easily  administered,  and  its  proph}-- 
lactic  effect  is  transitory,  lasting  perhaps  a  month.  So  far  as  the 
writer  knows  it  lias  never  yet  been  used  for  the  general  immunization 
of  a  community,  though  it  has  been  used  in  this  manner  in  infected 
families  and  institutions  with  markedly  beneficial  results.  In  scarlet 
fever  no  means  of  immunization  is  known.  Usually  in  severe  outbreaks 
of  these  diseases  the  health  officer  can  and  does  secure  a  stricter  enforce- 
ment of  existing  laws  than  at  other  times.  Sometimes  popular  alarm 
results  in  the  improvement  of  methods  long  known  by  the  sanitary 
department  to  be  defective,  but  continued  because  of  the  apathy  of  the 
public,  the  council,  or  the  legislature.  An  epidemic  of  these  commoner 
diseases  sometimes  results  in  a  better  organization  of  the  health  depart- 
ment, a  larger  appropriation,  the  purchase  of  an  ambulance,  or  a  disin- 
fecting plant,  or  the  construction  of  a  hospital.  Sometimes  new  and 
more  stringent  regulations  concerning  isolation  are  adopted.  More 
often  the  health  officer  merely   secures  better   enforcement  of  laws  sim- 


COMMUNICABLE   I>lsK.  [  sKs.  515 

ply  because  he  lias  the  active  approval  of  the  public,  the  press,  and  the 
physicians. 

Local  outbreaks  of  scarlet  fever  and  diphtheria  frequentlv  result  in 
the  closure  of  schools,  sometimes  by  the  health  department  and  some- 
times by  the  school  department.  If  a  number  of  cases  of  these  diseases 
occur  simultaneously  or  in  rapid  succession  in  a  given  school,  it  is  often 
an  indication  that  there  is  in  the  school  an  unrecognized  source  of  infec- 
tion. Sometimes  this  is  by  the  circumstances  rendered  almost  certain. 
It  is  usual  in  such  cases  to  close  the  school  for  a  few  weeks  and  to  dis- 
infect it  as  completely  as  possible.  In  Providence,  schoolrooms  are 
disinfected  by,  first,  the  application  of  formaldehyde  gas ;  second,  the 
washing  of  all  desks  and  other  woodwork  with  a  solution  of  corrosive 
sublimate  one  to  one  thousand;  third,  all  the  books,  pencils,  papers, 
and  kindergarten  materials  are  removed  in  baskets,  and  either  burned  or 
Submitted  to  the  action  of  steam.  In  that  city  it  is  rarely  that  schools 
have  been  closed  and  disinfected.  Usually  if  it  is  suspected  that  a 
school  is  infected,  a  thorough  inspection  is  made,  and  in  diphtheria,  cul- 
tures taken,  and  all  suspicious  cases  kept  out  of  school.  The  writer 
believes  that  with  an  efficient  medical  inspection  of  schools,  closure 
will  rarely  be  necessary. 

As  in  smallpox  and  yellow  fever,  so  probably  in  scarlet  fever  and 
diphtheria  it  is  mild  and  unrecognized  or  unreported  cases  which  are 
the  chief  cause  of  their  spread.  Nothing  new  has  of  late  years  been 
learned  concerning  the  recognition  of  cases  of  scarlet  lever  infection, 
but  it  is  otherwise  with  diphtheria.  The  use  of  the  microscope  leads  in 
this  disease  to  the  discovery  of  many  persons  who  are  infected  though 
sometimes  perfectly  well  and  who  may  give  the  contagion  to  others. 
In  families,  in  schools,  and  in  institutions,  the  use  of  the  swab  and 
microscope  should  lie  of  great  value  in  checking  an  outbreak.  There 
have  been  instances  in  Baltimore,  Denver,  Providence,  and  doubtless 
Other  cities  where  a  routine  examination  of  all  the  children  in  a  given 
school  has  resulted  in  the  isolation  of  the  source  (if  in  feet  ion.  In 
Asbnry  Park1  besides  a  regular  medical  inspection  of  the  schools  and 
cultures  from  all  suspected  eases,  there  was  practiced  a  weekly  disinfec- 
tion of  the  schoolrooms  with  a  bichloride  spray.  Alter  spraying  the 
desks  and  wookwork  were  wiped  off  and  the  floor  swept.  When  diph- 
theria appears  in  an  orphan  asylum,  reform  school,  or  similar  institution, 

it  is  extremel}  difficult  to  get  rid  of  it,  and.  in  nian\  such,  it  has  contin- 
ued epidemic  for  a  long  lime,  perhaps  years.  It  is  now  customary  in 
Such  cases    io  take  cultures  from    all    the    inmates    and    isolate    all    who 

have  diphtheria  bacilli  in  their  throats.     In  Providence  this  method  was 
N.-w  Jersey,  Keporl  of  State  Board  <.f  Flealtli  (1896),  page  157. 


516  COMMUNICABLE   DISEASES. 

followed  in  two  institutions  with  the  result  that  the  disease  disappeared, 
but  in  one  of  them  several  successive  negative  cultures  were  taken  from 
both  throat  and  nose.  In  two  other  instances  in  that  city  this  method 
was  not  successful.  The  most  conspicuous  instance  of  failure  after 
very  great  effort,  was  in  a  state  institution  at  Owatonna,  Minn.1  Here 
diphtheria  has  existed  for  several  years,  notwithstanding  the  practice  of 
ordinary  methods  of  isolation.  It  was  finally  determined  to  pass  all 
members  of  the  school  through  a  "  filter."  A  number  of  rooms  were 
selected,  in  each  of  which  a  single  pupil  was  placed  and  retained  there 
until  six  successive  negative  cultures  were  obtained  from  both  nose  and 
throat.  All  members  of  the  school  were  passed  through  these  isolation 
rooms.  Of  course,  thorough  disinfection  of  clothing  and  rooms  was  also 
practiced.  Nothwithstanding  these  efforts,  it  was  found  that  diphtheria 
bacilli  could  be  detected  in  a  number  of  the  members  of  the  school  and 
cases  of  the  disease  have  since  occurred  there. 

Cholera. 

Since  the  discovery  of  the  spirillum  of  Asiatic  cholera,  this  country 
has  twice  been  threatened  by  European  outbreaks,  once  in  1885  and 
again  in  1892,  but  the  disease  reached  our  shores  only  once  in  1892,  and 
then  did  not  extend  beyond  a  few  cases  in  New  York  City.  On  both 
occasions  of  the  presence  of  the  disease  in  Europe,  great  alarm  was  felt 
in  the  United  States  and  active  precautions  were  taken  to  prevent  its 
introduction  and  spread.  The  quarantine  regulations  will  be  elsewhere 
discussed.  It  has  long  been  believed  that  a  filthy  condition  of  houses, 
yards  and  streets,  vacant  lots,  and  streams  and  ponds  of  water,  conduces 
to  the  spread  of  this  disease,  and  that  if  a  community  is  kept  clean 
cholera  will  not  prevail  to  any  great  extent.  Acting  on  this  belief  our 
cities  in  1885  and  1892  made  very  great  efforts  to  put  themselves  in 
"  better  sanitary  condition  "  by  a  general  house  cleaning.  Nearly  all 
cities  employed  an  additional  force  of  inspectors  and  made  house  to 
house  inspections.  Owners  were  ordered  to  abate  nuisances,  put 
plumbing  and  drainage  in  order  and  cleanse  their  premises.  In  many 
cities  considerable  amounts  from  the  public  funds  were  spent  in  clean- 
ing streets,  removing  filth  from  vacant  lots  or  draining  stagnant  ponds, 
and  distributing  disinfectants.  The  following  quotations  from  a  report 
of  what  was  done  in  Brooklyn2  will  serve  as  illustrations  of  the  nature 
of  the  work  done  : 


1  F.   F.   Wesbrook  and   L.   B.  Wilson,  Transactions  of  American  Public   Health 
Association,  Vol.  XXV.,  p.  546. 

2  Preparation  of  Brooklyn  for  cholera,  J.  II.    Raymond,  M.  D.,  Brooklyn  Medical 
Journal,  10  September,  1892. 


CO  MMVWIC.  1 B  I  E    D  is  h\  l  s  ES.  5 1  7 

"  For  some  time  the  efforts  of  the  Department  of  Health  had  been  directed  to 
Closing  up  the  wells  of  the  city,  which  at  the  outset  of  the  undertaking  numbered 
three  hundred  and  sixteen,  varying  in  depth  from  fifteen  to  one  hundred  feet.  An 
analysis  of  the  water  of  these  wells  showed  that  of  the  whole  number,  but  seventeen 
furnished  water  tit  for  consumption.  These  were,  of  course,  liable  at  any  time  to 
become    contaminated.     As   a  result  of    these  efforts   all   the    wells,  but  one,  were 

closed. 

"  Special  police  force  was  obtained  to  make  repeated  examinations  of  the  exist- 
ing vaults,  the  exact  location  of  which  by  street  and  number  was  known. 

••  The  old  fashioned  method  of  emptying  privies  had  been  prohibited  and  the  so- 
called  ■  odorless  "  was  the  only  one  permitted.  The  night-soil  was  removed  to  farms 
and  utilized  as  fertilizer,  hut  arrangements  were  made  by  which,  had  cholera  come, 
this  woidd  have  been  discontinued  and  the  material  wouldhave  been  carried  to  sen 
in  boats.     This  latter  method  of  disposal  was  adopted  in  August.  1885. 

••  During  the  season  of  1884  and  1885,  twenty-three  stagnant  ponds  were  drained 
and  tilled;  in  the  whole  city  there  were  fifty-nine  tilled  at  an  expense  of  8:55,108.85. 
The  material  employed  for  this  filling  was  in  every  case  fresh  earth  or  clean  ashes, 
no  garbage  or  other  decomposable   matter  being  used  in  a  single  instance. 

"During  the  two  years  the  inspectors  made  11,622  inspections  of  the  plumbing  in 
old   houses.  • 

"  As  sailors  coming  to  the  city  were  liable  to  find  their  way  first  to  the  lodging 
houses,  special  attention  was  directed  to  these.  Nine  of  them  with  •">:',:!  beds  existed  in 
the  city.  These  were  thoroughly  examined  from  cellar  to  attic,  and  when  dele 
plumbing,  ventilation,  or  overcrowding  were  found,  these  were  corrected.  The 
disinfecting  corps  disinfected  them  thoroughly,  and  it  was  made  a  part  of  the  in- 
spect, ir's  duties  to  visit  them  often.  The  proprietors  were  summoned  to  the  Health 
<  ►ffice  and  instructed  as  to  the  necessity  of  cleanliness  and  of  prompt  notification  to 
the  Health  Officer  of  all  cases  of  sickness. 

"  The  frequency  with  which  disease  has  been  spread  by  rags  made  it  important 
to  have  these  under  surveillance. 

••A  census  showed  that  there  wen-  279  places  in  which  rags  were  stored.  In 
order  to  have  the  necessary  control  over  them,  the  following  ordinance  was  passed  : 

•Section  188.      No  person   engaged    in   buying,  selling   or  storing    skins,  hides,  rags, 

bones  or  similar  articles,  or  who  has  become  possessed  by  purchase  or  otherwise  ol 
skins,  hides,  rags,  bones  or  similar  articles,  for  the  purpose  of  selling  the  same,  shall 
store  or  keep  any  of  said  above  mentioned  articles  within  the  limits  of  the  Citj  of 
Brooklyn  without  first  obtaining  a  written  permit  so  to  do  from  the  commissioner 
,,f  health  of  said  city,  the  terms  and  conditions  of  which  permit  shall  be  strictlj 
complied  with  by  the  person  obtaining  the  same.'  Of  the  279  places,  lb;  were  per- 
mitted to  continue,  theothers  were  ordered  closed  as  being  unlit  places  for  the  busi- 
ness. 

••  Vacant  lots  have  always  proved  a  standing  invitation  to  householders  and  others, 
who  have  filth  to  dispose  of.  To  keep  such  spots  in  an  inoffensive  condition  a  force 
of  thirty-two  men  with  eighteen  .arts  was  kept  employed  from  Maj  15  to  December 
1.  1885,  in  removing  such  tilth  wherever  deposited,  in  streets,  vacant  lots  or  yards. 
Three  t  bousand  nine  hundred  and  sixty-two  loads  of  su.h  material  were  removed  by 
boat  to  sea.     The  cosl  of  this  service  was  $9,128.89. 

1 '  The  total  amount  of  money  expended  bj  the  health  department  in  anticipa- 
tion of  cholera  over  ami  above  the  regular  salaries  and  expenses  was  |56,785.i 

In  N.w   York  :  ' 
■•  Early  in  September,  it  was  decided,  owing  to  the  presence  of  cases  of    Asiatic 
cholera  in  the  city,  to  stop  the  work  of  trimming  the  scows  of  the  street  cleaning 

\.  w    York.   Report  of  Health   Department   (1892),   p.  B6. 


518  COMMUNICABLE    DISEASES. 

department.  This  work  consists  of  gleaning  whatever  may  be  of  value  from  the 
ashes  and  garbage  that  are  brought  to  the  dumps,  such  as  bones,  rags,  old  iron,  bot- 
tles, etc.  The  privilege  of  doing  this  work  is  valuable  on  account  of  the  property 
obtained,  and  a  source  of  large  revenue  to  the  city.  During  the  prevalence  of  such 
infectious  disease  as  Asiatic  cholera  in  the  city,  the  refuse  at  the  dumps  would  be 
presumably  infected.  About  the  first  of  November  the  work  was  permitted  to  be 
resumed,  but  with  the  proviso  that  all  gleanings  from  the  dumps  should  be  disin- 
fected.    The  latter  provision  was,  with  some  difficulty,  carried  into  effect.1' 

Circulars  giving  directions  how  to  prepare  for  and  ward  off  cholera 
were  issued  and  very  generally  distributed  in  cities.  They  were  usually 
written   in   popular  language  and  an  example  is  given  in  Appendix  92. 

The  seaboard  states  and  cities  of  course  redoubled  their  care  in 
quarantining  immigrants  as  will  be  shown,  but  some  of  the  interior 
states  distrusted  the  efficiency  of  the  methods  employed  and  took  addi- 
tional measures  to  prevent  the  introduction  of  the  disease.  This  was 
done  by  the  states  of  Illinois,  Michigan,  .Minnesota,  Wisconsin,  and  by 
several  of  the  cities  in  these  states. 

In  several  cities  hospitals  were  built  so  as  to  be  ready  for  the  recep- 
tion of  cholera  patients.  In  Boston  two  such  were  constructed  and 
also  a  steam  disinfecting  plant. 

What  was  actually  done  when  cholera  appeared  in  New  York  City 
is  shown  by  the  following  extract  r1 

"  During  the  early  part  of  September  a  stable  was  constructed  on  the  river  front, 
south  of  East  Sixteenth  Street,  to  be  used  exclusively  by  the  ambulance  service  con- 
nected with  cholera  in  this  city. 

Four  ambulances,  specially  designed  for  this  service,  were  purchased,  they  were 
lined  with  rubber  cloth,  witli  the  following  equipment: 

"  Two  mattresses;  two  pillows  —  these  were  covered  with  rubber  sheeting  so  they 
could  not  be  infected,  and  could  be  readily  rendered  aseptic;  two  heavy  woolen 
blankets;  two  canvas  bags,  (J  feet  in  length  by  24  inches  wide,  provided  with  a  draw- 
ing-string for  the  purpose  of  encasing  the  patient  while  being  removed  to  the  vehicle ; 
two  canvas  bags,  3  feet  in  length  and  15  inches  wide,  for  the  removal  of  soiled  and 
infected  bed  linen,  clothing,  etc.;  two  bed  pans;  two  emesis  basins;  one  2-gallon 
demijohn,  containing  a  solution  of  bichloride  of  mercury  (1-500) ;  twenty  pounds  of 
sulphur;  one  pound  of  bichloride  of  mercury;  three  india-rubber  suits;  three  india- 
rubber  coats;  three  pairs  india-rubber  shoes;  three  pairs  india-rubber  gloves. 

"  Four  drivers  and  four  helpers  are  constantly  on  duty,  two  being  detailed  in 
relays  every  twenty-four  hours.1' 

"The  summer  corps  of  fifty  physicians,  as  well  as  sixteen  additional  ones,  were 
transferred  for  service  in  the  investigation  and  care  of  cholera  cases.  These  with 
the  regular  inspectorial  corps  of  this  division,  operated  in  the  following  manner: 

11  The  six  diagnosticians  were  on  duty  at  all  times. 

"  The  special  corps  were  detailed  as  follows: 

"  Three  were  stationed  at  central  office  to  act  as  ambulance  physicians;  three 
were  stationed  at  central  office  to  answer  telephone  calls;  six  were  stationed  at  cen- 
tral office  to  answer  emergency  calls,  in  order  to  establish   the  quarantine  of  the 


iNew  York,  Report  of  Health  Department  (1892),  p.  118. 


( 'OMMl  Wit '.  1  BLE    DISEASES.  5 1 9 

houses  witliout  delay.  The  remainder  were  ordered  to  make  house  to  house  inspec- 
tion, searching  for  diarrheal  cases,  and  to  investigate  all  cases  where  death  from 
diarrhoea]  diseases  had  occurred,  and  also  those  who  had  visited  the  city  dispensaries 
for  treatment  of  diseases  of  a  like  character. 

"  When  a  case  suspicious  of  cholera  was  reported  to  this  division,  the  diagnos- 
tican  was  immediately  sent,  provided  with  a  sterilized  bottle  placed  in  a  wooden 
casing,  prepared  by  the  bacteriologist  of  the  department,  and  a  bottle  of  antiseptic 
solution  to  render  the  same  aseptic,  subsequent  to  the  placing  in  it  of  a  specimen  of 
the  vomit  or  diarrheal  discharge.  If  this  specimen  was  procured,  it  was  forwarded 
immediately  to  the  laboratory  of  the  department.  The  ambulance  was  then  ordered 
to  be  in  readiness  to  start  at  once. 

"  Upon  a  report  being  received  from  the  diagnostician  that  the  case  was.  in  his 
opinion,  suffering  from,  or  dead  of,  the  disease,  the  following  line  of  action  was 
taken : 

ltIf  the  patient  was  dead,  a  coffin  was  placed  in  the  ambulance. 

"  The  ambulance,  with  the  driver  and  helper,  was  notified  by  telephone  to  pro- 
peed  immediately  to  the  house,  and  the  ambulance  physician  and  the  physician  to 
establish  quarantine  started  from  the  central  office  at  the  same  time. 

"  The  captain  in  charge  of  the  precinct  where  the  case  occurred  was  notified  by 
polite  telegram  to  detail  a  police  officer  for  duty  under  the  control  of  the  physician 
in  charge  of  the  quarantine. 

"Upon  arriving  at  the  house  the  driver,  helper,  and  ambulance  physician  clothed 
themselves  in  their  rubber  suits  before  entering  the  apartment. 

"The  patient  was  placed  in  the  large  canvas  bag,  with  a  drawing  string  around 
his  neck,  and  removed  from  his  rooms  directly  to  the  ambulance,  the  phyician  in 
attendance  carrying  the  emesis  basin  to  receive  any  vomits.  The  patient  was  placed 
in  the  ambulance  ami  removed  to  the  Reception  Hospital,  accompanied  by  the  phy- 
sician and  driver.  If  the  patient  had  succumbed  to  the  disease,  the  body  was 
wrapped  in  a  sheet  thoroughly  saturated  with  a  bichloride  solution  (l-oOO),  placed 
in  the  coffin  and  re \ed  to  the  autopsy  room  at  the  Reception  Hospital. 

"  The  helper  remained  at  the  house  with  the  quarantine  physician,  prepared  a 
large  quant  itj  of  the  solution  of  bichloride  of  mercury,  and  proceeded  to  disinfect 
the  premises,  under  tic  direction  of  the  physician,  in  the  following  manner: 

"  All  bedding,  clothing,  carpets,  and  all  textile  fabrics  in  the  room  where  the 
patient  had  been  were  saturated   with  a  disinfecting  solution;  soiled  bedding  and 

Infected  clothing  were  placed  in  canvass  hags,  the  carpets  taken  from  the  il \  and 

then  removed  in  a  wagon  provided  for  the  transportation  of  infected  goods  to  the 
disinfecting  station  at  t  lie  foot  of  East  Sixteenth  street  and  cremated. 

"The  walls,  floors,  and   wooden  furniture  in  apartment,  the  floors,  surbase  of 

halls,  i  he  floors,  SUrbase,  balusters,  handrails  of   stairways,  the  door  knolis,  faucets 

of  water-pipes,  the  seats  and  floors  of  water-closets,  were  all  thoroughly  scrubbed 
wiih   hand  brushes  saturated  with  a  disinfecting  solution.     The  water-closet  bowls 

and  pipes  were  thoroughly  Hushed  with  a  solution  of  carbolic  acid  or  milk  of 
lime. 

"  The  room  or  rooms  which  bad  been  occupied  by  the  patient  were  fumigated 
(after  the  cracks  ol  doorways  and  windows  were  made  air-tight,  having  paper  pasted 
over  them)  with  burning  sulphur  (3  pounds  to  the  1,000  cubic  feet).  After  this 
action  had   been   taken  the  apartment  was  placed  under  strict  quarantine,  a  police 

officer  stationed   in  t  he  ha  1 1  on  t  hat  H ■,  who  allowed  no  one  to  enter  or  leave  the 

apartment  Whenever  it  was  necessary  for  anj  of  the  quarantined  family  to  visit 
t  he  water-closet  they  were  accompanied  by  the  physician  in  charge  "f  t  lie  quarantine 
and  reconducted  as  quickly  as  possible  t"  their  rooms.     The  quarantine  physician 

then  made  a  Complete  census  of  the  OCCUpantS  Of  the  house  nanus,  ages,  ..ecu 
pation,  and  where  employed  and  sent  postal  cards  t"  principals,  notifying  them  to 
exclude  from  their  Schools  all  children  residing  in  that   In.  use.       I  le  a  Ih  .w  ed  no  fain  ily 


520  0  OMMUNIGABLE   I)  I  SB  A  S  ES. 

to  remove  their  goods  from  the  house  without  a  permit  from  the  Chief  Inspector. 
He  kept  surveillance  over  the  water-closets,  noting  any  of  the  occupants  who  visited 
the  same  more  than  twice  in  twenty-four  hours. 

"All  supplies  for  the  family  were  purchased  and  paid  for  by  the  quarantine  phy- 
sician, who  made  a  report  of  the  condition  of  affairs  every  eight  hours  by  telephone 
to  the  central  office. 

"  This  strict  quarantine  was  maintained  for  seven  days  from  the  time  the  case  or 
body  was  removed.  Then  all  the  persons  under  quarantine  were  required  to  bathe 
and  dress  themselves  in  clothing  which  had  been  disinfected  by  the  department,  and 
the  clothing  they  had  worn  was  left  in  the  rooms,  and  they  were  required  to 
leave  the  apartment. 

"The  rooms  were  again  scrubbed  with  disinfectant  solution  and  ,the  apartment 
thoroughly  fumigated  with  sulphur  (3  pounds  to  the  1,000  cubic  feet). 

"  For  the  next  seven  days  the  premises  were  visited  by  the  quarantine  physician 
once  every  twelve  hours,  and  report  made  by  telephone  to  the  central  office.1' 

Tuberculosis. 

The  first  step  to  be  taken  in  the  prevention  of  tubercular  phthisis 
was  the  distribution  of  circulars  giving  information  as  to  the  coutagious 
character  of  the  disease  and  the  means  which  should  be  taken  to  pre- 
vent its  spread.  Until  within  a  very  few  years  physicians  have  not 
generally  considered  this  disease  contagious,  and  even  now  a  consider- 
able number  deny  it.  Thus  in  Denver  in  18971  of  215  physicians,  16 
unqualifiedly  denied  its  contagiousness,  and  10  more  gave  only 
a  qualified  assent.  In  this  as  on  many  other  subjects  the  sanitary  offi- 
cials have  been  foremost  in  disseminating,  even  among  the  medical  pro- 
fession, the  results  of  biological  research.  As  early  as  1890  a  circular 
of  information  of  this  character  was  issued  by  the  board  of  health  of 
New  York  City.  According  to  S.  A.  Knopf2  circulars  or  similar  publi- 
cations are  at  present  issued  by  the  state  board  of  health  of  twenty-two 
states.3 

In  some  cities  outside  of  these  states,  as  St.  Paul,  Chicago,  St.  Louis, 
Minneapolis,  and  Philadelphia,  similar  circulars  have  been  issued.  Ex- 
amples of  these  circulars  are  found  in  Appendices  93-95.  In  Minneap- 
olis the  circular  is  printed  in  the  form  of  a  card  which  it  is  intended 
shall  be  hung  in  the  room  of  the  sick  person.  An  excellent  criticism 
of  these  circulars,  which  it  would  be  well  for  every  one  contemplating 
issuing  one  to  read,  may  be  found  in  Knopfs  article  in  the  Journal  of 
the  American  Medical  Association,  30  October,   1897.     In  New  York 


1  Denver,  Report  of  Bureau  of  Health  (1897-8),  p.  53. 

2  The  Prophylaxis  and  Treatment  of  Pulmonary  Tuberculosis  (1899),  p.  68. 

3  California,  Colorado,  Connecticut,  Delaware,  Indiana,  Iowa,  Kentucky,  Maine, 
Massachusetts,  Michigan,  New  Hampshire,  New  Jersey,  New  Mexico,  New  York, 
Ohio,  Rhode  Island,  South  Carolina,  Tennessee,  Texas,  Virginia,  West  Virginia,  and 
Wisconsin. 


( ' 0 MMl 'XI <  A B L E    J> isK.  1  shs.  521 

City  these  circulars  are  sent  to  the  physicians,  and  distributed  among 
the  tenement  house  population.  From  20,000  to30,000are  distributed 
yearly.  In  Brookline,  Mass..  one  is  sent  to  every  family  in  the  town. 
In  most  cities  a  circular  is  sent  only  to  persons  who  are  reported  as 
having  phthisis. 

The  next  step  in  the  work  of  preventing  pulmonary  tuberculosis  is 
the  notification  of  cases.  As  was  shown  on  page  438,  this  is  now 
required  in  a  few  cities.  The  law,  however,  is  not  generally  enforced, 
and  unless  it  is  proposed  to  do  more  then  is  generally  done  in  the  way 
of  investigation,  isolation,  and  disinfection  by  the  sanitary  authorities, 
there  hardly  seems  to  be  much  use  in  attempting  to  enforce  it. 

In  Michigan  the  state  board  of  health  has  prepared  a  blank  on  which 
the  local  health  officer  is  to  report  all  cases  of  consumption  occurring  in 
his  township  (this  disease  is  to  be  reported  by  physicians  in  that  state). 
A  very  extended  report  of  the  action  taken  by  the  patient,  his  attend- 
ants, and  the  health  officer  must  be  made  to  the  state  board  of  health  on 
death  or  recovery. 

The  only  way  in  which  health  officers  usually  learn  of  the  exist- 
ence of  tuberculosis  is  by  the  death  returns;  but  after  the  death  of  the 
patient  nothing  can  be  done  except  to  disinfect  the  room  occupied  dur- 
ing the  last  sickness,  or  perhaps  the  whole  apartment.  This  is  done  in 
Detroit,  New  York  City,  and  Philadelphia.  Besides  this  little  is  done 
in  any  city  except  New  York.  The  board  of  health  of  that  city  is  the 
pioneer  of  this  work:  but  has  not  had  the  CO-Operation  of  a  large  part 
of  the  medical  profession  in  the  city.  The  work  of  this  department  is 
well  set    forth   in   a   "Circular  of  Information   for  Physicians." 

First.  The  sanitary  code  requires  that  all  cases  of  pulmonary  tuber- 
culosis shall  be  reported,  and.  of  course,  that  all  deaths  shall  be  reported. 
The  authorities  of  public  institutions  are  also  required  to  report  all  cases 
entering  and  Leaving  the  institution  and  the  address  from  which  thej 
came  or  to  which  thej  arc  going.  The  cases  and  deaths  are  recorded  on 
index    cards,  red    for   cases,  and    blue  for  deaths,  which  are  arranged  by 

streets.     Before   being  arranged  the\   are  carried   to  the  house  to  be 

tilled  by  the  inspectors  if  an  inspection  is  made.      See  Appendix   96. 

The  cases  are  also   noted  from  year  to  year  on  an  atlas  drawn  to  a 

scale  of  LOO  feel  to  the  inch.  A  different  mark  is  used  for  each  year. 
Iii  Rochester  a  similar  record  has  been  kept  of  deaths  since  L891  on  a 
large  wall  map,  pins  of  different  colors  for  different  years  being  used. 

Second.  In  tenement  houses  and  Lodging  houses  (unless  the  attend- 
ing physician  requests  not  >  an  inspector  is  sent  to  the  bouse  to  instruct 
the  fainiU  and  lea\e  circulars.     Subsequent   visits  arc  made   and   it   is 

claimed    by  the  board    that    the\    find    that    proper   precautions  are    taken 


522  COMMUNICABLE   DISEASES. 

in  about  one-half  the  cases.  In  cases  residing  in  other  than  in  tene- 
ments and  lodging  houses,  no  inspection  is  to  be  made  unless  the  physi- 
cian attending  so  requests. 

Third.  When  a  patient  removes  or  dies  the  inspector  reports  to  the 
board  what  disinfection  is  required,  and  the  board  issues  an  order  to  the 
owner  of  the  premises  to  disinfect  or  rather  to  clean  them.  In  some  cases 
when  it  is  believed  that  this  order  will  not  be  promptly  complied  with, 
a  notice  is  posted  on  the  apartment  stating  that  it  has  been  occupied  by 
a  consumptive  and  must  not  be  again  occupied  until  disinfected.  The- 
disinfection  required  is  to  wash  walls  and  all  woodwork  with  washing 
soda,  one-half  pound  to  a  pailful  of  hot  water,  and  then  re-paper,  white- 
wash, and  kalsomine.    Occasionally  goods  are  taken  away  and  steamed. 

Pennsylvania1  lias  passed  a  law  fori  lidding  the  employment  by  bakers- 
of  persons   having   consumption,  and   the    Sanitary    Code  of  Yonkers2 
makes  it  a  misdemeanor  for  bakers  or  marketmen  to  pursue  their  oecu 
pation  if  they  have  this  disease. 

The  importance  of  bovine  tuberculosis  in  causing  the  human  dis- 
ease cannot  be  here  discussed.  The  control  of  dairies  to  prevent  the 
production  of  tuberculous  milk  and  the  effort  to  eradicate  bovine 
tuberculosis  are  considered  in  other  chapters.  In  New  York  City 
the  board  of  education  requires  that  applicants  for  position  of  teacher 
shall  present  a  physician's  certificate  that  they  are  free  from  tubercu- 
losis. 

If  it  is  necessary  to  have  isolation  hospitals  for  smallpox,  scarlet 
fever,  and  diphtheria,  it  is  far  more  necessary  to  have  them  for  tuber- 
culosis, for  the  welfare  of  the  patient  depends  upon  hospital  life  far  more- 
than  it  does  in  the  other  diseases,  and,  as  in  other  diseases,  absolute 
isolation  can  rarely  be  obtained  outside  of  a  hospital.  ^Yhile  the  build- 
ing of  such  hospitals  has  for  several  years  been  urged  by  boards  of 
health,  as  yet  very  little  has  been  accomplished  in  this  direction.  There 
are  many  successful  private  sanatoria,3  but  only  two  or  three  operated 
by  cities  or  states.  Massachusetts  is  the  pioneer  state  as  it  opened  its- 
state  tubercular  hospital  1  October,  1898.  The  cost  of  the  hospital  was 
$180,878.85,  of  which  $45,839.87  was  for  land,  sewerage,  etc.,  and 
#123,684.24  for  buildings.4     The  following  is  from  Knopf: 

"The  institution  consists  of  a  series  of  two-story  buildings  arranged  in  a  half- 
circle,  in  the  middle  of  which  is  the  administration  building.     The  pavilions  are  of 


1  Pennsylvania,  Chapter  05  of  1897. 

2  Yonkers,  Sanitary  Code  (1897),  Sec.  28. 

s  See  Knopf's  Prophylaxis  and  Treatment  of  Pulmonary  Tuberculosis. 
4  Second  Annual  Report,  Trustees  Massachusetts  Hospital  for  Consumptives  and! 
Tuberculous  Patients,  p.  23. 


<  OMMUNK  ABL  E    DlsKA  SES. 


523 


524  COMMUNICABLE   DISEASES. 

two  kinds;  some  have  seven  small  rooms  and  a  large  ward  for  twenty-two  patients, 
and  others  have  the  same  number  of  rooms,  but  the  wards  are  smaller  and  can  accom- 
modate only  ten  patients.  Each  pavilion  has  a  solarium  made  entirely  of  glass,  and 
all  the  buildings  are  encircled  by  large  verandas.  The  pavilions  on  <me  side  of  the 
administration  building  are  for  the  women  and  those  on  the  other  side  are  for  men. 
As  the  accompanying  illustration  shows,  the  buildings  are  all  arranged  so  as  to  receive 
as  much  sun  as  possible.  There  are  in  all  200  beds.  Patients  can  have  their  choice 
in  regard  to  treatment — that  is  to  say,  whether  they  desire  to  have  a  regular  or  a 
homoeopathic  physician  for  their  attendant. 

"  What  makes  this  institution  particularly  interesting  is  that,  inasmuch  as  its 
primary  purpose  is  to  arrest  the  disease,  and  if  possible  to  extirpate  it,  only  such 
patients  will  be  admitted  as  are  deemed  not  too  far  advanced  to  admit  of  reasonable 
hope  of  radical  improvement.  In  no  sense  is  the  hospital  to  be  considered  as  a  home 
for  the  hopelessly  sick;  for,  great  as  is  the  recognized  need  for  homes  of  refuge  for 
advanced  consumptives,  such  service  is  manifestly  incompatible  with  the  even  more 
needed  service  of  rescuing  lives  that  can  be  saved  only  by  sanatorium  treatment. 
'  Patients  who  do  not  improve  after  a  stay  in  the  hospital  sufficiently  long  to  test 
the  effect  of  treatment  will  be  advised  not  to  remain,  and  their  friends  will  be  ex- 
pected to  arrange  for  their  removal  to  surroundings  primarily  devoted  to  or  better 
adapted  to  their  comfort.1  This  is  a  clause  contained  in  the  opening  announcement, 
and  is  one  of  the  most  distinct  features  of  the  work  of  the  institution.  The  fact 
that  the  charges  for  patients  are  uniform  and  only  fifty  cents  a  day,  that  no  private 
patient  will  be  received,  and  that  private  rooms  will  be  allowed  only  for  physical 
reasons,  and,  finally,  that  no  extra  charges  will  be  made  and  no  fees  and  tips  allowed 
to  be  accepted  under  any  circumstances,  makes  this  institution  in  the  truest  sense  a 
philanthropical  one." 

The  state  of  New  York  has  this  year  (1900),  made  an  appropriation 
for  a  similar  hospital.  The  same  state  has  also  authorized  cities  of 
250,000  inhabitants  to  establish  phthisis  hospitals  of  their  own  outside 
of  their  limits,  hut  with  the  approval  of  the  state  board  of  health,  and 
also  of  the  local  board  of  the  town  where  the  hospital  is  to  be.1 

Cincinnati  in  1897  converted  the  smallpox  hospital  which  is  a  sub- 
stantial brick  building  into  a  hospital  for  consumptives.  The  hospital 
itself  and  the  administration  buildings  cost,  exclusive  of  the  land,  about 
150,000.  It  accommodates  about  sixty  to  eighty  patients,  who  come 
from  among  the  poor,  who  would  naturally  seek  admission  to  the  gen- 
eral hospital.  In  fact  this  institution  is  primarily  intended  to  afford  a 
place  where  consumptives  may  be  treated  so  that  it  may  not  be  neces- 
sary for  them  to  be  a  menace  in  other  institutions.  Most  of  the  patients 
are  too  advanced  to  afford  much  hope  of  cure,  but  under  the  excellent 
management  of  Dr.  Lyle  most  of  them  make  some  improvement.  The 
hospital  is  in  the  outskirts  of  the  city  with  ample  grounds.  The  cost  of 
maintenance  has  been  $1.25  per  day.  Between  8  July,  1897,  and 
30  August,  1899,  there  had  been  301  persons  admitted.2  At  present 
(February,  1900,)  Dr.  Lyle  states  that  there  are  about  sixty  patients  and 
the  expenses  are  from  $1  to  $1.10  per  day  per  patient. 

1  Xew  York,  Chapter  637  of  1899. 

2  Ohio,  Sanitary  Bulletin,  September,  1899. 


COMMl  XI<  \  J  BLE    DISK  A  sEs.  5  o  5 

Cook  County,  111.,  has  recently  built  a  hospital  for  indigent  con- 
sumptives which  accommodates  300  persons  and  is  at  present  (  February, 
1900,)  well  filled. 

Leprosy. 

There  are  a  considerable  number  of  lepers  in  the  United  States, 
though  it  is  not  known  with  accuracy  how  many.  They  are  found  in  , 
considerable  numbers  in  California,  Iowa,  Louisiana,  Minnesota,  Wis- 
consin,  and  arc  scattered  about  other  parts  of  the  country.  California, 
Connecticut,  Iowa.  Maine,  North  Carolina.  New  Jersey,  and  Pennsyl- 
vania have  laws  which  require  the  report  of  these  cases  to  the  local 
health  department,  but  they  are  not  enforced.  The  United  States 
marine  hospital  service  is  at  present  investigating  the  prevalence  of  the 
disease  and  it  will  doubtless  soon  be  known  approximately  how  many 
lepers  there  are  in  the  country.  The  subject  has  received  renewed 
attention  since  the  acquisition  of  Hawaii  where  there  are  a  large  num- 
ber of  lepers. 

California1  has  a  stringent  law  forbidding  the  landing  of  persons 
afflicted  with  leprosy  or  elephantiasis.  The  commissioner  of  immigra- 
tion is  to  inspect  all  vessels  bringing  Asiatic  immigrants  and  the  ship  is 
taxed  seventy  cents  per  passenger  to  pay  for  the  inspection  and  the 
care  of  the  infected  persons  that  are  found. 

Louisiana2  provides  that  lepers  shall  be  confined  and  the  duly  of 
commitment  is  given  to  the  judges.  No  one  is  to  harbor  a  leper.  No 
attempt  has  been  made  to  enforce  this  law,  but  a  leper  home  has  been 
provided    by    the    state    at    which    dwell    about    forty   of   the  l!<H>  lepers. 

The  hospital  is  ■  of  the  old  state  quarantine  stations,  anil  the  patients 

are  eared  for  by  Sisters  of  Charity/1  Philadelphia  also  has  a  Leper 
hospital  with  four  beds,  and  in  New  York  City  lepers  have  been  con- 
fined on  North  Brother  Island,  to  which  all  the  major  communicable 
diseases  are  taken. 

I '<  nereal  Diseases. 

Accurate  statistics  in  regard  to  the  prevalence  of  venereal  diseases 

are  entirely    lacking  in  the  United  States,  but  1 oe  doubts  that  thej 

are  exceedingly  prevalent.  Syphilis  has  always  been  considered  a  seri- 
ous disease,  and  recent  patholog}  seems  to  teach  that  gonorrhoea  is 
nearly  as  bad  and  much  more  common.     These  diseases  would  certainly 

warrant   tin-  attention  of  the  health  officer  if  it   were  not   that   public  seii- 

1  California,  Penal  Code  1 1886),  Bees.  2952  68. 
-  Louisiana,  <  hapter85  of  L892. 
Reports  and  Papers  American  Public  Health  Association,  Vol.  XXV.,  p.  285. 


526  COMMUNICABLE   DISEASES. 

tiinent  is  strongly  averse  to  free  discussion  of  the  subject  or  to  any 
official  recognition  of  the  conditions  which  give  rise  to  the  diseases. 

A  letter  addressed  last  year  by  Dr.  Isadore  Dyer  of  New  Orleans1 
to  the  officials  of  every  city  of  20,000  inhabitants  in  the  United  States 
brought  out  the  fact  that  no  official  effort  is  anywhere  made  to  restrict 
these  diseases.  According  to  the  paper  referred  to,  there  are  nine  cities 
which  attempt  by  licenses  or  fines  to  restrict  the  number  of  houses  of 
prostitution,  and  three  cities  confine  such  houses  to  a  particular  district. 
There  is  no  city  which  attempts  by  a  medical  inspection  of  prostitutes 
to  limit  their  opportunity  for  spreading  diseases.  San  Francisco,  San 
Antonio,  and  St.  Louis  have  attempted  to  do  this,  but  only  for  a  short 
time,  as  public  sentiment  was  strongly  opposed  to  such  municipal  action. 
In  St.  Louis  the  act  was  in  force  from  1870  to  1874,  and  the  amount 
received  from  license  fees  was  used  to  establish  a  hospital  for  venereal 
diseases  in  women,  but  the  hospital  is  now  used  for  all  diseases  of 
women.  In  San  Antonio  in  1880  houses  of  prostitution  were  licensed 
with  a  fee  of  ¥500.  The  city  physician  examined  each  prostitute 
weekly,  and  if  free  from  disease  gave  her  a  certificate  and  sent  a  dupli- 
cate certificate  to  the  city  clerk.  During  the  ten  months  that  the  law 
was  in  operation  2886  examinations  were  made  of  230  women,  and 
forty-two  cases  of  venereal  disease  were  discovered.  The  ordinances  of 
Denver2  provide  that  the  health  commissioner  may  inspect  prostitutes 
and  isolate  those  who  are  infected,  but  this  is  nut  done. 

In  Massachusetts3  if  a  ease  of  venereal  disease  is  found  in  any  pub- 
lic institution  it  may  be  isolated  if  necessary,  and  may  be  kept  in  isola- 
tion even  after  the  time  of  discharge.  In  Ohio4  the  cost  of  caring  for 
diseased  prostitutes  may  lie  charged  to  the  house. 

A  law  recently  passed  in  Michigan5  provides  that  persons  afflicted 
with  syphilis  or  gonorrhoea  shall  be  incapable  of  contracting  marriage. 


>  New  <  >rleans,  Medical  and  Surgical  Journal,  December,  1899. 
2  Denver,  Ordinance  No.  44  of  1893,  Sec.  15:1. 
:i  .Massachusetts,  Chapter  420  of  1891. 

4  Ohio,  Annotated  Statutes  (1900),  Sec.  2126. 

5  Michigan,  Chapter  247  of  1899. 


CHAPTER  XI. 
COMMUNICABLE  DISEASES 

(continued). 

Disinfection,  Laboratory  Work,  Vaccination,  Antitoxin. 

PROBABLY  no  one  will  deny  the  advisability  of  disinfecting  after 
the  communicable  diseases,  though  in  the  opinion  of  the  writer 
the  danger  from  goods  or  rooms  exposed  to  infection  lias  been  consider- 
ably exaggerated.  Disinfection  of  infected  things  has  been  attempted 
from  the  earliest  times  and  the  practice  is  more  general  now  than  ever 
before.  Owing  to  our  better  knowledge  of  the  nature  of  the  disease 
poisons,  or  at  least  some  of  them,  and  of  the  action  of  disinfectants 
upon  them,  modern  methods  are  much  more  efficienl  than  those  for- 
merly employed.  Disinfection  may  he  practiced  during  the  course  oi 
a  disease  for  there  are  always  certain  things,  ashed  linen  and  clothing, 
which  must  he  from  time  to  time  removed  from  the  sick  room.  Disin- 
fection of  this  kind  is  described  in  the  various  circulars,  examples  of 
which  are  elsewhere  given,  and  is  of  course  to  be  carried  out  hv  the 
family.  Sometimes,  as  in  Providence  and  the  District  of  ( lolumbia,  dis- 
infectants for  such  purpose  are  furnished  by  the  health  department. 
Disinfection  of  the  infected  premises  including  goods,  after  the  patient 
is  well,  is  usually  done  h\  the  sanitarj  officials  and  it  is  this  disinfec- 
tion which  is  here  considered. 

Disinfection  is  made  compulsory  by  the  laws  of  several  states.1 
Many  cities  outside  of  these  states  require  disinfection  by  their  local 
regulations.  Even  in  cities  where  there  are  no  such  regulations,  as  in 
Providence,  the  District  of  Columbia,  and  St.  Paul,  disinfection  is 
nevertheless  done  bj  the  health  department  in  nearly  ever}  case.  In 
several  states,  as  in  Massachusetts,  it    is   required  thai    the  disinfection 

Colorado,  Indiana,  Iowa,  Maryland,  Massachusetts,  Mississippi,  Michigan, 
Nortli  Dakota,  North  Carolina,  Ohio,  Pennsylvania,  South  Dakota,  Wisconsin,  Qtali 
and  Vermont;  in  Minnesota  and  New  Jersey  the  local  boards  of  liealth  are  author- 
ized t(  i  disinfeel . 


528  COMMUNICABLE   DISEASES. 

shall  be  to  the  satisfaction  of  the  board  of  health.     The   Massachusetts 
statute  is  a  good  example  of  this  class  of  laws.1 

Ohio,  Pennsylvania,  and  Wisconsin  also  require  that  the  owner  or 
householder  shall  disinfect,  but  in  all  of  these  states  wherever  there  are 
active  sanitary  officials,  the  work  is  done  by  them,  as  it  is  sure  to  be 
done  much  better  than  when  left  to  the  householder,  even  if  it  is  done 
under  the  direction  of  the  board  of  health  as  is  required  in  Iowa,  North 
Carolina,  Pennsylvania,  North  Dakota,  South  Dakota,  and  Vermont. 
In  North  Carolina  the  disinfection  is  to  be  paid  for  by  the  householder 
if  he  is  able.  In  St.  Paul  no  charge  is  made  for  sulphur  fumigation, 
but  if  formaldehyde  is  used  a  charge  of  fifty  cents  a  pound  is  made. 

In  North  Dakota  the  law  takes  the  form  of  a  prohibition  to  "  let  or 
hire  any  house,  or  room  in  a  house,  or  building  where  any  of  these  dis- 
eases have  been,  until  the  same  has  been  thoroughly  disinfected."  Sim- 
ilar rules  are  found  in  Bridgeport,  Buffalo,  Macon,  Ga.,  and  Salt  Lake 
City.  In  order  to  make  certain  that  disinfection  has  been  property  per- 
formed, the  North  Dakota  law  and  also  that  of  Maryland  and  Vermont, 
require  that  a  certificate  to  that  effect  shall  be  given  by  the  health  offi- 
cer. 

In  Minnesota  and  New  Jersey  the  board  of  health  is  authorized  to 
destroy  goods  as  well  as  to  disinfect  them,  and  in  both  states  the  goods 
so  destroyed  must  be  paid  for.  Even  if  this  is  not  so  provided  by 
statute  it  is  probable  that  the  courts  would  award  damages  as  was  done 
under  such  conditions  in  Detroit.2  In  New  Jersey  the  board  of  health 
must  make  an  inventory  of  the  goods  destroyed  and  immediately  certify 
their  value  to  the  municipal  authorities  who  shall  pay  the  sum  certified 
to  the  owners.  Nevertheless,  in  most  cities  it  is  not  the  general  prac- 
tice to  pay  for  damages  inflicted  by  disinfection.  In  North  Carolina  the 
statute  requires  the  disinfection  to  be  in  accordance  with  the  regulations 
of  the  state  board  of  health,  and  in  Indiana  and  Mississippi  the  state 
board  of  health  regulations  which  require  disinfection  specify  how  it 
shall  be  done.  Quite  full  specifications  are  given  by  the  state  board  of 
health  rules  of  each  of  these  states. 

Methods    of    Disinfection. 

In  1895  the  writer  prepared  a  paper  on  methods  of  disinfection  in 
vogue  in  fifty-live  of  the  principal  .cities  of  the  United  States.  At  that 
time   fifty-one  of  these  cities  relied    on  the   use  of  sulphur  dioxide  and 

1  Massachusetts,  Chapter  102  of  1890: 

"  .  .  .  .  and  upon  the  death,  recovery,  or  removal  of  such  person,  such  of 
the  rooms  of  said  house  and  such  of  the  articles  therein  as,  in  the  opinion  of  the 
hoard  of  health,  have  been  subjected  to  infection  or  contagion  shall  be  disinfected 
by  such  householder  to  the  satisfaction  of  said  board  of  health.1' 

-  Staff oid  vs.  Board  of  Health  of  Detroit,  8  July,  189G. 


COMMl  WIl  \  J  BL  K    J>lsK.  1  sEs.  529 

only  twelve  had  appliances  for  steam  disinfection.  At  the  present  time 
sulphur  has  been  almost  entirely  superseded  by  formaldehyde  and  there 
has  been  a  considerable  increase  in  the  number  of  steam  appliances. 

There  is  no  doubt  that  more  active  measures  are  taken  to  disinfect 
after  smallpox,  yellow  fever,  and  diseases  that  appeal  to  the  popular 
imagination,  than  after  scarlet  fever,  diphtheria,  measles,  and  phthisis, 
for  the  public  will  submit  to  and  even  demand  much  more  in  the  former 
than  they  will  in  the  latter.  In  smallpox  it  is  customary  to  burn  many 
articles  of  little  value  as  old  clothes,  carpets,  cheap  mattresses,  toys, 
etc.  If  steaming  facilities  are  available,  probably  most  things  that  can 
be  steamed  are  so  treated,  and  often  the  woodwork  and  furniture  are 
washed  with  a  liquid  disinfectant,  by  or  under  the  direct  supervision  of 
the  .sanitary  officials.  Furthermore,  the  rooms  are  usually  fumigated 
with  sulphur  dioxide  or  treated  with  formaldehyde.  Probably  ninety- 
nine  per  cent,  of  public  disinfection  is  done  for  scarlet  fever,  diphtheria, 
measles,  and  phthisis  and  other  common  diseases,  and  most  of  it  for 
scarlet  fever  and  diphtheria.  It  is  the  routine  practice  in  these  common 
diseases  which  will  now  be  considered.  There  are  three  methods 
employed  for  disinfection  after  communicable  disease.  One  consists  in 
the  application  of  gaseous  disinfectants  to  the  apartment,  another  con- 
sists in  subjecting  movable  articles  to  the  action  of  steam,  and  the  third 
consists  in  washing  woodwork,  walls,  and  furniture  with  a  liquid  dis- 
infectant. 

Sulphur  Dioxide.  In  1895  nearly  all  cities  in  the  United  States 
relied  on  sulphur  dioxid  for  disinfecting,  only  four  out  of  titty-live  cities 
making  use  of  chlorine  gas.  The  experiments  conducted  by  Sternberg 
and  Raymond  under  the  auspices  of  the  American  Public  Health 
Association1  showed  that  sulphur  fumigations  are  of  considerable  value 
in  the  destrudic f  the  virus  of  vaccinia,  and  presumably  thai  of  small- 
pox, and  also  of  the  known  non-spore-forming  bacteria.  In  the  absence 
of  anything  better,  health  officers  generally  persisted  in  the  use  of  this 
disinfectant,  although  ii  was  known  to  have  almost  no  penetrating 
power  and  was  not  entirely  successful  for  surfaces  even  under  The  mosl 
favorable  conditions,  conditions  which  could  not  generally  be  secured. 
It  was  shown  that  a  certain  amount  of  moisture  was  desirable  when 
this  substance  was  used,  and  as  a  result  of  the  recommendations  of  the 
above  mentioned  reporl  there  was  generally  adopted  the  method  of 
placing  a  vessel  of  burning  sulphur  in  a  pan  of  water.  In  Providence 
the  oiittit  consisted  of  an  iron  pol  which  was  placed  in  a  dishpan  con- 
taining   about     tWO    inches  of    water.       The    pan  stood     upon    a  wire  SUp- 


Disinfection  and  Disinfectants,  Reporl  of  Committee  ol  American  Public  Health 
Association,  1- 


.530  C OMML  rXK  ABLE   DISEA  sj-;s. 

port  -such  as  is  used  to  stand  flatirons  on.  Sets  of  tins  apparatus  were 
carried  about  in  a  wagon  and  placed  in  the  rooms  to  be  disinfected. 
About  three  or  four  pounds  of  roll  brimstone  were  used  for  every  1,000 
cubic  feet  of  space  to  be  disinfected.  An  ounce  or  two  of  alcohol  was 
poured  on  the  sulphur  and  set  on  fire  with  a  match,  and  the  room  closed 
by  pasting  up  the  door  with  strips  of  paper.  Occasionally  the  windows 
were  pasted  if  very  loose.  If  the  room  was  to  be  used  the  same  day, 
the  disinfector  generally  called  to  open  it  as  he  was  used  to  the  action 
of  the  gas.  The  room  was  usually  closed  five  to  eight  hours,  and  if  it 
was  left  over  night,  the  gas  was  found  to  have  pretty  nearly  escaped 
before  morning. 

At  one  time  the  so-called  sulphur  candles  were  largely  sold  for 
domestic  disinfection  by  the  householder.  These  are  convenient  to 
carry  and  light  but  are  not  as  cheap  as  roll  brimstone,  and  have  rarely 
been  used  by  health  officers,  though  they  have  been  in  Atlanta  and  New 
( hleans  even  within  the  last  few  years.  Liquid  sulphur  dioxide  con- 
densed in  tins,  was  at  one  time  sold  by  Elmer  &  Amend  of  New  York, 
but  there  was  not  much  demand  for  it.  With  the  introduction  of  for- 
maldehyde, sulphur  has  generally  dropped  out  of  use,  though  it  is  some- 
times used  in  smallpox,  and  is  employed  quite  generally  in  a  few  cities. 
In  Cincinnati  it  is  used  considerably,  especially  in  smallpox,  and  in  1898 
it  was  used  some  in  Philadelphia,  New  Orleans,  St.  Paul,  Seattle,  Erie, 
and  doubtless  many  smaller  places,  and  in  Atlanta  it  was  used  in  houses 
that  were  so  open  that  formaldehyde  would  escape  too  rapidly.  In 
Montclair,  N.  J.,  in  1897,  formaldehyde  was  tried  and  given  up  as  value- 
less, and  sulphur  was  again  used.  Since  then  (1899)  sulphur  has 
been  again  abandoned. 

In  Denver  also  sulphur  has  been  used  recently  and  tested  on  dipb> 
theria  bacilli  and  under  some  conditions  gave  better  results  than  for- 
maldehyde.1 On  the  other  hand  in  tests  made  by  the  state  board  of 
health  of  Iowa  it  failed  completely.'2 

Formaldehyde.  The  use  of  this  gas  was  brought  to  the  attention 
of  health  officers  in  1895-G  and  rapidly  sprang  into  general  favor.  Two 
claims  were  made  for  it;  that  it  had  great  penetrating  power  and  would 
not  injure  any  articles  with  which  it  was  liable  to  be  brought  in  contact. 
Both  of  these  claims  have  been  substantiated,  but  the  very  quality 
which  makes  it  valuable,  its  divisibility  by  virtue  of  which  it  will  pene- 
trate fabrics,  renders  it  very  difficult  to  confine  in  an  ordinary  house, 
and  greatly  interferes  with  its   successful  use.     It  is  probably  the  diffi- 


1  Denver,  Report  of  Bureau  of  Health  (1897-8),  p.  101. 

2  Iowa,  Tenth  Biennial  Report  of  State  Board  of  Health  (1898),  p.  249. 


( '  OMMl  Wit '.  1 BI K    1>  USE.  1  SES. 


53] 


culty  of  confining  it  which  has  given  less  success  in  actual  practice  than 
in  laboratory  experiments.  Nevertheless  it  is,  as  ordinarily  used,  prob- 
ably much  better  than  sulphur,  and  its  introduction  marks  a  step  in 
advance  in  the  art  of  disinfection.  Various  methods  have  been  designed 
for  using  this  substance,  and  all  soils  of  devices  are  found. 

Of  as  much  importance  as  the  method  of  generating  the  gas  is  the 
securing  of  the  room  so  that  the  gas  will  not  escape.  In  most  cities 
some  attempt  is  made  to  make  the  room  tight  by  pasting  over  or  stuff- 
ing all  openings.  The  faithfulness  with  which  this  is  done  is  an  import- 
ant factor  in  the  success  of  the  disinfection.  Doors  and  windows,  ven- 
tilators, and  chimney  openings  should  of  course  be  pasted,  but  besides 
these  there  are  in  poorly  built  houses  many  openings  through  which  the 
gas  may  escape.  One  of  the  most  convenient  methods  of  pasting  over 
openings  is  by  the  use  of  gummed  paper  which  was  introduced  by  the 
board  of  health  of  Boston.      This  should   be  two  inches  wide   and   may 


Fig.  18. 
Method  "i  applying  -mi -.i  papei  In  Providence 


532 


COMMUNICABLE   1)1  SEA  SES. 


be  ordered  in  rolls  of  any  size,  and  costs  about  twenty-five  cents  a 
pound.  All  that  needs  to  be  done  is  to  moisten  it  with  a  sponge,  tear 
it  off  the  roll  and  apply  to  the  openings.  In  Providence  the  inspector 
carries  the  paper  in  a  roll  in  the  basket  with  his  other  apparatus  and 
uses  it  as  shown  in  Fig.  18.  In  Montclair,  N.  J.,  surgeons'  adhesive 
plaster  is  used  for  this  purpose. 

It  is  the  purpose  of  the  various  methods  of  generating  the  gas  to 
get  as  large  a  quantity  into  the  room  in  as  short  a  time  as  possible.  It 
is  done  in  various  ways ;  it  may  be  generated  from  wood  alcohol,  it 
may  be  driven  off  by  heat  from  its  solution  in  formalin   or  formol,  it 


Fig.  19. 
Ward's  Formaldehyde  Generator. 


Fig.  20. 
Ward's  Formaldehyde  Geivnitor  ready  for  transportation. 


t  OMMUNIi  \  I  BLE    Dish'.  |  .s/-;.s. 


533 


Fig.  21. 

The  Kulin  Formaldehyde  Generator. 


may  be  generated  from  the  solid  paraformaldehyde,  or  formalin  may  be 
used  as  a  spray,  and  the  gas  allowed  to  escape  from  the  small  droplets 
(1f  fluid. 

First.  Generation  from  wood  alcohoL  This  was  the  method  first 
employed,  and  was  then  though!  to  lie  the  most  economical.  Platinum, 
or  asbestos  treated  with  platinum  salts,  have  the  property  if  slightly 
heated  of  decomposing  the  vapor  of  methyl  alcohol  and  producing  formal- 
dehyde. Various  forms  of  apparatus  have  been  devised  for  this  pur- 
pose, but  it  is  not  now  generally  thoughl  thai  thej  produce  as  good  or 
lonomical    results   as   may  be   secured   1>\  other   methods.     These 

generators  are  used  in  Cambridge,  Minneapolis,  Lynn,  and  Newton. 
Those  used  iii  Newton  and  Cambridge  and  shown  iii  Figs.  1'.'  and  l'ii, 
are  made  by  W.  A.  Ward.  5   Harvard   Street,  Brookline,  and  cost   $20 

each.       Another  device  "f    this  kind  shown   in    Fig.  1\    has  recently  heen 

put  on  the  market  by  the  Kulin  Formaldehyde  Generator  Co.  of  Wash- 
ington,  I).  C       It    lias  Keen  tested    by    the  officers  of  I  he  marine  hospital 


5b'4 


i  'OMMUNH  AJiLE    hi  SKA  SJE8. 


service  with  very  satisfactory  results,1  and  is  said  to  have  been  put  in 
practical  service  by  that  department.     Tt  is  sold  for  £50. 

At  one  time  Eli  Lilly  &  Company  of  Indianapolis  and  Richard 
Kny  of  New  York  had  on  the  market  a  generator  operating  on  this 
principle.  They  were  used  experimentally  in  a  number  of  cities,  among 
others  quite  extensively  in  Dayton,  O.,  but  have  now  pretty  generally 
gone  out  of  use  and  are  not  on  the  market, 

Second.  Formalin  is  a  solution  of  formaldehyde  gas  in  water. 
That  put  on  the  market  is  supposed  to  be  a  saturated  solution  containing 
about  forty  per  cent,  of  formaldehyde.  It  sells  at  the  present'time  in  car- 
boys for  about  twenty-live  cents  a  pound.  It  is  said  that  some  of  it  runs 
less  than  thirty-eight  percent.,  and  it  not  infrequently  contains  a  precipi- 


Fig.  22. 
Trillat  Autoclave. 


1  Public  Health  Reports,  Marine  Hospital  Service.  1!)  October,  1900. 


t  oMMVXK  \  VBLE    I>ls]-;_  f  sKs. 

D  B 


535 


Fig.  28. 
i\n\  Bchcerei  Vox  raaliii  Generatoi 


536  COMMUNICABLE    DISEASES. 

tate  of  paraformaldehyde  which  for  use  in  a  spray  diminishes  its  value. 
The  term  formochloral  is  applied  to  formalin  to  which  has  been  added 
twenty  per  cent,  of  calcium  chloride.  The  addition  of  the  chloride  is 
to  prevent  the  polymerization  of  the  formaldehyde  by  heat,  i.  e.,  its 
transformation  into  comparatively  inert  substances.  Ten  per  cent,  of 
glycerine  is  sometimes  added  with  the  same  object  in  view.  Formalin, 
when  heated  under  pressure,  rapidly  gives  off  formaldehyde  gas.  Sev- 
eral forms  of  apparatus  have  been  put  upon  the  market.  One  made  by 
the  Sanitary  Construction  Company  heated  the  liquid  in  a  coil  into 
which  it  slowly  flowed  from  the  reservoir.  H.  K.  Mulford  &  Co.,  of 
Philadelphia,  afterward  took  their  business  and  sold  many  of  these 
which  are  still  in  use,  but  this  firm  has  now  substituted  a  simpler 
arrangement.  The  Trillat  autoclave  (Fig.  22),  sold  by  Fries  Brothers 
of  New  York,  operates  on  the  pressure  principle.  It  is  used  in  Atlanta, 
Fall  River,  Macon,  Ga.,  Nashville,  New  Orleans,  Pittsburgh,  Savannah, 
and  to  some  extent  in  Milwaukee  and  Philadelphia.  It  costs  $100 
and  is  shown  in  the  figure.  A  somewhat  similar  apparatus  is  made  by 
the  Kny-Scheerer  Co.  of  New  York,  and  is  sold  for  $60.  It  has  been 
used  in  the  District  of  Columbia,  San  Francisco,  New  Orleans,  and 
Buffalo.     See  Fig.  23. 

The  object  of  heating  the  liquid  under  pressure  is  to  prevent  poly- 
merization or  the  production  of  the  solid  paraformaldehyde  or  "  para- 
form  "  instead  of  the  diffusible  gas ;  but  the  experiments  of  Novy 
showed  that  it  was  just  as  well  and  even  better  to  carry  on  the  evapora- 
tion in  a  vessel  with  a  freer  opening  and  under  atmospheric  pressure. 
The  gas  is  thus  rapidly  disengaged,  and  if  any  paraform  is  left  behind 
after  the  evaporation  of  the  water  it  too  is  speedily  returned  to  gas 
again.  H.  K.  Mulford  &  Company  now  have  tins  apparatus  on  the 
market,  using  their  kerosene  burner  to  heat  the  liquid.  The  price  for 
this  is  $25,  the  same  as  that  for  their  old  apparatus,  and  it  does  not 
annoy  the  disinfector  by  frequent  clogging,  such  as  occurred  in  the 
coil.     It  is  shown  in  Figs.  24  and  25. 

Either  this  or  Mulford's  coil  generator  is  used  in  Baltimore,  Boston, 
Cincinnati,  Fitchburg,  Louisville,  Newark,  Pittsburgh,  and  St.  Paul. 

Another  form  of  this  apparatus  (Fig.  26)  is  made  by  Charles  Lenz  & 
Sons  of  Philadelphia,  and  another  still  by  Parke,  Davis  &  Company  of 
Detroit.     The  cost  of  the  former  is  $12.50. 

In  using  all  these  forms  of  apparatus  it  has  in  the  experience  of 
the  writer  been  found  convenient  to  use  a  larger  outlet  tube  than  will 
go  through  a  keyhole.  Moreover,  many  doors  have  no  keyhole,  so  that 
in  Providence  the  disinfector  carries  a  locksmith's  screw-driver  and 
takes  off  the  knob  and  inserts  the  tube  through  the  opening  through 
the  latch. 


(  OMMUNIi  .  1 11 LK    1)1 SEA  SES. 


■^ 


Fig.  24. 
Mulford's  Formaldehyde  Generator. 


Fig.  25. 

Diagram  Bhowing  construction  oi 
Mulford's  Generator. 


Mechanical  Opekation —  A.  quantity  of  solution  of  Formaldehyde  is  put  into 
tin-  receiver  B  through  the  opening  A :  the  heating  lamp  is  lighted,  and  the  chamber 
I)  broughi  to  ;i  red  heat.  The  solution  of  Formaldehyde  in  receiver  V>  is  vaporized, 
rise-,  in  the  top  of  the  dome  C,  passes  down  the  pipe  to  the  heating  chamber  1>. 
where  the  gas  is  no!  only  superheated  but  also  thoroughlj  dried,  and  passes  through 
the  pipe  E. 

In  many  of  the  Maine  towns  the  gas  is  generated  by  soaking  a  Large 
i<»ll  of  shod  asbestos  in  formalin  and  placing  it  upon  the  top  of  an  oil 
stove  in  the  room  t<>  !>••  disinfected. 

The  amounl  of  formalin  used  varies  in  differenl  cities,  bul  the 
makers  usually  recommend  from  six  to  ten  ounces  per  1,000  cubic  feel 
of  space  to  be  disinfected,  and  this  is  the  amounl  usually  employed.  In 
Boston,  however,  the  routine  practice  is  twent)  ounces  for  the  same 
space,  and  in  Pittsburgh,  four  pounds.  As  in  the  Latter  citj  test  cult- 
ures are  placed  in  everj  room  and  failures  to  kill  them  arc  nol  infre- 
quent, the  results  are  no1  reassuring  to  those  places  thai  rel}  on  ten 
ounces. 


ru)s 


(  OMMUXK  A  BLE    DISEA  SES. 


Fig.  26. 
The  Lentz  Formaldehyde  Generator. 


Third.  From  a  saturated  watery  solution  of  -formaldehyde  is  de- 
posited a  white  solid  called  paraform  or  paraformaldehyde,  this  by  dry- 
ing becomes  a  powder  known  as  trioxymethelene.  Both  of  these  are 
polymeres  of  formaldehyde  and  are  both  probably  found  in  the  com- 
mercial paraform.  The  solid  is  itself  inert,  but  even  at  room  tempera- 
ture slowly  gives  off  formaldehyde.  When  heated  it  is  rapidly  changed 
into  the  gas,  and  in  this  manner  large  quantities  can  be  evolved  in  a 
short  time. 

Sobering  and  Glatz  have  prepared  this  paraform 
in  pastilles  containing  one  gram  each,  which  are  sold 
in  tin  boxes  of  500  at  $3.50  per  box.  Crude  para- 
form in  bulk  is  also  sold  by  Fries  Bros.,  of  New  York, 
at  ninety  cents  a  "  cake."  Sobering  has  a  lamp  for 
heating  the  pastiles,  as  shown  in  Fig.  27.  This  is 
sold  for  '$3,  and  has  been  used  to  some  extent  in 
Baltimore,  and  Providence,  and  is  now  used  in  Monfc- 
clair,  N.  J.,  Memphis,  Trenton,  Raleigh,  Elizabeth, 
X.  J.,  and  Charleston.  It  however  appears  to  be  a 
very  expensive  way  of  generating  the  gas,  and  it  has 
been  said  that  if  overheated  the   pastilles  sometimes 


Fig. 


Sobering  and  Glatz's 
Paraform  Lamp. 


( '  OMM I  WI(  A 11 LE    DISK.  [  s  Ks.  5  3 < , 

take  lire.  It  is  also  considered  somewhat  dangerous  to  leave  a  fire  01 
lamp  of  any  kind  burning  in  a  closed  room.  In  fact  to  escape  a  possible 
danger  from  fire  was  one  of  the  reasons  why  health  officers  were  glad 
to  give  up  sulphur  fumigations.  The  E.  D.  Taylor  Company  of  New 
Brunswick,  X.  J.,  furnish  a  candle  made  of  parafine  and  paraformalde- 
hyde which  is  said  to  be  efficient  and  easy  to  use.1 

Fourth.  If  a  liquid  disinfectant  of  sufficient  strength  is  sent  in  a 
fine  spray  over  a  room  and  its  contents,  everything  touched  by  the  spray 
is  sure  to  lie  disinfected.  This  method  has  been  used  a  great  deal  in 
Paris,  but  not  very  much  in  this  country.  In  Xew  Haven  and  Provi- 
dence a  common  garden  spray  has  besn  used  for  disinfecting  after 
smallpox,  and  this  method  has  been  employed  in  outbreaks  at  the  south 
by  the  marine  hospital  service.  In  Xew  York  a  spray  was  tried  and 
abandoned,  but  in  Philadelphia  it  was  used  for  a  number  of  years  and 
was  still  in  use  in  1898.  The  apparatus  cost  •-'loo  (243  francs  in 
Palis)  and  was  very  heavy,  requiring  two  men  to  lift  it.  It  was  made 
by  <ieneste  Herscher  &  Company  of  Paris.  At  first  a  solution  of  bichlo- 
ride of  mercury  was  used,  but  later  formalin  diluted  so  as  to  contain 
about  two  per  cent,  of  formaldehyde,  about  two  quarts  of  this  being 
\\si-i\  for  a  room.  By  using  formalin  it  was  expected  that  not  only 
would  the  things  actually  touched  by  the  liquid  be  disinfected,  but 
that  hidden  surfaces  would  be  disinfected  by  the  gas.  The  health 
departmenl  of  Chicago  has  devised  a  different  method  of  usin^  the 
formalin  spray  which  is  designed  simply  as  a  means  of  freeing  the  gas. 
The  process  is  described  as  follows: 

"Seal  up  all  cracks  around  windows  and  doors  and  other  places 
where  there  is  a  possibility  tor  the  gas  to  escape.  Hang  up  large  double 
sheets  across  the  infected  rooms  on  a  clothesline.  The  sheets  should 
be  hung  by  their  i'd^^s  so  us  not  to  he  double.  On  these  sheets  l>v 
means  of  the  sprinkling  apparatus  (see  cut)  apply  the  formaldehyde 
forty  per  cent.,  evenly  all  over  the  sheets,  distributing   it    as   much  as 

possible.       One  sheet    should    be   used    for  every    1,000   CublC    feet,   and    the 

quantity  necessar}  lor  everj  L,000  cubic  feet  is  aboul  five  ounces  or 
150  c.  c.  Seal  tie-  door  of  exit  immediately  and  allow  the  formaldehyde, 
to  evaporate  spontaneously.  Leave  the  rooms  thus  fixed  for  at  least 
five  hours  or  longer  if  possible.  Then  remove  the  sheets  and  allow  to 
air.  All  bedding  or  soiled  clothing  should  he  hung  up  on  lm 
placed  over  chairs  so  as  to  allow  the  gas  to  c e  to  every  pari   of  it. 

All    hi  ilea  I  IS.   etc..  should    be  opened.        I  '.oo|<  s  a  re  set    on  end    and  opened." 
'['his  method   has  been  used  to  some  e\  tent    in   P  id  \  id  el  ice  (  as  indeed 

have   most   other  methods  of  formaldehyde  disinfection),  bul  it  is  cus- 
1  Buffalo,  Monthly  Report  of  the  Departmenl  of  Health.  December,  1900. 


540 


COM  Ml  XI<  AH  LE    DISK  A  sEs. 


Fig.  28. 
Behin's  Spray  Apparatus  (Chicago  Method).    From  Bracken's  Disinfection  and  Disinfectants. 

tomaiy  there  to  spray  the  carpets,  mattresses,  and  sometimes  the  walls 
of  the  room  as  well,  so  as  to  get  the  direct  action  of  the  liquid  besides 
that  of  the  gas.  This  method  was  also  used  in  Bridgeport,  Conn., 
Concord,  and  Detroit.  In  the  District  of  Columbia  where  the  appro- 
priation has  not  been  sufficient  for  the  district  officials  to  disinfect 
every  infected  house,  the  householder  has  been  directed  to  use  sheets 
after  the  Chicago  method.  In  Asbury  Park  a  twenty  per  cent,  solution 
of  formalin  is  sprinkled  about  the  room  and  on  suspended  sheets  by 
means  of  a  watering-pot,  about  one  quart  of  the  liquid  being  used  for 
each  1,000  cubic  feet  of  space.  It  is  generally  believed  that  all  the  dis- 
infection that  is  accomplished  with  formaldehyde  occurs  during  the  first 
few  hours  of  exposure.  Usually  rooms  are  not  closed  for  more  than 
five  or  six  hours  and  are  opened  by  the  householder,  as  the  gas  that 
remains  is  not  at  all  dangerous,  though  even  after  airing,  enough  gas 
remains  in  the  room  for  some  days  to  be  quite  annoying.  This  could 
readily  be  gotten  rid  of  by  the  use  of  ammonia  gas,  but  this  is  rarely 
resorted  to  by  health  officers. 

Strum   Disinfection.     Textile    fabrics,  mattresses,   pillows,  carpets, 
woolen  clothing,  etc.,  can,  if  infected,  only  be  thoroughly  disinfected  by 


f  ■  <  >MM  I  ~XI< '- 1 1'>  L  E    1>  ISK.  I  sKs. 


541 


542  COMMUNICABLE    DISEASES. 

subjecting  them  to  the  action  of  steam  heat.  Formaldehyde  may  if  they 
are  well  exposed  to  it  disinfect  their  surfaces,  and  it  may  be  that  this  is 
generally  all  that  needs  to  be  done.  Many  sanitary  officials  have  how- 
ever felt  that  a  more  thorough  disinfection  was  necessary,  and  have  pro- 
vided facilities  for  using  steam.  Providence  had  a  steam  disinfecting 
plant  for  municipal  work  in  1889,  and  at  the  present  time  one  has  been 
provided  in  New  York,  Chicago,  Philadelphia,  Brooklyn,  Boston,  the 
District  of  Columbia,  Milwaukee,  Charleston,  Paterson,  New  Haven, 
Pittsburgh,  Utica,  Syracuse,  Worcester,  and  Newton. 

A  steam  disinfector  consists  of  a  wrought  steel  or  iron  chamber  usu- 
ally cylindrical,  but  sometimes  square  as  in  District  of  Columbia,  Phila- 
delphia, Ttica,  and  Brooklyn.  The  cylindrical  form  is  somewhat 
stronger  and  cheaper,  but  those  with  a  nearly  square  section  are  some- 
what easier  to  fill  with  goods.  They  vary  in  size  according  to  the 
amount  of  work  demanded  of  them,  usually  the  diameter  varies  from  .")  to 
8  feet  and  the  length  from  10  to  20  feet.  The  apparatus  in  Boston  is 
7  by  20  feet,  in  Philadelphia,  8  by  15  feet,  in  Providence,  6  by  14  feet, 
in  New  Haven,  5  by  8  feet,  in  Newton,  Mass.,  5  by  7  feet.  Some 
of  the  chambers  are  jacketed,  that  is,  have  double  walls  between  which 
steam  can  be  introduced.  In  Philadelphia,  Boston,  Milwaukee,  and 
New  Haven  the  steam  chest  is  not  jacketed  and  in  Boston  and  the  Dis- 
trict of  Columbia  a  sheet  metal  shield  is  suspended  near  the  top 
to  keep  the  drip  of  condensation  from  the  goods,  and  between  the 
shield  and  the  shell  is  a  coil  of  steam  pipe  which  also  tends  to  prevent 
condensation.  The  jacket  is  a  very  great  advantage,  as  by  keeping  a 
higher  pressure  in  the  jacket  than  is  maintained  in  the  chamber,  all  con- 
densation and  dripping  in  the  latter  is  prevented,  except  on  the  door 
winch  cannot  be  jacketed.  In  all  cases  the  apparatus  should  be  covered 
with  asbestos  magnesia,  felt  or  other  heat  insulating  material.  Some 
of  the  disinfectors  are  provided  with  a  vacuum  apparatus.  This  too,  is 
an  advantage  though  not  essential.  Sometimes  a  pump  may  be  used  for 
this  purpose  which  is  usually  operated  by  steam,  as  in  Brooklyn  and 
New  Haven.  Sometimes  ejectors  are  used  for  this  purpose,  working 
either  with  steam  or  water;  they  cost  much  less  than  pumps  but  are 
not  so  economical  in  operation.  Ejectors  are  used  in  Providence  and 
Paterson.  If  the  air  is  exhausted  before  the  steam  is  turned  on,  the 
penetration  of  the  goods  takes  place  quicker,  and  if  after  disinfection 
the  steam  is  exhausted  before  the  door  is  opened,  there  is  less  moisture 
condensed  when  the  cold  air  strikes  the  goods.  There  are  various  ways 
of  fastening  the  door.  Sometimes  a  wheel  and  screw  in  the  center 
of  the  door  are  used  to  force  out  radial  wedges  and  so  close  it  as  at  the 
Boston  City  Hospital,  and  sometimes   there  are  a  series  of  cams  with 


( 'OMMUNIL  'AB  L  E    DISE.  1  S  ES.  543 

handles,  around  the  rim,  which  force  the  door  down  on  the  packing. 
These  are  convenient  methods  but  do  not  make  as  tight  a  joint  as  can 
be  secured  with  hinged  bolts  and  nuts.  Sometimes  each  nut  has  a  han- 
dle by  which  it  can  be  screwed  down,  as  in  Brooklyn  and  Boston,  hut 
usually  a  ratchet  wrench  is  used  which  probably  is  about  as  good  a 
method  as  any.  The  door  may  be  hung  by  a  hinge  which  is  the  most 
common  way,  in  which  case  the  bottom  should  be  supported  by  a  roller 
to  prevent  sagging.  Sometimes  it  is  preferable  to  have  the  door 
detachable  and  supported  by  a  turn  buckle  from  an  overhead  trolley  or 
a  crane  as  is  shown  in  the  illustration  of  the  District  of  Columbia  dis- 
infect or. 

Some  of  the  disinfecting  chambers  are  built  with  a  door  at  each  end 
and  are  set  in  a  partition  separating  two  rooms,  one  of  which  is  used  for 
receiving  and  the  other  for  delivering  goods  as  in  Boston.  Philadelphia. 
and  the  District  of  Columbia.  In  this  way,  if  different  men  are  em- 
ployed tor  collecting  and  delivering  and  for  loading  and  unloading  the 
disinfector,  there  can  he  no  possible  chance  for  reinfection  of  the  goods  ; 
but  the  writer  after  ten  years"  experience  with  a  single  door  disinfector. 
has  never  seen  anything  to  suggest  that  any  other  arrangement  is  nec- 
essary. The  disinfecting  chamber  is  supplied  with  rails  and  a  car  for 
convenience  in  loading  and  unloading,  and  often  with  various  soil--  o\ 
racks  or  cages  for  separating  the  goods. 

The  car  and  racks  are  often  made  of  metal  and  sometimes  iron,  in 
which  case  they  may  he  covered  with  canvas  to  keep  rust  from  the 
goods.  In  Providence  the  cars  and  racks  are  made  of  whitewood  which 
is  free  from  resin  and  last-  for  years  if  the  disinfector  is  used  properly: 
hut  if  the  disinfector  IS  used  so  that  the  wood  is  exposed  to  moist  steam, 
the  racks  will  soon  he  warped  out  of  shape. 

The  apparatus  should  he  supplied  with  ;i  safety  valve  ami  steam 
gauges  tor  showing  the  pressure  and  vacuum,  and  sometimes  an  electric 

thermometer  is  used  to  indicate  when  the  interior  of  the  g is  has  been 

brought  to  a  proper  temperature.  In  Pittsburgh  with  each  treatment 
of  goods  a  self  registering  thermometer  is  pul  in  the  steam  chamber. 
This  is    enclosed    in    the    center   of    a    six-inch    roll    of    cotton    which  is 

enclosed  in  a  wire  basket  and  Locked  by  the  bacteriologist. 

The  following  description  and  figures  illustrate  the  ven  complete 
disinfecting  plant  in  the  District  of  Columbia:5 

The  building  containing  the  machinery  is  70  feci  long  by  32  feet  wide,  timbei 
framing1  covered  with  corrugated  galvanized  iron  siilrs  and  roof,  hip  rafters  12  feet 
clear  i"  1  lie  bottom  <a  1  mss.  granolithic  floor  with  ;i  pit  Id  feel  6  inches  wide,  26  feel 
0  inches  long,  ami  1  1  in<  lies  deep  for  the  sterilizing  chamber. 

1  District  of  Columbia,  Report  of  Bealtli  Officer  (1896),  p.  221. 


-344 


(  OMMUNK  'MILE    ]>IsEA  sEs. 


T       _ 


Fig.  30. 

Disinfection  Building,  District  of  Columbia.    From  Report  of  Health  <  Hiicer,  189(>, 


"  At  each  end  driveways  for  vans  are  provided  10  feet  wide,  and  a  frame  parti- 
tion divides  the  building  into  two  apartments,  for  infected  and  disinfected  articles. 
Provision  is  also  made  for  dressing  rooms,  bath,  and  closets,  accessible  from  each 
apartment. 

"■The  apparatus  consists  of  a  chamber  for  steam  disinfection,  boiler  and  neces- 
sary appurtenances,  chamber  for  sulphur  or  other  fumigation,  vats  for  bichloride  or 
other  liquid  disinfection,  and  sprays  for  disinfection  of  the  vans.  The  steam  cham- 
ber is  4  feet  4  inches  wide,  5  feet  4  inches  high,  and  9  feet  long,  and  is  made  rec- 
tangular to  give  the  most  effective  space  during  exposure,  with  the  greatest 
economy  of  steam,  and  is  constructed  of  an  inner  and  an  outer  steel  shell,  forming 
steam  jacket,  with  cast-iron  end  frames,  intermediate  truss  bands,  and  screw-stay 
construction. 

tl  The  doors  are  arranged  at  both  ends,  having  concave  steel  plates  riveted  to  cast 
iron  frames,  fitted  with  steam-tight  gaskets,  and  are  handled  by  convenient  cranes, 
being  drawn  tight  by  steel  eyebolts,  swinging  in  and  out  of  slots  in  the  frames. 

"  The  system  of  piping  is  so  arranged  as  to  give  thorough  control  of  the  circula- 
tion. Steam  may  not  only  be  admitted  at  top  and  bottom  at  will,  but  may  also  be 
admitted  at  either  end  on  top  and  discharged  at  opposite  end  on  bottom,  or  vice 
versa,  so  that  cross  currents  are  obtained  and  the  steam  handled  in  any  manner 
suited  to  obtain  the  best  results  from  the  articles  being  exposed. 

"  In  this  system  of  piping  a  patent  air  exhauster  is  attached  to  obtain  a  partial 
vacuum  in  chamber,  thus  preventing  a  possibility  of  life  to  the  germ  and  securing 
greater  penetration  to  the  steam. 

11  Thermometers,  to  indicate  the  temperature,  are  attached  to  each  door,  and 
gauges  are  provided  to  indicate  both  vacuum  and  steam  pressure  and  a  safety  valve  is 
introduced  to  prevent  a  possibility  of  overpressure  in  the  chamber,  the  amount  of 
working  pressure  being  regulated  by  a  reducing  valve  in  the  steam  pipe  from  the 
boiler. 

"For  convenience  in  handling  the  goods,  two  cars  are  provided,  of  light  iron  con- 
struction, with  three  removable  trays  in  each,  covered^with  galvanized  screens,  and 
on  the  top  three  rows  of  bronze  wardrobe  hooks  are  arranged,  so  that  articles  may 
be  laid  upon   the  trays  or  the  trays  removed  and  clothing  hung  upon  the  hooks. 


C  ■  OMMl  WIC,  I  IiLE   Bis  /-/.  j  s  /•/>. 


545 


The  chamber  is  placed  in  a  pit  14  inches  deep,  to  bring  the  track  in  the  chamber  on 
a  level  with  the  floor,  and  in  this  pit  are  two  transfer  tables,  so  that  the  cars  passing 
in  at  one  end  of  the  chamber,  after  being  unloaded  at  the  other,  can  be  returned  to 
the  working  end  of  chamber  by  means  of  the  transfer  tables  and  side  tracks,  thus 
securing  a  continuous  operation  and  a  complete  isolation  of  the  infected  from  the 
disinfected  end  of  the  building. 

"The  steam  chamber  and  boiler  and  all  steam  pipes  are  covered  with  magnesia 
non-conducting  covering  to  prevent  radiation  and  loss. 

••  The  working  of  such  a  sterilizing  chamber  may  be  described  as  follows: 

••The  steam,  generated  at  high  pressure  in  the  boiler,  is  reduced  to  a  proper  pres- 
sure by  a  reducing  valve  and  allowed  to  circulate  continuously  in  the  jacket,  slowly 
at  first  to  avoid  sudden  expansions. 

••  While  the  chamber  is  being  slowly  heated  the  goods  are  loaded  upon  one  of  the 
cars  and  then  pushed  into  the  chamber  and  the  doors  closed  and  made  steam  and  air 
tight.  When  the  thermometer  indicates  proper  temperature  in  the  inner  chamber 
the  air  exhauster  is  started,  until  a  vacuum  of  10  to  1")  inches  is  shown  on  the  gauge; 
then  it  is  stopped  and  steam  is  admitted  slowly  to  the  inner  chamber  until  there  is  a 
pressure  of,  say  10  pounds.  The  valves  from  the  jacket  are  then  closed,  while  the 
vents  are  opened  so  as  to  allow  the  steam  to  escape. 

••Theair  exhauster.is  again  started  and  the  above  process  repeated  ;  then  the  steam 
is  allowed  to  circulate  through  the  inner  chamber  under  .'.  or  10  pounds  pressure,  so 
as  to  secure  a  full  and  perfect  exposure  of  all  the  articles  to  the  current  of  steam. 
After  the  period  of  exposure  the  steam  is  closed  from  the  inner  chamber  and  the 
vacuum  again  started,  to  remove  any   condensation  which  may  occur.     After  the  ex- 


Fig.  31. 
Interior  ol   Disinfection  Bnilding,  District  ol  Columbia,    Prom  Report  ol   Health  Officer,  i-'» 


546  COMMUNICABLE    DISEASES. 

posure  the  door  at  the  opposite  end  of  chamber  is  opened,  the  car  removed  and  un- 
loaded, and  thence  passed  to  the  working  end  of  chamber  by  means  of  the  transfer 
tables. 

L-  Van  sprays  consisting  of  hand  pumps  attached  to  proper  receptacle  for  the  solu- 
tion, with  hose  sufficient  to  reach  the  vans  conveniently,  were  provided,  but  owing  to 
the  clogging  of  the  nozzle  were  abondoned,  and  the  vans  are  now  washed  with 
bichloride. 

"A  Kinyoun  formaldehyde  apparatus  such  as  is  used  by  the  Marine  Hospital  .Ser- 
vice has  recently  been  attached  to  steam  chamber  for  treating  articles  like  leather 
that  cannot  be  subjected  to  steam.''1 

In  Brooklyn,  in  1894,  a  disinfecting  plant  was  built  at  the  Kingston 
Avenue  contagious  disease  hospital.  It  is  a  three  story  brick  building  and 
cost  $22,103.50.  It  contains  besides  the  steam  chamber,  tanks  for  dis- 
infecting and  cleansing  the  hospital  clothing,  and  a  set  of  three  rooms, 
through  which  the  hospital  patients  pass  for  disinfection  at  the  time  of 
their  discharge.  The  following  description  of  the  sterilizer  used  at 
Worcester  is  from  the  report  of  the  board  of  health  of  that  city  for 
189$: 

"  The  sterilizer  is  a  jacketed  cylinder  seven  feet  in  length  and  five  feet  in  diam- 
eter, with  doors  at  both  ends.  A  brick  partition  crosses  the  sterilizer  in  the  centre. 
By  this  arrangement  the  ends  open  into  separate  rooms,  no  communication  existing 
between  except  through  the  sterilizer.  Upon  the  floor  at  either  end  is  laid  a  track; 
a  similar  track  is  laid  in  the  bottom  of  the  sterilizer;  an  iron  carriage  is  loaded  with 
the  infected  goods  to  be  sterilized,  and  is  rolled  into  the  sterilizer;  the  doors  are 
then  closed  and  the  steam  turned  on.  After  being  subjected  to  the  temperature 
necessary  to  kill  all  disease  germs,  the  door  at  the  opposite  end  is  opened  and  the 
car  run  out  over  the  track.  This  room  communicates  directly  with  the  laundry,  and 
no  goods  enter  the  laundry  except  in  this  way,  after  being  thoroughly  disinfected. 
A  temperature  of  300  degrees  can  be  obtained,  although  at  present  it  is  set  to  blow 
off  at  a  pressure  of  fifteen  pounds,  giving  a  temperature  of  250  degrees,  Fahren- 
heit. 

"  The  sterilizer  complete  was  made  and  set  up  by  the  Stewart  Boiler  Works  of 
this  city.  The  cut  of  the  sterilizer,  which  accompanies  this  article,  was  kindly 
loaned  by  that  concern. 

"  The  following  test  was  made: 

"  Specimens  of  the  cultures  described  below  were  placed  in  the  ordinary  glass 
lubes,  the  ends  plugged  with  cotton.  They  were  then  rolled  in  thirteen  blankets 
and  subjected  to  a  temperature  of  225  degrees,  Fahrenheit,  for  one  and  one-half 
hours. 

t;  Subsequent  cultures  were  made  from  all  these,  and  all  proved  to  be  sterile: 
Bacillus  anthracis. 
Bacillus  diphtheria;  (3  cultures). 
Streptococcus  aureus. 
Staphylococcus  pyogenes. 
Spirillum  cholera?  asiaticse. 
Micrococus  lanceolatus." 

The  cost  of  a  steam  disinfecting  plant  varies  greatly  depending  upon 
the  size  and  kind  of  building,  the  size  of  steam  chamber,  the  style  of 
cars,  the  form  of  vacuum  apparatus  and  whether  a  special  boiler  is  re- 


( 'OMMUWIl  \  I  BL  E    DTsK.  l  SES. 


54' 


548 


( ■  OMM I TNICA 11 L  E    ]>  is K.  j  sh  s. 


Fig.  33. 

Boston  Strain  Disinfecting  Chamber.     From  Report  of  Boston  Board  of   Health,  1S92. 

quired.  A  steam  chest  of  ample  size  for  a  city  of  150,000  inhabitants 
and  fitted  with  everything  necessary  for  first-class  work  ought  to  be 
purchased  for  $1,000.     The  Paterson  chamber  cost  $815. 

In  1895  a  portable  steam  disinfector  was  built  in  Milwaukee  at  a 
cost  of  $1,500.  Its  weight  was  8,220  pounds,  and  it  was  three  and  one 
half  by  nine  feet  inside  measurement.  Chicago  also  built  a  similar  van 
which  can  he  seen  in  the  accompanying  illustration.  This  van  is  now 
kept  at  the  hospital  and  is  used  as  a  stationary  disinfector,  hut  it  is  not 
often  put  in  service.  It  is  at  present  believed  that  a  stationary  plant  is 
much  to  he  preferred  to  one  that  is  portable.  The  latter  is  expensive 
toconstruct  and  more  expensive  to  operate,  and  in  any  event  can  hardly 
he  made  large  enough. 

It  is  generally  believed  that  the  application  of  a  strong  disinfectant 
solution  to  floors,  wood-work,  and  furniture  is  an  excellent  way  to  dis- 
infect them.  Washing  such  things  and  indeed  washing  everything  that 
can  he  washed  is  usually  recommended  in  disinfection  circulars.  After 
cases  of  communicable  disease  the  family  are  by  circular  or  otherwise, 
usually  advised  to  wash  with  disinfectants  all  solid  surfaces.  Carbolic 
acid  in  two  per  cent,  solution  or  corrosive  sublimate  one  to  one  thousand 
are  recommended.  Sometimes  these  disinfectants  are  given  to  the 
family  by  the  health  department.  In  Providence  the  disinfector  usually 
leaves  at  the  house  several  paper  pill  boxes  containing  three  drams  ^i 


(  OMMUNIi  'ABLE    VISE.  I  SE&. 


519 


550  0  OMM I  XI  (  A  B  L  1<;    I)  lsh\  j  sEs. 

corrosive  sublimate,  about  enough  to  give  a  strength  of  one  to  one  thou- 
sand when  dissolved  in  a  pailful  of  warm  water.  In  Charleston  a  pound 
bottle  of  carbolic  crystals  together  with  directions  for  solution  and  use 
are  sent  to  the  house  in  each  case  of  scarlet  fever  and  diphtheria.  In 
the  District  of  Columbia  formalin  is  given  to  the  householder  by  the 
municipal  disinfector.  In  most  cities,  as  in  Providence,  this  method  of 
disinfection  is  left  to  the  family,  and  unlike  Providence  the  disinfectant 
is  not  furnished  by  the  city.  In  a  few  cities  this  disinfection  is  dime 
by  city  employees.  In  New  York  City,  where  public  disinfection  is 
done  only  in  tenements  and  flats,  men  wash  the  floors'  with  brooms 
dipped  in  a  one  to  one  thousand  solution  of  bichloride,  and  for  other 
wood-work  sponges  are  used  in  a  solution  of  one  to  2,500.  The 
mercuric  salt  is  carried  in  thirty  grain  tablets  and  is  dissolved  at 
the  house.  In  phthisis  washing  soda  is  used.  In  Rochester  this  wash- 
ing is  relied  on  as  the  principal  means  of  disinfection.  A  man  and 
woman  are  employed  who  wash  all  washable  surfaces  with  bichloride  or 
electrozone,  and,  at  the  same  time,  carpets  and  upholstered  furniture  are 
removed  and  beaten,  and  afterwards  while  the  room  is  damp,  it  is  fumi- 
gated with  sulphur.  In  Newark  the  woodwork  is  washed  with  bichlo- 
ride in  diphtheria  cases. 

Details  of  Municipal  Work  hi  Disinfection.  Many  cities  distribute 
to  every  family  with  communicable  disease  a  circular  explaining  the 
methods  of  disinfection  used.  These,  of  course,  vary  in  substance 
according  to  the  practice  in  the  different  cities.  The  best  general  cir- 
cular on  disinfection  that  the  writer  has  seen  is  that  issued  by  the  state 
board  of  health  of  Maine.  As  has  been  stated,  most  cities  and  many 
states  require  by  ordinance  or  statute,  disinfection  after  every  case  of 
communicable  disease ;  but  some  cities,  as  the  District  of  Columbia,  St. 
Paul,  and  Providence,  do  not.  Nevertheless,  their  municipal  officers 
offer  disinfection,  and  the  offer  is  usually  accepted  by  the  householder. 
In  the  District  of  Columbia,  until  quite  recently,  formaldehyde  appara- 
tus was  loaned  by  the  city  to  the  householder.  Some  cities  have  special 
employees  to  do  their  disinfecting  work,  while  others  require  sanitary 
inspectors  or  medical  inspectors  to  do  it  in  addition  to  their  other  duties. 
The  following  shows  what  is  done  in  a  number  of  cities : 

Number  of  Annual 

City.  •  Disinfector*.  Salary. 

Baltimore 2  disinfectors $800 

Boston 1  chief  disinfector 1,000 

10  disinfectors per  day       2.25 

Brooklyn  (Borough  of) 4  disinfectors 900 

Cincinnati 1  disinfector 800 

Chicago 10  disinfectors $1,000 

District  of  Columbia 2  disinfectors 600 

3  disinfectors 300 

Newark 5  disinfectors per  day       2.7."> 


COMMUNICABLE    DISEASES.  551 

Number  of  Annual 

City.  Disinfectors.  Salary. 

New  York  (Borough  of  Manhattan) .  .'■)!  disinfectors 600  to  1,200 

Providence 1  disinfector per  week  12 

Rochester 1  disinfector 900 

1   disinfector 400 

St.   Louis I)  disinfectors 000 

W« trcester 1  disinfector per  day      2.75 

In  Cambridge,  New  Haven,  Newton,  San  Francisco,  Springfield, 
Mass.,  Wilmington,  Del.,  and  doubtless  in  many  other  smaller  places 
the  sanitary  inspectors  attend  to  disinfection,  and  in  Brockton  this  is 
done  by  the  inspector  of  plumbing. 

In  some  cities  the  health  officials  rely  upon  the  certificate  of  the 
attending  physician  to  determine  when  the  time  for  disinfection  has 
arrived,  but  usually  in  scarlet  fever  the  health  officer  or  medical  ins] ice- 
tor  personally  examines  the  patient,  and  in  most  places  where  laboratory 
facilities  are  available  one  or  more  negative  cultures  are  required  in 
diphtheria.  Whenever  a  disinfector  is  employed,  it  is  usual  for  an 
order  to  he  given  him  for  each  place  to  be  disinfected,  this  order  being 
issued  by  the  health  officer  or  medical  inspector.  This  order  contains 
the  items  which  it  is  desired  to  record  in  regard  to  the  disinfection  of 
the  ease,  and  when  returned  signed  by  the  disinfector  is  considered  his 
report,  and  may  be  filed  away  as  a  record.  The  form  used  in  ( Ihicago  is 
shown  in  Appendix;  97.  On  some  forms  a  list  of  several  places,  a  day's 
work,  i>  put  on  a  single  sheet.  In  Baltimore  the  return  has  a  blank  for  the 
signature  of  the  householder  to  enable  the  office  to  maintain  a  check  upon 
the  work  of  the  disinfector.  Sometimes  there  are  a  number  of  items 
in  regard  to  the  history  of  the  ease  which  the  disinfector  is  required  to 
gather  at  the  time  of  his  visit.  This  is  the  case  in  Newark  where  the 
disinfectors  placard  the  house  and  do  practically  all  the  work  of  med- 
ical inspectors.      In   Pittsburgh1  a  card   index  is  kept  of  all  disinfections 

1  Size  ::  x  5  inches. 


DISINFECTION. 
\. ..  Address  St  Ave.   \  \  Ward 

Householder  i  Patienl  i 

Iiisease  No.  Rooms 

i  lapacity 

Hours  exposure  to  formaldehyde  u;<s  Amount 

Boom  tests;  K.I..  B.  growth  hrs.  Anthrax  Spores  <jrowtli  lira. 

Steam  sterilization  <'.  Spores  growth  lira. 

spores  growth  Ins.  Q 

Result 


5  -")  2  C  0  MM  I  Wit  A BLE   DISK.  I  8  Es. 

on  cards  which  are  blue  for  diphtheria,  red  for  scarlet  fever,  and  white 
for  all  other  disinfecting. 

In  Pennsylvania  where  there  is  little  official  sanitary  authority  in 
the  smaller  places  and  where  disinfection  is  required  by  the  statute1  the 
state  board  of  health  has  prepared  a  certificate  of  disinfection  to  be 
signed  by  the  attending  physician  and  returned  to  the  school  authorities. 
In  Chicago  where  the  disinfectors  are  sent  to  their  work  on  the  request 
of  the  attending  physician  they  are  instructed  in  scarlet  fever  cases  to 
examine  the  patient  and  to  decline  to  do  the  work  if  desquamation  still 
continues. 

In  many  cities,  probably  most  cities,  as  Cambridge,  Philadelphia, 
Providence,  and  Rochester,  the  disinfector  is  provided  with  a  horse  and 
wagon  to  carry  his  apparatus.  In  most  cities  an  ordinary  light  one 
horse  covered  express  wagon  is  used  for  this  purpose.  In  Providence 
until  recently,  the  same  wagon,  which  has  wooden  sides  and  top,  was 
used  as  an  ambulance,  but  now  a  Concord  wagon  is  used  in  disinfec- 
tions. In  Rochester  the  disinfector  is  obliged  to  furnish  a  team  out  of 
his  salary  of  seventy-five  dollars  per  month.  The  use  of  the  formalde- 
hyde "  regenerator  "  renders  it  possible  for  the  disinfector  to  carry  it  by 
hand,  and  this  is  done  even  in  such  large  cities  as  Baltimore,  Cincinnati 
and  to  some  extent  in  Philadelphia ;  and  in  Newark  the  outfit  is  carried 
in  a  leather  box  to  render  it  less  conspicuous.  The  disinfectors  make 
use  of  electric  cars  in  getting  about  in  the  above  cities,  but  even  then  if 
much  formalin  and  a  roll  of  gummed  paper  is  carried,  the  burden  must 
be  considerable.  The  route  can  usually  be  more  quickly  covered  in  a 
wagon  than  in  electric  cars,  and  in  Providence  the  writer  is  certain  that 
if  the  horse  and  wagon  were  to  be  given  up  it  would  be  necessary  to 
hire  two  disinfectors  instead  of  one.  If  goods  are  to  be  steamed  of 
course  wagons  must  lie  provided  to  carry  them.  In  several  cities  as  in 
New  York  and  Philadelphia  one  van  or  set  of  vans  is  used  to  convey 
goods  to  the  steam  chamber,  and  another  set  with  different  drivers  to 
return  them  to  their  owners.  In  New  York  the  drivers  for  infected 
goods  wear  suits  of  brown  duck,  and  the  drivers  for  disinfected  goods 
wear  white  duck  suits.  In  other  cities,  as  Cambridge,  Charleston,  the 
District  of  Columbia,  Newton.  Mass.,  and  Providence,  only  one  van  is 
used  which  is  disinfected  after  each  trip,  usually  by  washing  with 
bichloride  solution.  In  most  cities  the  goods  are  tied  up  in  sheets. 
Sometimes  the  sheets  found  in  the  house  are  used.  In  New  York 
sheets  of  light  duck  about  ten  feet  square  are  preferred.  In  the 
District  of  Columbia  they  arc  made  of  bed  ticking.      In  Providence  can- 


1  Pennsylvania,  Chapter  124  of  1895; 


•   C  OMMUNIt  \  i  B  L  K    DIS  h\  1  5  E& .  5 .3  3 

vas  bags  large  enough  to  easily  receive  a  mattress  have  been  used. 
They  are  bound  on  three  sides  with  rope  and  have  a  loop  at  the  corners 
and  the  mouth  of  the  bag  is  closed  with  a  gathering-  cord.  They  cost 
about  six  dollars.  The  van  used  in  Chicago  for  carrying  goods  is  shown 
in  the  illustration  on  page  540.  Often  the  disinfectors  wear  their 
ordinary  clothes  when  about  their  work,  but  sometimes,  as  in  Providence, 
a  duster  is  worn  outside  and  is  frequently  disinfected.  In  some  cities, 
as  Philadelphia,  New  York,  and  Waltham,  a  complete  overall  suit  of 
duck  or  similar  material  is  worn  during  disinfection. 

Several  cities,  as  Philadelphia  and  Milwaukee,  have  printed  rules  for 
the  guidance  of  their  disinfectors.  When  the  disinfector  has  arrived  at 
the  house  and  found  everything  in  readiness,  he  is  to  at  once  proceed  to 
his  work.  This  varies  of  course  with  the  character  of  the  disinfection 
which  the  city  furnishes,  and  the  space  to  he  disinfected.  If  isolation 
in  one  room  has  been  faithfully  carried  out,  the  problem  is  much  sim- 
plitied.  Unfortunately,  except  in  a  few  cities  this  is  not  generally  done, 
and  disinfection  of  several  rooms  is  necessary.  In  small  tenements  of 
two  to  four  rooms,  usually  the  patient  has  been  in  all  of  them.  In 
Toronto  in  such  cases  the  inhabitants  are  removed  by  the  city  officials 
during  the  disinfection,  to  awaiting  room,  but  the  writer  has  not  heard 
of  such  an  arrangement  in  the  United  States.  In  our  cities  either  the 
inmates  arc  simply  turned  out.  or  a  part  of  the  house  is  disinfected  on 
one  day  and  the  remainder  on  another  day.  In  many  cases,  doubtless. 
when  it  is  claimed  by  the  family  that  isolation  has  been  maintained,  it 
has  not  been,  and  a  single  room  is  disinfected  when  the  whole  house 
needs  it  jusl  as  much.  Directions  printed  or  otherwise  are  usually  left 
at  the  infected  home  early  in  the  disease  giving  directions  how  to  dis- 
infect clothing  and  bedding  that  can  be  washed.  An  example  id'  such 
circulars  is  shown  in  Appendix  98.  <  me  of  the  best  and  most  complete 
•circulars  on  disinfection  is  that  issued  by  the  state  board  of  health  of 
Maine.  Snaking  in  a  disinfectant  and  boiling  is  usually  recommended 
and.  as  has  been  said,  disinfectants  tor  this  purpose  are  sometimes  fur- 
nished as  in  Providence,  bul  in  that  city. -it  least  1 1 1 .  ■  x  are  rarely  called 
for  till  the  termination  id'  the  disease  when  they  are  almost  always  left 
by  the  disinfector  formalin  for  clothes  and  spraj  ing  upholstered  furni- 
ture, and  corrosive  Bublimate  lor  washing  woodwork.  In  Providence, 
during  the  course  of  the  disease,  clothes  which  are  to  go  to  a  lanndiy 
are  called  lot-  by  the  health  department  wagon,  and  after  steaming  arc 
delivered  ai  the  lanndiy  in  that  city  also.  When  washing  is  found  at 
the    house  of   a  washerwoman  where  there  is  communicable  disease  it  is 

removed  and  steamed,  and,  if   already  Laundered,  it    is  then  returned  to 


554  COMMUNICABLE    DISEASES.     ' 

the  owner.  Laundered  clothing  is  not  injured  at  all  when  properly 
steamed  in  a  jacketed  chamber.  In  Rochester  when  the  disinfectors 
visit  a  house  they  put  the  soiled  clothes  to  soak  in  a  bichloride  solution, 
and  in  Newark  in  formalin  1  to  5,000. 

School  books  and  books  belonging  to  public  libraries  are  liable  to  be 
infected  and  are  difficult  to  disinfect.  In  the  case  of  cheap  school  books 
it  is  doubtless  economical  to  burn  them,  and  this  is  done  in  Providence 
and  probably  in  other  cities.  In  Philadelphia  the  same  plan  is  pursued 
in  regard  to  library  books,  but  in  Providence  these  are  disinfected  with 
steam,  being  first  set  on  edge  with  the  leaves  apart.  This  of  course 
destroys  leather  bindings  but  causes  no  other  injury. 

In  Cincinnati  the  clothing  manufacturers'  association  employs  a  man 
to  disinfect  for  them  all  clothing  which  may  have  become  infected  in 
the  process  of  manufacture. 

Disinfect  ion  of  Vaults,  Yards,  G-utters,  etc. 

Formerly  when  the  filth  theory  of  disease  dominated  nearly  all  san- 
itary work,  disinfectants  were  freely  applied  to  all  places  where  filth 
accumulates.  The  health  department  issued  circulars  showing  how  dis- 
infection could  be  done  and  sometimes  distributed  the  materials.  In 
some  cases  the  officers  actually  did  the  work  of  disinfection.  For  many 
years  in  New  York  City  and  Philadelphia  the  health  department  have 
disinfected  gutters  and  yards  with  copperas,  but  recently  "  electrozone  " 
has  been  used  in  Philadelphia. 

At  the  present  time  it  is  considered  better  to  remove  filth  than  to 
disinfect  it,  and  as  to  the  danger  of  its  giving  rise  to  infectious  disease 
it  has  been  shown  that  ordinary  filth  has  little  if  anything  to  do  with 
scarlet  fever,  smallpox,  whooping  cough,  typhoid  and  typhus.  It  is  still 
not  certain  how  the  virus  of  yellow  fever  is  spread,  and  it  is  the  opinion 
of  many  that  it  is  developed  in  filth,  so  that  in  southern  cities  which  fear 
this  disease,  disinfection  of  filth  is  held  to  be  more  important  than  it  is 
in  northern  cities.  In  Baltimore  one  man  is  employed  to  prepare  carbo- 
late  of  lime  which  is  distributed  for  the  disinfection  of  vaults  and  drains. 
In  Charleston,  in  1898,  carbolic  acid  was  furnished  to  800  persons  and 
lime  to  39,782  persons,  and  there  was  also  distributed  141,300  gallons  of 
copperas  solution,  one  and  one-half  pounds  to  the  gallon.  During  the 
summer  time  in  that  city  a  wagon  is  kept  constantly  at  work  distribut- 
ing these  materials,  but  if  the  citizens  need  them  in  the  winter  season 
they  must  call  at  the  health  department  for  them.  In  Baltimore  carbol- 
ate  of  lime  is  made  by  the  health  department  and  distributed  from  the 


COMMUNKJABLH    DISEASES.  555 

police  stations.     In  Boston  the  disinfecting  corps  during  summer  do  a 
good  deal  of  this  disinfection,  as  shown  by  the  table  given  below.1 

In  New  Orleans,  in  1897,2  during  the  outbreak  of  }"ellow  fever,  the 
following  unique  method  was  adopted  for  the  disinfection  of  the  surface 
of  the  ground  : 

"  A  number  of  small  gasoline  furnaces  on  rollers,  throwing  a  sheet  of  flame  on 
the  ground,  and  used  by  the  Barber  Asphalt  Company  for  repairs  to  asphalt  streets, 
were  loaned  us  by  that  company  in  Xew  Orleans.  These  furnaces,  which  were 
capable  of  generating  such  an  intense  heat  as  to  burn  quickly  green  vegetables, 
refuse,  and  other  household  debris,  without  odor,  were  utilized  in  the  worst  infected 
localities. 

"Owing  to  the  danger  of  setting  houses  on  fire,  the  manipulation  of  these 
machines  required  the  greatest  care.  }J  1.  Farrar  secured  the  services  of  an  engine 
of  the  rire  department  to  attend  each  corps  of  this  disinfecting  brigade.  The  mode 
of  operation  was  as  follows:  All  trash  and  other  debris  of  the  yard  and  alley  were 
removed  to  the  street  and  then  quickly  incinerated  by  the  furnace.  The  yards, 
alleys,  and  the  exterior  of  houses  were  then  thoroughly  washed  with  a  powerful 
stream  of  water  furnished  by  the  fire  engine,  and  afterwards  the  furnace  was  rolled 
over  the  alley,  yard,  banquette  and  streets,  after  the  fashion  of  ironing  a  garment  in 
a  laundry.'" 

When  yellow  tevei'  occurred,  the  whole  block  was  disinfected  with 
bichloride  of  mercury  and  chloride  of  lime.    The  board  of  health  states: 

••  It  has  been  our  practice,  as  far  as  possible,  to  throw  a  cordon  of  disinfection 
around  the  infected  district.  All  drains  and  sinks  and  surfaces  were  washed  with  a 
bichloride  of  mercury  solution  1-500.  The  vaults  and  other  places  where  tilth  or  de- 
composition existed,  w.re  disinfected  with  chloride  of  lime.  The  chloride  of  lime 
was  used  in  the  strength  of  three  pounds  to  the  average  vault,  and  was  used  quite 
freely,  when  possible,  under  the  houses  and  also  in  the  street  gutters." 


1  Boston,  Report  of  Health  Department  (1899),  p.  37: 

Places  Disinfected  in  Boston,  isoo. 

Streets 338 

Places 1,137 

<  ourts 1,184 

Alleys 4,113 

Yards 15,599 

Vaults 1,126 

Cellars 9,276 

Gutters 574 

Water-closets 8,856 

Passages  ays •;.;:;;»; 

Urinals 768 

Vacant    lots    ■ 898 

Filthy  rooms 

Filthy  sheds 6,697 

Sinks 1 ! ; .  1 !  '.7 

(  'ess|M  ioIs          1 4,336 

Total 95,29  1 

■  Louisiana.  Report  of  State  Board  of  Health  (1896-97),  pp.  12.  and  76. 


5  5  6  0  031 31 UNI CABLE    DISEu  1  SMS, 

During  this  outbreak  there  were  used  21,793  pounds  of  chloride  of 
lime,  1,743  pounds  of  bichloride  of  mercury,  and  4,391  barrels  of  lime 
and  260  barrels  of  copperas,  besides  formaldehyde  and  sulphur  for  house 
disinfection. 

Bacteriological  Laborat<  >kies. 

The  development  of  the  serum  culture  as  the  most  valuable  means 
of  recognizing  diphtheria  was  the  chief  cause  of  the  establishment  of 
the  municipal  or  state  bacteriological  laboratory,  though  something  had 
been  done  previously  to  that  time.  As  early  as  1888,  what  was  prob- 
ably the  first  municipal  laboratory  was  established  in  Providence  b}* 
the  energy  of  Dr.  G.  T.  Swans,  who  was  at  that  time  medical  inspector. 
The  work  done  by  Dr.  S warts  at  first  was  on  water  supplies  and  filters, 
and  he  also  made  use  of  the  laboratory  in  tracing  an  outbreak  of  typhoid 
in  1888,  which  was  due  to  pollution  of  the  city  supply.  The  first  state 
laboratory  was  also  established  by  Dr.  Swarts  in  1893,  when  he  was 
elected  secretary  of  the  state  board  of  health.  There  seems  to  be  no 
difference  of  opinion  as  to  the  necessity  for  the  maintenance  of  a  bac- 
teriological laboratory  by  all  cities  of  considerable  size,  say  from  75,000 
to  100,000  inhabitants,  and  even  by  smaller  cities  if  a  state  or  university 
laboratory  is  not  immediately  available.  Laboratories  have  been  estab- 
lished in  a  large  number  of  cities  of  the  size  mentioned.  For  the 
country  and  smaller  cities,  of  course,  the  maintenance  of  a  bacteriological 
laboratory  would  not  be  warranted  by  the  amount  of  work  needed. 
For  such  communities  the  state  laboratory  was  established.  At  present 
the  state  board  of  health  is  thus  equipped  in  Colorado,  Delaware, 
Louisiana,  Maryland,  Massachusetts.  Minnesota,  New  Jersey,  Ohio, 
Rhode  Island,  Tennessee,  and  Vermont. 

In  Minnesota  in  1898  it  was  reported  that  thirty-two  towns  made 
use  of  the  state  laboratory.  In  Massachusetts  in  the  same  year,  although 
there  are  a  number  of  local  laboratories,  there  were  examined  by  the 
state  board  of  health  1,591  diphtheria  cultures,  41-~>  specimens  of  sputum 
and  132  specimens  of  suspected  malarial  blood. 

When  state  laboratories  were  first  projected  much  difficulty  was 
experienced  in  sending  specimens  to  them.  The  post  office  department 
refused  to  accept  infectious  material  or  wet  or  liquid  matter ;  but  mail- 
ing boxes  were  devised  which  are  approved  by  the  post  office  depart- 
ment.    Sometimes  cultures  are  sent  to  distant  laboratories  by  express. 

There  are  three  uses  to  which  bacteriological  laboratories  may  be 
put.  The  original  and  principal  purpose  of  these  laboratories  is  to  per- 
form routine  work  in  the  diagnosis  and  control  of  communicable  dis- 
eases. The  second  purpose  is  to  engage  in  such  work  as  the  produc- 
tion of  the   antitoxins,  vaccine,  tuberculin,  etc.     The  third  purpose  is 


COMMUNIC  I VBLE   DISK.  I  SES.  557 

the  pursuit  of  original  investigations,  work  which  mpre  properly  belongs 
t<>  state,  federal,  or  university  laboratories,  but  which  sometimes  can 
best  be  done  in  connection  with  municipal  work. 

The  equipment  of  the  laboratory  and  the  working  force  employed 
will  of  course  vary  according  to  the  use  to  which  it  is  to  be  put.  If 
the  laboratory  work  is  to  be  simply  the  routine  work  of  examining 
diphtheria  cultures,  tuberculous  sputum,  and  typhoid  and  malarial 
blood,  an  extensive  laboratory  is  not  needed,  and  unless  the  city  be  a 
large  one,  a  single  bacteriologist  with  perhaps  an  assistant  to  do  the 
manual  work,  is  all  that  is  really  needed.  The  cost  of  such  a  labora- 
tory need  not  be  very  great,  as  a  skilful  worker  can  get  along  with 
very  simple  and  inexpensive  apparatus.  He  must,  however,  have  a  first- 
class  microscope,  in  the  purchase  of  which  parsimony  does  not  pay. 
Only  |300  was  at  first  expended  on  the  Denver  laboratory  in  which 
much  very  valuable  work  lias  been  done.  This  expenditure  included 
the  microscope.  In  Hartford  the  same  amount  was  spent  exclusive  of 
tin-  microscope. 

If  the  city  is  a  large  one  the  expense  may  be  somewhat  increased  in 
the  increased  amount  of  apparatus  required.  If  it  is  intended  to  en- 
courage original  research,  more  elaborate  arrangements  are  necessary. 
Original  scientific  research  is  not  properly  one  of  the  functions  of  muni- 
cipal government  :  but  sometimes  knowledge  is  almost  entirely  lacking 
for  the  solution  of  some  pressing  municipal  problem,  and  it  is  perhaps 
wise  to  undertake  research  which  should  have  been  made  by  others,  but 
which  has  been  neglected.  Thus  in  Berlin  the  erratic  working  of  the 
filters  called  forth  the  researches  of  Piefke  upon  the  mechanism  of  con- 
tinuous sand  filtration;  the  bad  odors  in  Boston*  waters  almost  qi 
Bitated  the  original  work  on  the  flora  of  the  water,  done  under  the  direc- 
tion oi  the  superintendent  of  the  works,  to  determine  the  cause  of  the 
trouble,  and  in  Providence  the  investigations  of  Weston  as  to  the  effi- 
ciency of  a  "mechanical"  filter  about  to  be  adopted  l>\  the  city  called 
public  attention  to  the  Value  of  a  method  of  filtration  concerning  which 

little  had  before  been   known,      ('ertaiii  lines  of  investigation  can  best   be 

conducted  in  the  municipal  laboratory.  Methods  of  practical  house  dis- 
infection can  best  be  studied  there  and  such  questions  as  the  variation 
in  the  morphology  and  physiology  of  the  diphtheria  bacillus  and  its  dis- 
tribution.     Another  reason   for  offering  facilities  for  original  research  is 

thatbv  bo  doing  greater  inducements  are  held  out   for  the  services  of 

first-class  men.  who  if  they  were  not  afforded  such  opportunities,  would 

surety  gravitate  to  the  universities.  For  these  reasons  some  of  the 
Larger  cities,  as  Boston,  New  York.  Philadelphia,  and  Pittsburgh,  have 
Been  lit  to  establish  bacteriological  Laboratories  on  a  Bomewhal  generous 

scale. 


558  COMMUNICABLE   DISEASES. 

The    following  are    some   of    the   salaries  paid   for   bacteriological 
work : 


Bacteriologists 

City.                                                                     and  Annual 

Assistants.  Salary. 

Baltimore 1  bacteriologist $1,500 

Boston 1  bacteriologist 2,500 

1  bacteriologist 900 

1  clerk 728 

1  assistant per  week  13 

Brooklyn 1  bacteriologist TOO 

1  assistant 300 

Buffalo 1  bacteriologist 1,500 

1  assistant 1,200 

Cambridge 1  bacteriologist 1,000 

Charleston 1  bacteriologist 900 

Chicago 1  bacteriologist 1,800 

2  assistants 1 ,000 

Cincinnati 1  bacteriologist 000 

Columbus 1  bacteriologist 400 

Denver 1  bacteriologist 1,500 

Fitchburg 1  bacteriologist per  culture  1 

Hartford 1  bacteriologist 600 

Lowell 1  bacteriologist 600 

Lynn 1  bacteriologist 900 

Minneapolis 1  bacteriologist 1,000 

Newark 1  bacteriologist .  . 2,000 

Newark 1  assistant 666 

New  Haven 1  bacteriologist 800 

New  York 1  director 2,500 

1  assistant  director 2,000 

2  assistant  directors 1,600 

12  bacteriologists 1,200 

Newton 1  bacteriologist 800 

Pittsburgh 1  bacteriologist1 2,000 

Philadelphia 1  director 2,400 

1  assistant 1,200 

1  assistant 900 

1  assistant 700 

1  clerk 1,000 

1  helper 600 

1  helper 500 

Rochester 1  bacteriologist 1,200 

St.  Louis 1  bacteriologist 2,400 

St.  Paul 1  bacteriologist 1,200 

1  assistant 300 

San  Francisco 1  bacteriologist 1,800 

Springfield,  Mass 1  bacteriologist per  case  2 

Syracuse 1  bacteriologist 1,000 

Worcester 1  bacteriologist 700 


1  Has  other  duties  connected  with  the  Bureau  of  Health. 


CO  MMl  WI(  - 1 B  L  E    1)1 ska  sKs.  5  5  9 

At  present  bacteriological  laboratories  have  been  established  in  all 
of  the  forty  principal  cities  of  the  United  States  except  Albany,  At- 
lanta. Cleveland.  Jersey  City,  Omaha,  Paterson,  Richmond,  Scranton, 
and  Toledo.  Probably  many  smaller  places  do  bacteriological  work. 
and  among  such  that  have  come  to  the  notice  of  the  writer  are  Brook- 
line,  Mass.,  Montclair,  and  Orange,  X.  J.,  and  Ottumwa,  la. 

It  is  only  the  routine  diagnostic  work  of  the  laboratory  which  will 
be  considered  in  this  connection.  The  different  diseases  will  lie  con- 
sidered separately. 

Diphtheria. 

In  the  official  diagnostic  work  done  in  diptheria  and  other  infectious 
diseases  health  officials  have  been  far  in  advance  of  the  medical  pro- 
fession. Almost  as  soon  as  simple  methods  of  technique  were  de- 
veloped for  the  recognition  of  the  diphtheria  bacillus,  sanitary  officials 
were  offering  to  make  such  examinations  for  physicians;  but  the  physi- 
cians  were  not  ready  to  avail  themselves  of  the  assistance  offered,  as 
they  had  not  generally  become  aware  of  the  value  of  the  latest  results 
of  bacteriological  research.  The  first  step  then  in  utilizing  the  serum 
culture  as  an  aid  in  the  diagnosis  of  diphtheria  was  the  publishing  of 
information  as  to  its  value,  and  the  method  by  which  it  could  be  em- 
ployed. The  earliest  bacteriological  laboratories  issued  to  the  medical 
profession,  as  the  first  step  in  their  work,  a  circular  giving  information 
concerning  the  value  of  the  serum  culture  in  the  diagnosis  of  diph- 
theria. As  this  knowledge  has  now  become  common  property  such 
a  preliminary  circular  ought  not  to  be  necessary,  but  even  as  late  as 
October,  1899,  the  agent  of  the  board  of  health  of  Brookline,  a  resi- 
dential suburb  of  Boston,  found  it  advisable  to  call  the  attention  of 
the  practicing  physicians  to  the  value  of  cultures,  although  the  health 
departments  of  his  own  and  the  neighboring  cities  had  been  usim.;  the 
Culture  method  for  four  or  five   years. 

The  outfit  for  diphtheria  cultures  consisted  at  first  of  aslant  tube  of 
Loeffler's  blood  serum  and  another  test  tube  containing  a  sterile  cotton 
swab,  both  tubes  being  earried  in  a  box  just  large  enough  to  hold  them. 
This  is  also  the  outfit  still  generally  employed,  but  in  several  cities  cer- 
tain   modifications   have  been  adopted.     The  original  swab  consisted  of 

COtton  wound  on  the  end  of   an  iron    wire  and  placed  in  a    test  tube    the 

same  size  as  the  serum  tube  and  plugged  with  cotton.     In  Philadelphia 
a  number  If  aluminum  wire  is  used.     This  is  preferred  because  it  can 

lie  readily  cleaned  with  dilute  sulphuric  acid,  and  because  the  end  can 

be  readily  nicked    with    a    knife  in   keep   the   cotton    from    slipping.      In 
Boston,  brass  wiiv  is  used   with    one  end    roughened    to  hold  the  cotti. p. 


5 6 0  <■ ' OMM I  rXICA BLE    DISEA SES. 

In  Providence  a  tinned  iron  wire  is  employed  (number  17  wire),  with 
the  end  slightly  flattened  to  better  hold  the  cotton  ;  these  wires  cost 
twenty-five  cents  a  pound,  of  about  800  wires.  Absorbent  cotton  is 
used  in  most  cities,  but  in  Boston  a  non-absorbent  cotton  of  fine  grade 
called  "  jewelers' cotton  **  is  used,  because  it  is  desired  that  the  swab 
should  be  non-absorbent.  In  Providence  raw  cotton  is  used  just  as  it 
comes  from  the  cards.  In  Chicago  the  swab  is  formed  of  a  wooden 
skewer,  the  end  on  which  the  cotton  is  wound  being  a  little  smaller 
than  the  rest.  The  swab  is  kept  in  a  tube  of  only  slightly  greater 
diameter  than  the  skewer  and  slightly  shorter  and  it  is  kept  in  by 
means  of  the  rubber  part  of  a  medicine  dropper.  Professor  Ernst  of 
Harvard  University  gave  up  the  use  of  the  swab  entirely  and  substi- 
tuted a  small  platinum  wire  about  three  inches  long.  This  is  fastened 
in  a  small  brass  tube  and  this  in  turn  kept  in  a  little  larger  tube.  When 
it  is  to  be  used,  it  is  pulled  out  from  the  larger  tube  and  stuck  in  the 
other  way  with  the  wire  projecting.  This  was  used  in  Boston  and 
other  Massachusetts  cities  for  which  Professor  Ernst  examined  and  is 
still  employed  in  Cambridge  and  Eitchburg.      See  Eig.  37. 

The  serum  tubes  are  almost  always  not  far  from  one-half  inch 
inside  diameter,  though  somewhat  smaller  tubes  are  sometimes  used. 
The  length  however,  lias  varied  considerably.  The  tubes  used  at  first 
in  Boston  were  six-inch,  while  those  put  on  the  market  by  Parke,  Davis 
&  Co.  are  four-inch.  The  most  common  lengths  are  five  and  six  inches. 
Common  test  tubes  were  used  at  first  and  are  to  some  extent  at  present, 
but  the  loss  from  breakage  is  very  great  and  it  is  annoying  and  some- 
times dangerous  to  have  them  break  after  inoculation.  Hard  glass 
ignition  tubes  without  lip  are  generally  preferred.  The  prices  vary  of 
course  with  the  price  of  glass,  but  for  a  year  or  two  such  tubes  have 
been  furnished  by  Whitall,  Tatum  &  Co.  at  $3.60  per  gross.  The 
Boston  board  of  health  purchase  thick  tubes  without  lip,  of  J.  Elwood 
Lee  Co.  of  Coshocken,  Penn.,  at  $13  per  thousand.  Recently  in  Prov- 
idence about  two  inches  of  the  tube  has  been  etched  with  hydrofluoric 
acid  to  furnish  a  surface  on  which  the  name  of  the  patient  may  be 
written.     See  Fig.  35.     The  serum  tubes  are,  of  course,  plugged  with 


WBBt- 


Fig.  35. 

Swab  Tube  used  in  Fro\  idence,  with  etched  surface  for  writing  name  of  patient. 


COMMUNIGABLE    DISEASES.  5(31 

cotton  through  which  evaporation  takes  place  quite  rapidly  and  this 
drying  up  of  the  serum  has  rendered  it  very  difficult  to  keep  the  tubes 
at  the  depots  in  a  suitable  condition.  In  Philadelphia  the  tubes  are 
covered  with  rubber,  medicine  droppers  with  the  rim  cut  off,  being 
used  for  the  purpose.  In  Providence  small  nipples  were  used  but  the 
plan  was  abandoned  as  it  proved  hardly  worth  the  trouble.  In  Balti- 
more the  tube  is  sealed  by  inverting  it  and  dipping  the  cotton  in  melted 
para  tine.  In  Boston  a  small  cork  is  concealed  in  the  cotton  plug  to 
check  evaporation.  In  the  District  of  Columbia  the  cotton  is  pressed 
down  into  the  tube  and  a  sterile  cork  inserted.  In  Chicago  the  use  of 
the  tubes  for  serum  has  been  given  up  and  small  flat  aluminum  boxes 
are  substituted.  These  are  filled  with  serum  and  covered,  and  when 
sterile,  a  rubber  band  is  put  around  the  box.  making  a  pretty  tight  seal. 
These  boxes  are  compact  and  do  not  break  and  it  is  claimed  that  they 
can  be  conveniently  incubated  in  an  inside  vest  pocket.  They  cost 
#13. o<)  per  thousand  and  are  made  by  the  Illinois  Can  Company  of  Chi- 
cago. Dr.  Gehrmann  states  that  unless  great  care  is  taken  to  obtain 
perfectly  pure  aluminum  they  corrode  very  rapidly.     See  Fig.  36. 


Fig.  36. 

Chicago  Diphtheria  out  tit.      Wooden  spatula,  glass  slide  fur  smear,  alum  inn  in  i»>\  for  medium, 
with  rubber  ring  to  close  it,  and  swab  enclosed  in  tube;  all  enclosed  in  a  strong  envelope. 


The  outfit  used  by   Professor  Ernst  contains  two  serum  tubes,  one 

of  which  is  intended  to  be  inoculated  from  the  throat  and  the  other  from 
the  nose.  One  of  the  difficulties  of  keeping  drug  stores  and  physicians 
supplied  with  serum  tubes,  is  that  the  serum  rapidly  becomes  dry.  and 
if  used  in   this  condition,  gives   verj    unsatisfactory   results.     In  a  few 

cities  serum  tubes  are  not  sent  out  at  all,  swabs  only  being  supplied  to 
the  physicians.  This  is  done  in  most  cases  in  Columbus,  (  >..  Manches- 
ter. X.  II..  in  Minneapolis,  Nfev  Haven,  Pittsburgh, Providence,  Roches- 
ter, Springfield,  Mass.,  and  in  the  Delaware  and  New  Jersey  state  labor- 
atories. It  has  been  found  by  experience  in  these  cities  that  better 
results  by  far  are  obtained  by  this  method    than  when  poor  serum  tubes 

are  used  by   physicians,  as  the}  certainly  will  be   if   generally   distrib- 


562' 


COMMUNK  'ABLE   I)  I  SEA  SEK 


utecl.  If  the  swab  is  returned  to  the  laboratory  within  a  few  hours, 
and  rubbed  on  a  good  serum  tube,  it  gives  as  good  results  as  when  it 
is  rubbed  on  the  serum  at  once.  At  least  this  was  the  result  of  a  large 
number  of  comparative  tests  made  in  Providence.  One  advantage  of 
this  method  is  that  the  bacteriologist  is  more  likly  to  swab  the  serum 
thoroughly  than  is  the  practicing  physician.  In  Pittsburgh1  it  was 
found  that  better  results  were  obtained  from  swabs  which  had  been  kept 
even  as  long  as  a  number  of  days,  than  from  tubes  which  had  been  inoc- 
ulated at  the  bedside  and  kept  out  of  the  incubator  for  some  hours.  It 
was  explained  that  tubes  so  kept  probably  allowed  the  growth  of  sapro- 
phytic bacteria  which  obscured  the  examination,  while  no  such  result 
occurred  if  the  tube  was  inoculated  just  before  it  was  put  in  the  incu- 
bator. The  Minnesota  state  laboratory,  however,  did  not  get  quite  as 
good  results  with  swabs. 

When  a  serum  tube  and  a  swab  tube  are  sent  out  together  as  a 
"  diphtheria  outfit,"  as  is  done  by  most  laboratories,  the  two  are  en- 
closed in  a  box  which  may  be  made  of  various  materials.  In  Cam- 
bridge and  Fitchburg  the  boxes  are  made  of  copper  of  the  style  shown 
in  Fig.  37.     These  boxes  are  1  by  2  by  6  inches  in  size  and  cost  eighty 


Fig.  37. 
Diphtheria  Outfit  used  in  Fitchburg.    The  wire  is  used  for  inoculating  the  serum;  a  swab  in 
the  upper  tube  is  for  cover  glass  examinations. 

cents.  They  are  made  by  Peter  Gray  of  Boston.  The  advantage  is 
that  they  can  be  readily  sterilized  and  are  strong  and  durable.  Their 
disadvantage  is  that  they  are  expensive  and  heavy.  When  they  were 
used  in  Boston  the  department  lost  about  fifty  a  year  and  gave  them 
up  as  they  were  too  expensive.  In  Buffalo  a  round  wooden  box  with  a 
screw  cover  is  used.  In  Cincinnati  and  Denver  a  package  made  of  a 
block  of  wood  bored  with  two  holes  is  preferred.  In  New  Haven 
where  a  swab  tube  only  is  sent  out,  it  is  enclosed  between  two  grooved 


1  Pittsburgh,  Report  of  Bureau  of  Health  (1895),  p.  103. 


( ■  OMMUNIi  .  1  B  L  K    B  IS  A'. 1  5  E8. 


563 


Fig.  38. 

Swab  Bent  out  for  diphtheria  cultures   in  New  Haven,  between 
grooved  aud  hinged  blocks. 


K.-tum    K 


•pt..      trty      Hull. 


innen poh 


Fig.  39. 
Swab  used  for  diphtheria  culture;-  in  Minneapolis.    No  serum  tube  is  sent  mit. 


J^. 


Fig.  40. 
i  tiphtheria  <  (utflt  used  in  Philadelphia. 


pieces  of  wood  hinged  a1  one  end.  Fig.  38.  In  Minneapolis  the  swab 
tube  is  smt  out  in  ;i  tin  box.  Fig.  39.  In  Newark.  Ww  V«»rk  and 
Philadelphia  wooden  boxes,  as  shown  in  Fig.  l<».  have  been  adopted. 
These  cannol  be  sterilized  by  heat,  as  the}  are  glued  and  varnished, 
hut  they  iiia.\  be  washed  with  a  disinfectant  Thej  maybe  obtained  of 
Blooniinerdale  Bros.,  Third  Avenue  and  Fifty-ninth  Street,  New  York, 
at  a  cosl  of  >■•!'»  per  hundred.  The}  are  cheap,  Light,  and  fairly  durable. 
In  Baltimore,  Boston,  the  District  of  Columbia,  and  Providence, 
pasteboard   boxes  an-   preferred.     The}    are   made  of  size  to  hold  two 


564  0  OMMUNICABLE   DISEA  SE<S. 

tubes  and  cost  $7  per  1,000.  They  are  used  only  once.  Similar  boxes 
are  used  by  the  Rhode  Island  state  board  of  health  but  they  have  a 
partition  and  cost  $1  more.     Fig.  41.      In  Chicago    the   aluminum  box 


Fig.  41. 

Diphtheria  Outfit  used  by  the  State  Board  of  Health  of  Rhode  Island; 
pasteboard  box  with  serum  tube  and  cotton  swab. 

and  the  small  swab  tube  are  sent  out  in  a  tough  brown  paper  envelope. 
It  is  certain  that  the  package  containing  a  diphtheria  outfit  is  pretty 
likely  to  become  infected  and  should  not  be  sent  to  another  case  un- 
less disinfected.  The  metal  boxes  are  disinfected  when  they  are  used, 
but  the  wooden  boxes  rarely  are.  In  the  District  of  Columbia  they  were 
formerly  disinfected  by  washing  with  a  solution  of  corrosive  sublimate, 
one  to  two  hundred,  but  they  are  now  disinfected  with  formaldehyde 
gas.  In  New  York  City  they  are  disinfected.  The  pasteboard  boxes 
are  used  only  once  in  Providence  and  the  District  of  Columbia,  but  in 
Boston  they  are  disinfected  with  dry  heat  and  used  several  times.  It 
is' important  also  that  the  outfit  should  be  as  light  and  compact  as 
possible,  qualities  which  have  been  secured  in  the  Chicago  outfit.  In 
Philadelphia  the  culture  box  is  sealed  when  it  leaves  the  laboratory. 
It  also  contains  unused  seals  which  may  be  used  by  the  physicians.  In 
Boston  and  some  other  cities  a  spatula  made  of  a  thin  strip  of  soft  pine 
five  and  one-half  by  five-eighths  of  an  inch  is  supplied  with  each  outfit 
and  is  to  be  burned  at  the  house.  These  are  purchased  of  Schlegel  & 
Fottler,  seedsmen,  at  #1.25  per  thousand. 

The  culture  outfit  usually  contains  two  printed  slips,  one  contain- 
ing directions  how  to  take  the  culture,  and  the  other  being  a  form  on 
which  the  maker  of  the  culture  is  to  note  various  items  of  interest  to 
the  bacteriologist  or  the  health  officer.     Below1  is   a  form  of  direction 


Directions  for  Making  Cultures  in  Cases  of  Suspected  Diphtheria: 
"  The  patient  should  be  placed  in  a  good  light,  and,  if  a  child,  properly  held.    In 
cases  where  it  is  possible  to  get  a  good  view  of  the  throat,  depress  the  tongue  and 
rub  the  cotton  swab  gently,  but  freely,  against  any  visible  exudate.     In  other  cases, 


COMMUNICABLE   DISEASES.  565 

which  is  commonly  used  and  seems  to  be  explicit  enough,  but  physicians 
sometimes  fail  to  follow  it  on  the  first  trial.  In  Providence  where  a 
great  many  outfits  are  supplied  to  physicians  at  the  department  office, 
directions  are  not  put  in  the  boxes  there,  as  almost  all  who  call  are 
known  to  be  familiar  with  the  operation. 

In  most  cities  outfits  are  not  distributed  to  physicians  at  the  health 
office  but  are  left  at  stations  to  be  called  for  by  the  physician  when 
needed.  Experience,  however,  has  shown  that  they  are  taken  by  the 
physicians  and  sometimes  kept  by  them  a  long  time  and  used  when  very 
dry.  It  is  the  usual  custom  to  leave  these  outfits  at  various  drug 
stores  scattered  in  convenient  portions  of  the  city.  In  Buffalo  and 
Philadelphia  they  are  kept  at  police  stations  and  in  Pittsburgh  at  police 
and  fire  stations.  In  the  smaller  cities  and  towns  there  is  no  need  of 
such  a  general  distribution,  and  even  in  Cambridge  they  are  kept  only 
ai  the  laboratory  and  office  of  the  bacteriologist. 

It  is  of  course  necessary  for  the  physician  to  see  that  his  name  ami 
that  of  the  patient  accompanies  the  outfit  on  its  return,  and  most 
laboratories  have  required  him  to  note  many  other  items.  When  this 
system  was  introduced  it  might  have  been  necessary  to  ask  for  more 
information  than  now  need  be  required.  If  there  is  no  official  super- 
vision of  the  case,  the  report  of  the  physician  is  the  only  way  in  which 
information,  interesting  from  a  scientific  point  of  view  or  useful  for  the 
work  of  the  laboratory,  can  be  obtained:  but  if  the  case  is  to  be  t'ol 
lowed  up  as  it  should  be,  all  desired  information  can  be  obtained  by 
the  medical  inspector  at  his  visits.  The  less  the  physician  is  asked  to 
QOte  on  a  written  report,  the  more  satisfactory  will  it  be.  Some  ot  the 
physicians'  memoranda  which  accompany  diphtheria  outfits  have  many 
items.     See  Appendix  99. 

In  Philadelphia  the  memorandum  is  in  a  cardboard  book  ol  eight 
pages  l.l  inches  by  .">.',  inches,  which  is  tiled  away  when  returned  and 
serves  as  a  permanent  record:  it  also  has  blanks  on  it  for  the  record  o! 
the  examination.      A  card  is  sent  out    in   Baltimore,  and  on  its  return  is 

used  as  a  permanent   record.     See  Appendix  Phi. 

Including  those  in  which  the  exudate  is  confined  to  the  larynx,  avoiding  the  tongue, 
pass  ill'-  swab  [at  back,  ami  rub  it  freely  againsl  the  mucous  membrane  of  the 
pharynx  ami  tonBils.  Without  laying  the  swab  down,  withdraw  the  cotton  plug 
from  the  culture  tube,  inserl  the  swab,  and  rub  that  portion  of  if  which  has  touched 
//,.  exudaU  gently  but  thoroughly  back  "<"'  forth  over  tin  aurfaci  of  the  blood 
terum.  Do  net  push  the  swab  into  the  blood  serum,  nor  break  the  surface  in  any 
way.  Then  replace  the  Bwab  in  its  own  tube,  plug  both  tubes,  pul  them  in  the 
box,  ami  return  tin-  culture  outfit  at  once  to  die  station  from  which  it  was  obtained. 
•  \  report  will  he  Forwarded  the  following  morning  by  mail,  or  can  he  obtained  bj 
telephone,  after  L2  noon.11 

There  is  a  list  nf  stations  <»n  i  he  reverse. 


566  COMMUNICABLE   DISEASES. 

All  that  is  required  in  Providence  is  the  filling  of  the  form  shown 
below  which  is  stamped  on  the  cover  of  the  box.  All  the  other  items 
can  be  readily  obtained  in  other  wa}'s,  and  the  filling  out  of  such  a 
small  memorandum  causes  the  physician  very  little  trouble,  and  it  pays 
the  health  officer  to  trouble  the  practicing  physician  as  little  as  pos- 
sible.1 

In  Providence  the  medical  inspector  has  found  it  convenient  to  carry 
a  number  of  tubes  in  a  large  package  and  mark  each  tube.  The  tubes 
have  the  upper  two  inches  etched  with  acid  and  are  written  on  with  an 
ordinary  lead  pencil.  In  some  cities,  as  Baltimore,  New  York,  and 
Philadelphia,  a  different  memorandum,  one  containing  fewer  items,  is 
sent  out  with  outfits  intended  for  secondary  cultures,  but  as  culture  out- 
fits will  not  always  be  used  when  intended,  confusion  must  sometimes 
result. 

It  is  necessary  that  all  the  old  tubes  should  be  called  in,  and  fresh 
tubes  supplied  at  intervals.  This  is  done  every  two  weeks  in  Balti- 
more, every  six  weeks  in  Hartford,  every  two  months  in  Boston,  and 
every  three  months  in  Cincinnati.  In  Providence  all  physicians  who 
ask  for  them  are  supplied  with  swab  tubes  and  boxes  which  they  may 
keep  in  their  offices  or  buggies. 

In  some  cities,  as  Baltimore,  Cambridge,  and  Providence,  the  phy- 
sician must  return  the  inoculated  tube  to  the  laboratory,  but  usually 
outfits  may  be  returned  to  the  drug  stores  and  other  stations,  and  pro- 
vision is  made  for  their  collection  from  these.  In  New  York  City  there 
are  a  number  of  main  stations  which  the  laboratory  messenger  visits  at 
4  p.  M.  The  other  stations  send  the  boxes  to  these  before  that  time. 
In  Pittsburgh  the  sanitary  police  collect  the  tubes  at  4.45  p.  m.,  and  in 
Philadelphia  and  Buffalo  they  are  collected  by  the  police.  In  Buffalo 
as  soon  as  the  box  is  received  at  the  police  station  it  is  wrapped  in  a 
paper  with  one  edge  gummed  so  that  it  can  be  sealed  and  endorsed  on 
the  back  with  the  name  of  physician,  name  of  receiver,  and  time  re- 
ceived. 

A  list  on  a  printed  blank,  of  the  pl^sicians  and  number  of  outfits, 
is  sent  from  the  stations  each  day  with  the  package  of  boxes. 

In  Boston  the  cultures  are  sent  by  the  drug  stores  to  the  laboratory 
before  <i  p.  m.     The  messenger  receives  twenty  cents  for  each  trip,  and 


If  there 

is  any  water 

in  Se 

ruin  Tube,   Pour 

it  Out. 

Name 

of 

Patient 

Residence 

Docto 

r's 

Name 

RETURN 

TO 

CJTY  HALL. 

Date 

(  OMMUNIi  A BLE    DlsK.  I  .v/->.  537 

there  is  a  desire  on  the  part  of  druggists  to  secure  the  privilege  of  keep- 
ing outfits.  In  Newark  there  is  a  collector  of  cultures  who  receives 
$750  a  year.  In  Chicago,  Detroit,  and  Providence,  if  the  physicians 
telephone  to  the  health  department  a  messenger  is  sent  for  the  outfit. 
In  some  of  the  larger  cities  the  health  department  is  kept  open  all  night 
for  the  reception  of  diphtheria  cultures,  while  in  other  cities  the  bac- 
teriologist sometimes  has  an  incubator  at  his  house,  as  in  Cambridge, 
( Ihicago,  and  Denver. 

While  a  serum  culture  is  supposed  to  give  correct  results  in  ninety 
per  cent,  of  the  cases,  direct  examination  of  a  smear  from  the  throat  or 
the  swab  will  only  give  correct  results  in  from  thirty  to  fifty  per  cent., 
yd  >ometimes  it  is  so  desirable  to  ascertain  the  result  of  the  examina- 
tion promptly,  that  the  examination  of  the  swab  may  be  resorted  to. 
This  is  done  when  requested  in  many  laboratories.  Of  course  a  posi- 
tive result  only  is  considered  decisive  in  such  cases.  In  Boston  they  are 
made  in  from  rive  to  ten  per  cent,  of  the  cases.  In  about  the  same 
number  of  cases  an  examination  of  the  growth  on  the  serum  is  made 
alter  the  latter  lias  remained  five  hours  in  the  incubator. 

The  technique  of  the  laboratory  will  not  be  discussed,  but  only  those 
matters  which  more  directly  concern  the  relations  of  the  health  depart- 
ment to  tlie  physician  and  the  patient.  Suffice  it  to  say  that  the  very 
best  professional  work  should  be  done  with  the  greatest  care  to  avoid 
any  mistake.  In  large  laboratories  the  slides  are  often  examined  by 
two  persons,  and  two  or  three  cover  slips  arc  often  taken  from  each  cul- 
ture. In  Philadelphia  and  Buffalo  in  order  to  correct  any  mistake 
which  may  have  arisen,  the  slides  are  kept  for  one  year. 

Accurate  records  should  be  kept  of  all  examinations.  In  Providence 
the  laboratory  record  is  entered  by  the  examiner  in  a  common  blank 
Itook  as  lie  makes  the  examination,  the  principal  forms  of  organisms 
being  noted.  The  result  of  the  examination  whether  positive  or  nega- 
tive is  also  entered  on  the  record  slip  of  the  case.  In  Baltimore  and 
Philadelphia,  as  shown  above,  the  examiner  notes  his  findings  on  the 
physician's  memoranda,  which  are  preserved,  arranged  alphabetically  or 

h\    BtreetS.       In  other  cities  a  Separate  slip  is  tilled  out    by  the  examiner, 

and  in  New  York  all  slips  are  kept  in  envelopes,  on  the  outside  oi  which 
is  a  summary  of  results,  and  the  envelopes  are  arranged  in  drawers. 

Alter  the  examination  is  made  the  result  is  Bent  to  the  physician  as 
soon  as  possible.  Most  laboratories  send  their  reports  by  the  afternoon 
mail  of  the  da\    next   afteithe  taking  of  the  culture.       Most  laboratories 

offer  to  answer  all  telephone  requests  after  noon.  In  Pro\  ideme  nearly 
all  important  cultures  are  examined  before  nine  o'clock  of  the  next  day 

anil  are  telephoned    the  physicians  before  that   hour,  at    which  time  most 


568  COMMUNICABLE   DISEASES. 

of  them  go  out  on  their  morning  calls.  The  same  method  is  pursued 
in  Brookline,  Mass.  All  reports  are  telephoned  in  Cincinnati.  When 
cultures  are  examined  in  another  city  from  that  in  which  they  are  taken, 
as  when  the  work  is  done  by  the  state  laboratory,  results  are  often  tele- 
graphed at  the  expense  of  the  city  sending  the  cultures  ;  but  in  all  cases 
reports  are  sent  by  mail  even  when  they  are  also  telegraphed  or  tele- 
phoned. Communications  by  mail  are  sometimes  sent  on  postal  cards, 
as  in  Baltimore,  Buffalo,  and  Providence,  but  usually  they  are  sent 
under  seal  as  physicians  prefer  it.  Very  often  the  reports  of  positive 
and  negative  results  are  sent  on  cards  of  different  colors  or  are  printed 
in  different  colors  as  in  Boston  and  Philadelphia.  Sometimes  the  report 
simply  states  the  fact  that  diphtheria  bacilli  have  or  have  not  been 
found  in  the  culture  referred  to.  Occasionally  other  items  are  added  to 
the  report  besides  the  mere  statement  that  diphtheria  bacilli  are  found. 
In  Pittsburgh  it  is  stated  whether  the  diphtheria  bacilli  are 

1.  In  pure  culture. 

2.  Associated  with  staphylococci-stivptococci-bacterial  mixture. 

The  form  used  in  Chicago  is  shown  in  Appendix  101. 

It  is  seen  that  this  form  is  used  for  reporting  both  positive  and 
negative  results,  but  as  was  before  stated,  usually  different  and  distinc- 
tive blanks  are  used  for  reporting  positive  and  negative  results. 

Many  of  the  blank  forms  state  in  addition  that  the  case  in  all  prob- 
ability is  not  diphtheria  and  will  not  be  treated  as  such.  It  seems 
unwise  to  send  out  such  a  notice,  for  it  has  been  shown  that  the  margin 
for  error  on  the  first  culture  is  certainly  eight  or  ten  per  cent,,  and  this 
is  too  large  to  warrant  the  phrase  "in  all  probability."'  It  would  be 
better  to  call  attention  to  this  chance  of  error  and  suggest  that  if  any 
doubt  as  to  the  nature  of  the  case  exists,  another  examination  should 
be  made.     Such  a  suggestion  is  made  in  the  Philadelphia  form. 

A  certain  number  of  examinations  will  always  be  unsatisfactory  and 
indeterminate,  and  usually  in  such  cases  a  special  form  of  report  is  sent 
out,  most  of  which  have  been  copied  from  that  used  in  New  York  City. 
See  Appendix  102. 

The  Baltimore  report  adds  very  properly  that  another  culture  is 
desired. 

Besides  sending  the  report  to  the  attending  physician  the  bacteri- 
ologist in  New  York  City  sends  to  each  medical  inspector  a  list  of  all 
cases  in  his  district  which  have  that  day  been  examined  with  the  results 
of  the  examination.  In  Providence  in  those  cases  which  the  attending 
physician  has  turned  over  to  the  health  department  for  final  cultures, 
reports  of  the  results  are  sent  to  the  family. 


COMMUNIi  \  I BL  K    VISE.  1  8J8&.  569 

Tuberculosis*. 

The  aid  given  to  diagnosis  by  bacteriological  examinations  in  tuber- 
cular phthisis,  though  not  as  great  as  in  diphtheria,  is  very  important. 
Most  bacteriological  laboratories  offer  the  same  facilities  for  bacteriologi- 
cal examinations  in  phthisis  as  in  diphtheria,  but  some  do  not.  Cain- 
bridge,  Detroit.  Fitchburg,  Hartford,  San  Francisco,  and  Worcester,  and 
nmst  of  the  state  laboratories  make  this  test.  As  in  diphtheria,  explan- 
atory circulars  are  usually  sent  out  to  physicians  as  a  preliminary  to 
the  introduction  of  this  system.  In  most  cities  physicians  are  expected 
to  furnish  the  receptacle  to  contain  the  sputum.  Much  annoyance  is 
sometimes  caused  by  the  use  of  improper  and  leaky  receptacles,  and 
sometimes  suitable  ones  are  furnished  by  the  laboratory.  This  is  done 
by  the  state  laboratories  of  Delaware,  Rhode  Island,  New  Jersey,  and 
in  Pittsburgh  and  New  York  City  :  and  in  Rhode  Island  the  outfits 
are  left  at  the  same  depots  as  the  diphtheria  outfits.  The  outfit  used 
in  Rhode  Island  consists  of  a  glass  bottle  with  screw  cap  made  of  metal 
and  enclosed  in  a  stiff  pasteboard  box.  In  Pittsburgh  an  ordinary  wide 
mouth  stoppered  bottle  in  a  plain  wooden  box  is  furnished.  Accom- 
panying the  outfit  are  directions  and  a  blank  on  which  the  name  of  the 
patient  and  certain  clinical  data  are  to  be  filled  in  by  the  attending 
physician.     See  Appendices  103  and  104. 

In  New  York  unless  the  name  of  the  patient  accompanies  the 
sputum,  the  result  of  the  examination  is  not  sent  to  the  physician,  but 
a  notice  to  that  effect  is  sent  instead.  Otherwise  the  result  is  scut,  a 
positive  result  on  one  form  and  a  negative  result  on  another,  the  latter 
calling  attention  to  the  indecisive  character  of  failure  to  find  bacilli. 

A  record  book  is  kepi  for  all  examinations  and  the  data  furnished  by 
the  physicians  are  also  recorded.  A  separate  book  is  kept  for  institu- 
tions and  all  discs  are  noted  on  a  large  atlas. 

Typhoid. 

As  for  tuberculosis  so  for  typhoid,  fewer  laboratories  offer  facilities 
for  its  diagnosis  than  for  diphtheria.  The  first  step  is  the  issuing  of  a 
Circular  of  information  and  the  preparation  of  an  outfit  for  collecting 
and  sending  the  blood  to  the  laboratary.  Various  methods  arc  employed 
forthe  latter  purpose.  Theoretically  the  best  method  is  to  collect  a 
little  blood  in  a  capillary  tube,  but  practically  it  is  difficult  t<>  gel  tins 
done  properly,  and  tubes  are  rarely  provided.     In  Providence  such  tubes 

have    been    used    lo    a    Slight    extent    bill    Hot    Willi    lllUcll    success.         Ill     New 

York    City  an  outfit    is  sometimes  used    which   consists  of   a  small   glass 
bulb    in  a  wooden    box.  a    felt    vaccine    shield    and    a    bit    of    cant  liarides 

plaster.     The  latter  is  applied   t<>  the   skin  and   protected   by   the   felt 


570  COMMUNICABLE    DISEASES. 

shield.  After  a  blister  is  raised  the  glass  bulb  is  rilled  from  it  by  gravity 
and  the  end  sealed.  Fig.  42.  The  most  common  method  is  to  recom- 
mend that  the  blood  be  collected  on  a  piece  of  paper.     In  the  Baltimore 


Fig.  42. 

Typhoid  Outfit  used  in  New  York  City.    Cantharides  plaster  for 
raising  blister  and  capillary  tube  for  serum. 

city  labor  atoiy  a  piece  of  paper  2x3^  inches  is  sent  out  with  the  direc- 
tions that  about  five  large  drops  of  blood  should  be  allowed  to  dry  upon 
it.  In  Delaware  and  New  Jersey  a  piece  of  paper  four  inches  square 
is  used  folded  like  a  powder  paper.  The  Boston  outfit  is  shown  in  Fig. 
43.     The  Maryland  state  board  of  health  sends  out  small  tin  boxes  like 

Size  3*  x  44-  Inches. 


1EALTH     OEPAF 


-o 


Fig.  43. 

Typhoid  Outfit  used  in  Boston. 

those  used  in  Chicago  for  diphtheria  cultures.  These  are  sent  out  in 
pasteboard  boxes.  In  Minnesota  aluminum  foil  is  used,  and  after  the 
blood  is  gathered  upon  it  it  is  made  into  a  roll.  In  Denver,  Newark, 
New  York  City,  Pittsburgh,  St.  Louis,  and  some  other  cities,  glass 
slides  in  a  wooden  box  are  used.     See  Fief.  44. 


( '  OJfJIL  'XI CABLE    VISE.  I  sEs. 


01 


Fig.  44. 

Typhoid  Outfit  used  in  Newark. 


Ill  Chicago  a  bit  of  sterilized  mica  is  wrapped  in  a  sheet  of  paper 
and  is  enclosed  in  an  envelope  directed  to  the  health  department.  The 
mica  is  preferred  because  it  does  not  break  and  does  not  absorb  the 
blood. 

Printed  directions  accompany  the  outfit  and  also  a  blank  to  be  filled 
by  the  attending  physician.  The  form  used  in  Baltimore  is  shown  in 
Appendix  105. 

Reports  to  the  physician  must  be  made  and  sometimes  two  forms 
are  used,  one  for  negative  and  one  for  positive  reports.  In  Pittsburgh 
only  one  form  is  used  for  all  cases.  Records  are  kept  of  all  examina- 
tions, either  on  cards,  as  in  Baltimore  and   Pittsburgh,  or  in  book  form. 

Malaria. 

This  disease,  though  qoI  of  bacterial  origin,  has  received  some  atten- 
tion from  health  department  laboratories.  Most  laboratories  do  not 
offer  to  examine  blood  for  the  malarial  organism,  but  it  is  done  by  the 
state  laboratories  of  .Massachusetts  and  Maryland,  and  the  city  labora- 
tories of  Lowell  and  Baltimore.  In  Charleston  it  is  the  principal  work 
of  the  laboratory.  The  blood  is  collected  and  sent  in  on  cover  glasses 
in  the  manlier  prescribed  in  the  directions  issued  by  the  laboratory. 

Bacteriological   Laboratories  are  occupied  chiefly  in  the  diagnosis  of 

the  diseases  JU81  considered,  diphtheria,  tuberculosis,  typhoid   lever,  and 

malaria:  but  they  sometimes  offer  their  assistance  in  other  directions. 
As  a  bacteriologist  must  be  a  good  microscopist,  his  aid  ma\  sometimes 
he  asked  in  the  diagnosis  of  rallies,  actynimycosis,  glanders,  trichinosis, 
gonorrhoea,  cerebronapinal-meningitis,   or  almost    an}    parasitic  disease, 

but  it  is  seldom  that  a  public  offer  of  assistance  is  made  in  an\  of  tlie-e. 
Ileceiiib  the  bacteriologist  of  the  health  department  in  Minneapolis 
offered    assistance    iii  the    diagnosis    of    cerebro-spinal-nieiiiugitis    and    a 


572  COMMUNICABLE    DISEASES. 

number  of  cases  were  investigated  by  him  by  means  of  spinal  puncture.1 
In  Chicago  considerable  work  has  been  done  in  the  diagnosis  of  epidemic 
influenza.  The  examinations  were  made  chiefly  from  cultures  of  the 
bronchial  secretions  grown  on  blood  serum.  Some  examinations  were 
made  of  the  bronchial  secretions  direct.2  In  Boston  many  examinations 
.  are  made  for  glanders,  and  in  Minnesota  for  rabies. 

Persons  familiar  with  danger  are  apt  to  become  careless  of  their  own 
safety,  and  bacteriologists  are  no  exception  to  the  rule.  A  number  of 
cases  are  on  record  where  they  have  been  infected  during  their  labora- 
tory work.  The  health  officer  should  guard  against  this'as  against  all 
other  means  of  spreading  communicable  disease,  and  the  board  of  health 
of  New  York  City  has  adopted  rules  for  laboratory  work  which  are  in- 
tended to  reduce  the  danger  to  a  minimum.3 

1  Minneapolis,  Report  of  Health  Department  (1899),  p.  30. 

-  Chicago,  Bulletin  of  Department  of  Health  (January,  1899). 

3  Xew  York,  Report  of  Department  of  Health  (1896),  p.  222: 

"  The  following  rules  for  the  prevention  of  possible  infection  in  the  bacteriologi- 
cal laboratories  of  this  department  must  be  strictly  obeyed.  The  assistant  directors 
in  immediate  charge  of  said  laboratories  will  enforce  the  same: 

"First  —  After  handling  tubes,  bottles,  etc.,  containing  diphtheria  cultures, 
samples  of  sputum  or  any  other  possible  infectious  material,  or  any  culture  made 
from  the  same,  the  hands  must  be  thoroughly  washed  with  soap  and  water,  using  a 
nail  brush,  and  must  then  be  rinsed  in  a  solution  of  bicloride  of  mercury,  1  to  1,000. 
This  must  be  done  immediately  after  handling  such  material,  and  before  proceeding 
to  other  work. 

"Second  —  The  hands  must  be  washed  and  rinsed  as  above  when  leaving  the 
laboratory  at  the  lunch  hour,  or  at  the  conclusion  of  a  day's  work. 

"  Third  —  Desks  must  be  thoroughly  wiped  off  at  least  once  daily  with  a  solution 
of  carbolic  acid,  5  per  cent.  Floors  must  be  mopped  with  the  same  solution  at  least 
once  weekly. 

"Fourth  —  Samples  of  sputum,  diphtheria  culture  tubes  and  all  other  possible 
infectious  material,  together  with  all  cultures  made  from  the  same,  must  be  steri- 
lized as  soon  as  work  on  them  is  concluded. 

"  Fifth  —  The  blanks  accompanying  samples  of  sputum  must  be  sterilized  imme- 
diately after  unwrapping  samples. 

"Sixth  —  Vials,  receptacles,  corks,  wrappers  and  everything  accompanying 
samples  of  infectious  material  must  be  sterilized  as  soon  as  possible.11 

"  In  addition  to  the  above,  more  specific  rules  have  been  formulated  and   posted, 

regarding  the  precautions  to  be  taken  in  handling  specimens  of  sputum.     These  are 

as  follows: 

Direction*  for  Handling  Samples  of  Sputum. 

First — Receipt  of  samples: 

(a)  Remove  outer  wrappings  and  burn  them  at  once. 

(b)  Place  samples,  with  blanks,  in  metallic  box  and  cover  with  layer  of  cotton, 
moistened  with  5  per  cent,  carbolic  acid  solution. 

(c)  Wash  the  hands  with  soap,  etc. 

Second  —  Preparations  of  specimens  for  examination: 
(a)  Mark  blanks  and  specimens  for  identification. 
(ft)  Sterilize  blanks. 


( •  OMM I  WI(  A  B  L  E   BltiEA  sEs.  573 

Vaccination. 

Vaccination  is  rightly  considered  the  most  important  individual 
prophylaxis  against  smallpox  and  a  very  valuable  means  of  controlling 
outbreaks  of  that  disease.  The  ideal  condition  would  be  the  main- 
tenance of  complete  vaccination  in  every  individual  in  the  community. 
By  that  means  smallpox  would  be  entirely  abolished.  At  the  time  of 
the  discovery  of  this  measure,  it  was  hoped  and  expected  that  this 
desirable  result  would  soon  be  accomplished  :  but  the  difficulties  in 
maintaining  complete  vaccination  in  every  one  are  so  great  that  the  end 
desired  seems  scarcely  nearer  than  it  did  a  century  ago.  While  it  is 
true  that  there  are  in  the  Tinted  States,  few.  if  any,  communities  which 
are  even  approximately  protected  in  this  manner,  it  is  also  true  that 
vast  numbers  of  individual  men,  women  and  children  are  so  protected  : 
and  it  is  furthermore  true  that  in  a  majority  of  outbreaks  occurring  in 
our  cities,  vaccination  is  employed  with  great  effect  in  subduing  them. 
It  is  also  certain  that  the  vaccination  which  we  have  is  due  almost 
entirely  to  the  active  exertions  of  sanitary  officials. 

Vaccination    Legislation. 

Vaccination  legislation  is  very  largely  statutory,  though  there  are 
a  good  many  local  regulations  on  the  subject.  Federal  laws  concerning 
vaccination  operating  uniformly  throughout  the  United  States,  would 
of  course  from  a  practical  standpoint  be  the  most  desirable,  but  they 
are  not  permitted  under  our  constitution.  The  most  that  the  federal 
government  can  do  is  to  legislate  concerning  the  vaccination  of  passen- 
gers included  in  foreign  and  interstate  traffic.  Under  the  authority  of 
an  act  of  congress  the  secretaryof  the  treasury  lias  issued  the  following 
order  to  inspectors  at  foreign  ports: 

steerage  passengers  and  crew,  coining  from  districts  where  smallpox  prevails 
in  epidemic  form,  or  who  have  been  exposed  to  smallpox,  shall  he  vaccinated  before 
embarkation,  unless  t  bey  show  evidence  of  immunity  to  smallpox  by  previous  attack 
or  recent  successful  vaccination.1' 

Steamship    companies    also  require    vaccination    and    it    has  been    for 

man}  years  the  custom  of  state  and  municipal  quarantine  stations  to 
require  the  vaccination  of  immigrants.  At  Portland,  Ore.,  all  unvac- 
cinated  immigrants  are  required  to  pay  twenty-five  cents  for  being  vac- 
cinated. 


1 1  ,1  Wash  1  he  bands  \v  n li  soap,  eb  . 

(</)  Make  smears,  pul  awaj  specimens,  wipe  desk  with  b  percent,  carbolic  arid 

solnl  ion. 

(e)    Wash  1  be  hands  w  ith  soap.  etc. 

I  /')    Stain  smears  and  mount. 

[g)    Wash  tin-  hands  with  soap,  etc. 


574  COMMUNICABLE    DISEASES. 

The  general  grant  of  sanitary  power,  particularly  of  the  power  to 
legislate,  undoubtedly  confers  authority  to  make  rules  in  regard  to  vac- 
cination even  if  the  subject  is  not  specifically  mentioned.  Power  to 
"  make  rules  necessary  for  the  public  health  "  would  so  evidently  cover 
this  subject  that  it  is  rarely  named  in  ennabling  acts  even  if  other 
specific  subjects  are  referred  to.  It  is  recognized  that  nothing  can  be 
more  necessary  for  the  public  health  than  to  make  rules  for  vaccination 
and  to  provide  for  its  performance. 

It  does  however  sometimes  happen  that  special  power  is  given  by 
statute  to  make  such  rules.  Thus  in  Connecticut : J  a  The  health 
officers  may  adopt  such  measures  for  the  general  vaccination  of  the  in- 
habitants of  their  respective  towns  as  they  shall  deem  proper  and  nec- 
essary to  prevent  the  introduction  or  arrest  the  progress  of  smallpox." 
In  Michigan2  boards  of  health  may  order  the  vaccination  of  all  children 
or  others  who  have  not  been  vaccinated  within  five  years.  In  North 
Carolina,3  cities,  towns  and  counties  may  make  rules  requiring  vaccina- 
tion, and  a  similar  rule  is  found  in  Virginia,4  Colorado,5  and  Kentucky.6 
The  health  officer  in  the  District  of  Columbia,  the  board  of  health  in 
Buffalo,  and  bureau  of  health  in  Pennsylvania  cities  of  the  second  class 
have  similar  powers.  In  South  Carolina  the  state  board  of  health  may 
order  vaccination.7 

Legislation  concerning  vaccination  may  have  one  of  two  objects  in 
view.  It  may  provide  for  the  employment  of  this  method  of  combat- 
ing outbreaks  of  smallpox,  or  it  may  seek  to  secure  the  permanent  im- 
munity of  the  general  population. 

Colorado,  Indiana  and  North  Carolina  merely  authorize  the  local 
sanitary  authority  to  provide  for  vaccination  during  the  prevalence  of 
smallpox,  and  even  then  only  as  an  alternative  to  isolation.  In  Col- 
orado the  health  officer  is  "  to  order  the  prompt  isolation  or  vaccination 
of  persons  who  have  been  exposed  to  smallpox.'"  In  North  Carolina 
the  superintendent  of  health  on  the  appearance  of  smallpox  is  to  vac- 
cinate all  poor  persons  in  the  neighborhood. 

In  Indiana  it  is  a  rule  of  the  state  board  of  health  which  must  be 
promulgated  by  each  local  board  of  health  when  smallpox  occurs  or  is 
threatened,  "  to   compel  a  vaccination    or  revaccination  of  all  exposed 


1  Connecticut,  General  Statutes  (1888),  Sec.  2607. 
-  Michigan,  Compiled  Laws  (1897),  Sec.  4465. 

3  North  Carolina,  Act  of  1  March,  1893,  Sec.  23. 

4  Virginia,  Code  (1887),  Sec.  1733. 

5  Colorado,  Act  of  13  April,  1893,  Sec.  42. 

6  Kentucky,  Statutes  (1894),  Sec.  4610. 
South  Carolina,  Chapter  78  of  1899. 


COMMUNIt  ABLE    DlsE.  I  5 ES.  575 

persons.'*  Similar  provisions  are  found  in  New  Jersey,  but  this  state 
has  other  laws  as  well.  The  law  for  the  District  of  Columbia  also  re- 
quires that  all  persons  exposed  to  smallpox  shall  he  vaccinated,  and  a 
similar  ordinance  is  found  in  Mobile.  In  addition  to  this  employment 
of  vaccination,  the  statutes  in  North  Carolina  permit  the  municipalities 
to  make  rules  in  regard  to  vaccination,  and  in  the  District  of  Columbia 
allow  the  health  officer  to  order  a  general  vaccination  at  his  pleasure. 
In  New  Mexico  the  governor  may  order  vaccination  and  appoint  vac- 
cinators. In  Georgia  county  and  municipal  authorities  may  order 
vaccination  to  prevent  smallpox. 

Most  of  the  vaccination 'laws  contemplate  the  vaccination  of  the 
whole  population  or  certain  large  and  susceptible  portions  of  it.  The 
vaccination  of  school  children  has  very  generally  and  for  a  long  time 
been  considered  a  practical  and  effectual  method  of  securing  the  vac- 
cination of  the  larger  part  of  the  population  at  a  very  susceptible  period 
of  life.  It  is  argued,  and  rightly,  that  it  is  not  only  the  right  but  the 
duty  of  the  state  to  protect  its  schools  against  the  invasion  of  com- 
municable disease,  and  that  this  method  of  requiring  the  vaccination  of 
pupils  is  a  simple  and  effectual  means  of  preventing  the  invasion  of  the 
schools  by  smallpox.  It  is,  however,  unwise  to  assume  that  the  vac- 
cination which  is  required  before  entrance  into  school  will  protect 
throughout  the  school  course.  If  the  vaccination  is  performed  just  be- 
fore the  beginning  of  school  life  and  attendance  does  not  continue 
beyond  the  twelfth  or  fourteenth  year,  one  vaccinatioE  may  perhaps  be 
Sufficient  protection,  but  if  the  vaccination  is  done  in  infancy  or  school 
lite  extends  beyond  this  age  the  degree  of  protection  is  probably  \er\ 
slight.  It  is  certainly  a  grave  mistake  to  assume  that  vaccinations  in 
early  life  will  protect  a  population  when  it  has  become  adult.  It  is  this 
aSSUmptiOD  either  actually  made  by  or  attributed  to  sanitarians  by  ain.i- 
vaccinationists,  that  has  been  the  text  for  much  of    the  literature  of  the 

latter.    The  vaccination  of  school  children  is  a  valuable  means  of  keeping 

Smallpox  out  of   scl Is  and  is  successfully  insisted  on  in    many  states: 

but  to  rely  on  it  to  secure  an  adult  immune  population,  is  to  rely  upon 
a  broken  iced.  Laws  requiring  the  vaccination  of  school  children 
have   been   declared    constitutional    in    Indiana,1    Pennsylvania,2    New 

York,8  ami    (  alifornia.' 

Indiana,  Report  of  State  Board  of  Health  1 1894),  p.  384. 
-  Pennsylvania,   Report  of  State  Board  of  Health   (1895),    Vol.  11..   \>.  82.     W.  F. 
Sprague  vs.  .1.  E.  Baldwin,  </.  ,,/.,  L896. 

Brooklyn,  Report  "'  Department  •<(  Health  (1895). 

i  alifornia,   Report  of  State  Board  of  Health  (1889  90),  p.  i".     r>.  K.  Abell  »*. 
o.  ('.  Clark,  L890. 


576  COMMUNICABLE    DISEASES. 

The  following  states  have  legislation  concerning  the  vaccination  of 
school  children  :  In  several  states,  Connecticut,  Maine,  New  Jersey,  and 
Ohio,  the  governing  board  of  the  public  schools  is  authorized  to  make 
rules  excluding  all  unvaccinated  children,  but  they  are  not  directed  to 
do  so.  In  Connecticut  the  board  must  pay  for  the  vaccination  of  the 
poor.  In  Ohio  the  school  board  may  exclude  children  who  are  not  vac- 
cinated and  may  call  on  the  board  of  health  to  vaccinate  children 
whose  parents  neglect  to  do  it.  In  New  Jerse}r  the  board  of  education 
is  empowered  to  require  the  vaccination  of  all  school  children  before 
admission,  and  also  to  require  their  revaccination  if  smallpox  occurs  in 
the  city  or  district.  It  is  also  provided  that  when  the  school  census  is 
taken,  the  unvaccinated  children  shall  be  so  designated,  and  if  their 
"parents  desire  them  to  be  protected  from  smallpox  "  and  are,  in  the 
opinion  of  the  board  of  education,  unable  to  pay  for  it,  they  shall  be 
sent  to  any  physician  to  be  vaccinated,  who  shall  receive  from  the  town 
the  sum  of  fifty  cents. 

In  California,  Delaware,  Florida  for  cities  of  2,000  inhabitants. 
Iowa,1  Illinois,1  Maryland,  Massachusetts,  New  Hampshire,  North 
Dakota,1  New  York,  Pennsylvania,  and  Rhode  Island,  the  statutes  ex- 
plicitly forbid  the  attendance  at  school  of  unvaccinated  persons,  and  in 
Wisconsin  a  similar  rule  made  by  the  state  board  of  health  was  for- 
merly in  force,  but  has  recently2  been  declared  unconstitutional,  the 
state  board  of  health  not  having  such  legislative  power.  These  laws 
differ  somewhat,  although  none  of  them  are  very  extensive.  Perhaps 
one  of  the  clearest,  is  that  of  Delaware  : 3 

"  The  trustees  or  commissioners  of  school  districts,  and  boards  of  education,  are 
required,  within  one  month  after  the  passage  of  this  act,  to  oblige  all  children 
applying  for  admission  to  the  free  schools,  and  all  children  who  have  previously 
been  admitted  to  the  said  schools,  to  be  vaccinated,  unless  already  protected  froBfi 
smallpox  by  vaccination  or  by  an  attack  of  smallpox." 

Most  of  the  laws  are  made  applicable  to  public  schools  only  :  but  in 
Florida  the  superintendents  of  all  institutions  of  learning  are  to  enforce 
the  law,  and  in  Iowa  the  rule  applies  to  every  person  entering  any 
school.  A  similar  rule  is  enforced  in  the  cities  of  Denver,  Chicago, 
Cleveland,  Minneapolis,  Omaha,  and  St.  Louis. 

Though  many  of  these  vaccination  laws  are  worded  so  as  to  apply 
only  to  pupils,  yet  it  certainly  ought  not  to  be  so,  and  is  not  in  Iowa, 
where  "  every  person  entering  any  school  "  must  be  vaccinated,  and  in 

1  In  this  state  it  is  a  rule  of  the  state  board  of  health,  made  in  accordance  with 
the  statute  organizing  the  board. 

a  Wisconsin,  Supreme  Court,  23  February,  1897,  State  rx  rel  Adams  vs.  Budge 
ft.  (d.     School  board. 

3  Delaware,  Act  of  21  March,  1883,  Sec.  1. 


COMMUNICABLE    DISEASES.  077 

Florida  -iin  child  or  person  "  shall  be  admitted  contrary  to  tin-  rule. 
The  same  provision  is* found  in  the  California  and  New  York  laws. 

Most  of  the  laws  simply  require  that  everypupil  must  he  vaccinated, 
although  of  course  iliis  cannot  he  done  in  those  who  have  previously 
had  smallpox,  and  who  would  by  a  strict  interpretation  of  the  law.  he 
excluded  from  school  privileges.  The  exception  in  favor  of  those  who 
have  had  smallpox  is  made  in  Delaware,  New  Hampshire,  Pennsylvania, 
and  Cleveland.      In   California  the  law  reads: 

''provided  that  any  practicing  and  licensed  physician  may  certify  that  the  child  or 
person  has  used  due  diligence  and  cannot  ho  vaccinated  so  as  to  produce  a  success- 
ful vaccination,  whereupon  such  child  or  person  shall  be  exempted  from  the  opera- 
tion of  tins  act." 

A  still  more  important  exception  is  found  in  .Massachusetts:1 

■•  \o  child  who  lias  not  been  duly  vaccinated  shall  he  admitted  to  a  public  school 
except  upon   presentation  of  a  certificate  signed  by  a  regular   practicing  physician 

that  such  chilil  is  an  unfit  subject  for  vaccination."'' 

In  Florida2  it  is  a  rule  of  the  state  hoard  of  health  that  all  children 
shall  he  successfully  vaccinated  unless  some  reputable  physician  certifies 
thai  it  would  he  injurious  to  the  .health  of  the  child   to  vaccinate  it. 

It  without  dotiht  frequently  happens  that  a  child  is  not  in  a  suitable 
condition  lor  vaccination  hut  yet  might  very  well  lie  at  school.  It  is  to 
provide  for  such  cases  that  the  above  were  enacted  ;  hut  it  is  claimed  by 
some  that    this   provision   is  ahused.   and    many   of  the   Massachusetts 

health  officers  think  that  the  health  officer  alone  should  have  authority 
to  grant  exemptions  from  the  law.  In  Iowa  children  may  he  tempo- 
rarily excused    from  vaccination  if  they  are  not  well. 

Several  of  the  Laws  like  that  of  Delaware  merely  require  that  the 
child  be  "  vaccinated."  In  Massachusetts  and  New  Hampshire  he  must 
he  --(Inly  vaccinated."  In  Florida  and  Rhode  Island  the  vaccination 
mnsi  he  ••  successful"  and  in  Illinois  the  vaccination  must  be  "proper 
and  successful,"  and  in  the  hitter  slate  the  state  hoard  of  health  by 
whom  the  rule  is  made  have  defined  very  accurately  what  shall  he 
deemed  evidence  of  a  ••  proper  ami  successful  vaccination.'"  In  Penn- 
sylvania the  rules  of  the  state  hoard  of  health  formerly  required  thai  no 
pupil  should  be  admitted  who  had  not  been  successful!}  vaccinated  within 
seven  years.  A  similar  rule  is  found  in  Chicago,  Denver,  Omaha, 
and  Spokane,  and  in  Cleveland  the  period  is  live  years. 

( >utside  the  states  mentioned  as  Legislating  on  the  school  attendance 
of   mi  vaccinated  children,  the  important    cities  of  Cleveland,  Omaha, 

Spokane,   Mobile,    and     Denver    have    local    rules    of     a     similar    import 

1  Massachusetts,  Chapter  196  of  1898,  Sec.  LI. 

-  Florida,  Rules  of  the  State  Board  of  Health  (1897),  Rule  54. 


578  COMMTTNIt  'A BLE    DISK.  1  6'  ES. 

enacted  by  the  sanitary  authority,  and  there  are  doubtless  also  a  great 
many  smaller  places.  In  St.  Louis  it  is  a  rule  of  the  school  board  and 
has  been  sustained  in  the  courts.1  Even  in  some  of  the  states  which 
have  a  general  compulsory  vaccination  law  it  is  evidently  not  well 
enforced,  and  it  becomes  necessary  for  cities  in  such  states  to  take 
additional  precautions.  Thus  in  Louisville,  Ky.,  although  in  a  state 
where  it  is  required  that  every  child  be  vaccinated  before  it  is  a 
year  old,  there  is  a  local  regulation  requiring  the  vaccination  of 
school  children,  and  in  18942  the  health  officer  found  8,039  school 
children  requiring  vaccination.  Minneapolis,  though  in  a-  state  having 
compulsory  vaccination,  has  a  local  rule  concerning  school  attendance. 

Sometimes  the  parochial  schools  have  required  certificates  even  when 
not  compelled  to  do  so  by  law.  This  was  done  in  accordance  with  the 
direction  of  the  bishop  in  Chicago  in  1893  during  the  smallpox 
epidemic  and  in  Providence  in  1885,  when  the  importation  of  small- 
pox from  Montreal  was  feared,  but  it  was  not  continued  in  either  city. 

In  Florida  no  manufacturer  is  to  admit  an  employee  unless  vac- 
cinated. In  Massachusetts  the  law  provides  that  when  the  local  board 
of  health  orders  it,  all  manufacturing  corporations  shall  at  their  own 
expense  cause  all  their  employees  to  be  vaccinated,  and  the  superin- 
tendents of  all  institutions  for  the  dependent  and  defective  classes  shall 
do  the  same.  In  Kentucky  all  inmates  of  state  institutions  are  required 
by  law  to  be  vaccinated.  In  Connecticut  a  law  to  secure  the  vaccina- 
tion of  workers  in  paper  mills  requires  that  paper  manufacturers  shall 
bear  all  the  expense  if  any  one  of  their  employees  is  taken  sick  with  the 
smallpox.  In  Maine  the  owners  of  paper  mills  must  employ  no  one 
who  is  not  vaccinated  and  must  prepare  a  list  of  all  employees  in  Janu- 
ary and  September,  and  the  board  of  health  must  examine  the  employees 
in  March  and  October. 

The  following  is  from  Maryland: 

"  No  small  fruit-grower,  canner,  truck  farmer,  or  fish  packer  shall  take  into  his 
employ  any  person  or  persons  who  do  not  show  written  proof  of  vaccination  of  more 
recent  date  than  July,  1898.  Any  person  or  persons  violating  this  law  shall  he  fined 
nut  less  than  $50  nor  exceeding  $500."3 

The  persons  who  handle  the  rags  in  paper  mills  have  in   past  years 

been  particularly   affected  by  smallpox,  the  infection  being  carried  in 

the  rags.     The  benefits  arising  from  vaccination  have  been  so  apparent 

to  the  paper  makers  of  Massachusetts  that  the  large  manufacturers  of 

paper  have  always  been  strong  supporters  of  the  vaccination  laws  of 

that  state. 


1  St.  Louis,  Report  of  Health  Commissioner,  1895-96,  p.  44. 

2  Report  of  Health  Officer  for  year  ending  31  August,  1897,  p.  5. 
:i  Maryland,  Order  of  State  Board  of  Health,  6  March.  1899. 


( ■  OMM I  rNJ( '.  I B  L  E    D  Z3  A'.  1  S  ES.  .",  7  9 

True  compulsory  vaccination  contemplates  the  vaccination  of  the 
entire  community.  It  seeks  to  secure  immunity  from  smallpox  by 
having  every  person  in  the  community  vaccinated.  To  bring  about 
such    a   result   in   the   United  States  with  a  population  rapidly  shifting 

from  city  to  city  and  state  to  state  and  increased  each  year  by  large 
numbers  of  immigrants,  it  would  be  necessary  to  require  the  vaccination 
of  all  immigrants  and  to  have  compulsory  vaccination  laws  in  all  the 
states.  Thr  latter  we  are  far  from  having.  Given  a  state  even  with 
strict  vaccination  laws,  the  amount  of  executive  energy  and  espionage 
necessary  to  secure  their  absolute  enforcement  upon  a  shifting  popula- 
tion is  so  great  that  it  can  hardly  lie  expected  that  with  our  notions  of 
government,  it  would  be  possible  to  have  an  immune  population  except 
perhaps  for  a  brief  time  during  some  emergency.  Yet  there  are  a  good 
many  compulsory  vaccination  laws  on  the  statute  books  of  the  different 
states  and  cities,  and  great  effort  is  made  in  some  localities  to  enforce 
them.  Most  of  these  laws,  however,  provide  for  the  compulsory  vac- 
cination i'f  children.  Florida,  Iowa.  Kentucky,  .Maryland.  Massachu- 
setts, and  Minnesota  have  laws  of  this  character. 

The  Florida1  law  simply  requires  that  parents  shall  have  their 
children  vaccinated  whenever  the  health  authorities  shall  direct.  The 
Maryland  statute  is  much  the  same.  In  Massachusetts'-  the  law  requires 
parents  and  guardians  to  cause  their  children  and  wards  to  be  duly  vac- 
cinated before  they  attain  the  age  of  two  years  unless  a  regular  prac- 
ticing physician  certifies  that  they  are  unfit  subjects  for  vaccination. 
The  most  stringent  law  is  found  in   Kentucky:3 

'•All  persons  of  the  age  of  twenty-one  years  ami  over,  who  have  not  been  vac- 
cinated, or,  it  vaccinated,  not  successfully,  shall,  within  three  months  after  this 
revision  takes  effect,  procure  their  own  vaccination  or  re-vaccination,  as  the  case 
may  lie. 

••All  parents,  guardians  and  other  persons  having  t  he  care,  custody  or  control  of 
any  child  or  children,  or  who  ma\  have  in  their  employ  any  minor  or  minors,  shall 
have  the  same  vaccinated;  and  every  parent,  guardian  ami  person  that  m;i\  have  the 
care,  custodj  or  control  of  anj  child  horn  hereafter,  shall  have  said  child  vaccinated 
within  twelve  months  after  iis  birtli  or  after  it  comes  under  his  or  her  care,  custody 
mi-  conl  nil. 

"All  persons  coming  into  this  state  1 » .  abide  or  become  citizens  "ho  have  not 
been  vaccinated,  or  who  maj  have  children  under  their  care  or  control  t hat  have  not 
been  vaccinated,  shall  procure  the  vaccination  of  themselves  and  said  children  within 
six  months  aftei  coming  into  the  state.11 

In  low  ;i  o\  1  ty  person  over  one  year  of  age  must  be  vaccinated  unless 
protected.     While  compulson  vaccination  laws  are  found  in  onl}  a  lew 

'Florida,  Rules  of  the  State  Board  of  Health  (1807),  Rule  54. 
-.Massachusetts,  Chapter  515  of  1894,  Sees,  l  2. 
Kentuckj .  Mai  utes  i  1804  i,  Sees.  W08   L0. 


580  COM  Ml  WIG1  ABLE    DIKE  A  SMS. 

states,  there  are  quite  a  number  of  cities  outside  of  these  states  which 
have  local  regulations  of  like  character,  as  Denver,  Jersey  City,  Memphis, 
New  York,1  Omaha,  and  Yonkers. 

\\\  Atlanta  every  resident  of  the  city  is  required  to  be  successfully 
vaccinated  or  to  be  vaccinated  a  sufficient  number  of  times  to  make  it 
evident  that  successful  vaccination  is  impossible.  A  similar  rule  is  found 
in  Scranton. 

In  Nashville2  it  was  ordered  in  1900  that  all  persons  who  had  not 
been  vaccinated  since  1  December,  1899,  should  be,  but  the  rule  was 
not  to  apply  to  persons  seventy  years  of  age  or  over,  to  'women  more 
than  five  months  pregnant,  nor  to  any  too  ill  to  submit  to  it. 

There  are  certain  states  in  which  vaccination  is  not  made  compul- 
sory by  statute,  but  in  which  the  local  governments  are  authorized  to 
make  it  so.  Such  states  are  Connecticut,  Maine,  Michigan,  North 
Carolina,  Virginia,  and  by  their  charters  it  is  authorized  in  Buffalo,  the 
District  of  Columbia,  and  Pennsylvania  cities  of  the  second  class. 

Louisiana3  is  the  only  state  in  which  compulsory  vaccination  is  for- 
bidden by  statute. 

Up  to  the  time  of  the  introduction  of  bovine  virus  into  the  United 
States,  humanized  virus,  so-called,  was  employed  partly  in  the  form  of 
dried  lymph  on  quills,  partly  by  the  arm  to  arm  method,  but  mostly  by 
triturating  and  moistening  the  crusts.  Owing  to  the  efforts  of  Dr.  LL 
L.  Martin  of  Massachusetts  the  attention  of  the  medical  profession  was 
called  to  the  merits  of  bovine  virus,  and  Dr.  Martin  was  himself  the 
first  to  furnish  a  reliable  form  of  this  virus  in  commercial  quantities. 
The  use  of  bovine  virus  rapidly  became  popular  and  almost  entirely  dis- 
placed the  humanized  form.4  A  few  physicians  in  all  parts  of  the  coun- 
try are  found  who  prefer  humanized  virus,  but  although  it  has  been 
preferred  by  some  owing  to  the  better  results  obtained  than  from  the 
ivory  point  bovine,  it  has  not  of  late  been  much  used  on  account  of 
popular  prejudice.  Humanized  virus  one  or  two  removes  from  the  cow 
is  recommended  in  Louisville.5  For  twenty-five  years,  and  until  within 
a  year  or  two,  almost  all  the  vaccine  virus  employed  in  this  country 
was  bovine  virus  furnished  on  ivory  points. 

1  New  York  City.  Sanitary  Code  (1899),  Sec.  108. 

2  Nashville,  Order  of  Board  of  Health,  5  January,  1900. 

3  Louisiana,  Chapter  180  of  1877. 

i  Humanized  virus  has  been  continuously  cultivated  in  Providence,  R.  I.,  and  it 
is  probable  that  this  strain  is  the  only  pure  Jennerian  virus  to  be  found  in  the  United 
States.  It  has  been  employed  continuously  since  1856  by  the  public  vacainator,  and 
since  18G8  careful  records  have  been  kept  of  each  transfer.  Between  1868  and  1900 
there  were  638  transfers.  The  virus  at  the  present  time  produces  symptoms  and 
a  vesicle  precisely  like  those  described  and  figured  by  Jenner. 

5  W.  P.  White,  Louisville  Medical  Monthly,  January,  1895. 


<  OMM  I ~XI<  \  I  B  L  E    1>  ish\  j  .s  /-/>  58 1 

To  provide  or  control  the  supply  of  vaccine  virus  is   very   properly 

considered  one  of  the  functions  of  the  hoards  of  health  and  has  been 
provided  for  by  statute  in  several  states.  Some  states  provide  for  the 
supervision  and  control  of  the  vaccine  made  or  used  in  the  state.  Thus 
in  Massachusetts:1  "All  vaccine  institutions  in  the  commonwealth  shall 
be  under  the  supervision  of  the  state  hoard  of  health."  This  law  only 
provides  for  the  control  of  vaccine  made  in  the  state,  and  the  law  is  of 
little  value  as  no  penalties  are  attached.  The  New  Jersey2  statute 
attempts  a  supervision  of  the  virus  used  in  the  state  In  California  the 
virus  furnished  by  the  vaccine  agent  must  be  approved  by  the  state 
hoard  of  health.  The  Maryland3  law  compels  care  on  the  part  of  the 
physician  in  selecting-  humanized  virus.  In  Indiana  it  is  a  rule  of  the 
state  hoard  of  health  that  no  humanized  virus  shall  he  employed  except 
in  an  emergency,  and  in  Florida  bovine  virus  is  required.  The  Michigan 
statute  also  requires  that  bovine  virus  only  shall  be  used  in  public  vac- 
cinations, and  a  similar  rule  is  found  in  Denver  and  Omaha. 

\\\  only  a  lew  states  have  the  state  hoards  of  health  taken  it  upon 
themselves  to  carefully  inspect  the  places  where  virus  is  produced,  and 
to  test  tlie  virus  and  publish  the  results  of  their  investigations.  The 
state  board  of  health  of  Tennessee  during  the  summer  of  L898  directed 
the  state  bacteriologist  to  inspect  the  vaccine  virus  farms  from  which 
virus  was  sent  to  that  state.  As  a  result  of  the  investigation  the  state 
hoard  of  health  recommended  vaccine  from  three  places.  In  1896  the 
state  hoard  of  health  of  Pennsylvania4  sent  a  bacteriologist  to  examine 
the  principal  vaccine  establishments  of  the  country.     In  all  fourteen  were 


1  Massachusetts,  Chapter  355  of  L894. 
\>w  Jersey,  Public  Laws  of  L895,  p.  493,  Sec,  I: 

"Thai  it  the  board  of  health  of  the  state  of  New  Jersej  shall  ascertain  any  vac- 
cine virus,  antitoxin  or  oilier  animal  producl  sold,  or  offered  for  sale,  or  held  for 
sale  "i-  use  wit  liin  this  stair  for  prophylactic  or  remedial  purposes,  to  lie  dangerous 
t<>  human  health,  or  mi  impure  or  inert  as  te  he  inefficacious  in  rendering  immune  or 

less  susceptible  to  disease  anj  person  in  w  I i  such  product  may  he  used,  it  shall  he 

lawful  to  i'  t  he  said  hoard  ot  health  of  the  state  of  New  Jersey  to  prohibil  i  he  further 
sale  or  use  within  this  state  of  any  vaccine  virus,  antitoxin  or  other  animal  product, 
as  aforesaid,  manufactured  or  produced  bj  the  party  who  shall  have  manufactured 
or  produced  such  dangerous,  inert,  impure  or  inefficacious  product.11 

1  .Maryland.  Public  General  Laws,  Vol.  I.,  p.  786,  Chapter  257  of  1872,  see.  5i 
■\u\    physician  who  shall  knowingly  or  wilfully  use  any  virus  defective  in  its 

oat ure,  hy  having  passed  through  a  scrofulous  system,  from  liaving  been  taken  iron; 

one  laboring  under  anj  disease  of  the  skin,  chronic  sore  or  other  febrile  or  other 

disease,  during  the   progress  of  the  vaccine  disease,  or  any  crusl  which  duriffg  the 
ess  oi   said  vaccine  disease,  was  punctured  or  had  sustained  other  injury,  shall 

upon  conviction  thereof  forfeit  and   paj    a   sum  not   less   than   1100,  nor  more  than 

ft 

'  Pennsylvania,  Report   of  State    Board  of  Health  (1896),  Vol.  I.,  pp.  '-"•'.  99,  156. 


5  8  2  ( '  OMMl  Wit  A  BL  E    I)  I  SEA  SES. 

visited  by  the  bacteriologist  together  with  a  veterinary  surgeon,  and  a 
most  elaborate  and  complete  investigation  was  made  as  to  the  characters 
of  the  farms  and  the  methods  employed,  and  the  condition  of  the  virus 
produced.  Only  four  stations  were  found  worthy  of  commendation. 
The  Association  of  State  Boards  of  Health1  has  appointed  a  committee 
which  has  investigated  many  of  the  farms  with  much  the  same  results 
as  given  by  the  Pennsylvania  board.  The  committee  has  not  as  yet 
made  its  final  report  recommending  the  proper  method  of  dealing  with 
this  subject. 

Something  in  the  way  of  determining  the  character  of  the  virus 
employed,  at  least  of  that  employed  by  the  municipal  officers,  has  been 
done  b}*  several  cities  even  outside  of  those  which  furnish  their  own 
virus.  In  1895  the  bacteriologist  of  the  Chicago  board  of  health  tested 
a  large  number  of  samples  of  virus  to  determine  which  was  most  free 
from  extraneous  organisms,  and  as  a  result  of  the  tests  selected  one 
make  which  was  found  to  be  considerably  superior  to  others.2  This 
was  a  glycerinized  virus.  Since  that  time  each  lot  of  virus  received  by 
the  city  has  been  tested  :  1.  For  the  presence  of  bacteria,  moulds,  etc. 
2.  For  tubercle  bacilli.  3.  To  determine  its  vaccinal  value.  The 
virus  is  received  in  lots  of  5,000  capillary  tubes,  and  of  these  ten  samples 
are  taken  at  random  for  each  of  the  above  tests.  If  the  results  of  the 
tests  are  not  satisfactory  the  whole  lot  is  returned.  This  has  sometimes 
been  done  because  of  the  presence  of  a  large  number  of  bacteria  and 
sometimes  because  of  failure  to  "take."  No  tubercle  bacilli  have  ever 
been  found  in  this  or  in  any  of  the  numerous  samples  of  other  makes 
of  virus  that  have  been  tested.  The  department  of  health  of  Minne- 
apolis3 also  tests  the  virus  used  by  its  officers,  for  tubercle  bacilli. 
In  Brooklyn  several  makes  of  glycerinized  virus  were  tested  in  1896, 
but  all  were  found  to  contain  bacteria.4  Charleston  and  Denver  also 
test  their  virus  for  the  presence  of  bacteria.  In  St.  Louis  and  St.  Paul 
the  department  of  health  tests  virus  for  its  vaccinal  power.5 

A  number  of  states  and  cities  have  deemed  it  best  to  furnish  virus, 
and  in  some  cases  to  produce  it.  In  California6  there  is  a  state  vaccine 
agent  who  "  must  furnish  genuine  vaccine  matter  approved  by  the  state 
board  of  health  to  any  regular  practicing  physician  in  good  standing  in 


1  Conference  of  State   Boards  of  Health,  Proceedings  of  10th  and  11th  meetings, 
pp.  "A  and  70. 

2  Chicago,  Report  of  Department  of  Health  (1895-6),  p.  237. 

3  Minneapolis,  Report  of  Department  of  Health  (1S97),  p.  :!. 

4  Brooklyn,  Report  of  Health  Commissioner  (1895-0),  p.  107. 
5St.  Louis,  Report  of  Department  of  Health  (1896),  p.  112. 
"California,  Civil  Code  (1886),  Sec.  2994. 


<  ■  OMMUNIt  \  1 BLE    I)Ish\  J  SES.  5  s ; ; 

his  profession  in  this  state.  He  may  charge  and  receive  for  every 
parcel  of  vaccine  matter  furnished  the  sum  of  five  dollars,  which  is  full 
compensation  for  his  services  and  expenses."  In  Georgia  the  governor 
is  to  buy  vaccine  and  distribute  it  to  the  "ordinaries  of  counties."'  In 
Louisiana  the  state  board  of  health  is  to  furnish  "  pure,  fresh  vaccine 
matter  to  the  district  sanitary  inspectors  and  city  physicians  for  the 
purpose  of  gratuitous  vaccination,"  the  expense  to  be  borne  by  the  state 
board  of  health.  In  Maryland  the  governor  appoints  a  state  vaccine 
agent  who  is  to  have  bis  agency  at  Baltimore.  The  state  maintains  a 
vaccine  farm  and  the  product  is  distributed  gratuitously.  The  agent 
shall  advertise  monthly  in  Baltimore  and  annually  in  each  county.1  In 
.Mississippi  the  state  board  of  health  is  to  furnish  virus  to  the  local 
health  officer  when  lie  orders  it  :  but  the  health  officer  must  previously 
(or  in  emergencies  as  soon  as  possible)  certify  to  the  county  clerk  the 
ssity  for  the  order.  The  secretary  of  the  state  board  of  health 
must  keep  virus  on  hand  and  the  board  is  to  pay  for  the  same. 

The  city  of  Mobile  requires  its  health  officer  to  keep  on  hand  a 
supply  of  vaccine  virus  which  shall  be  distributed  to  physicians  free  of 
'•barge.  In  Brooklyn,  Minneapolis,  Philadelphia,  and  St.  Louis,  virus 
is  distributed  without  charge  to  private  physicians.  In  St.  Louis  the 
physician  is  obliged  to  report  on  a  blank  furnished,  the  results  of  the 
use  of  the  virus.  Such  distribution  is  not  however  common ;  but  a 
number  of  cities,  as  Chicago,  Denver,  and  Omaha,  require  the  health 
department  to  keep  on  hand  a  supply  of  virus,  presumably  for  its  own 
use. 

New  York  is  the  only  city  which  prepares  its  own  virus,  which  it 
has  done  since  L876.  In  1895  this  work  was  turned  over  to  the  bac- 
teriological laboratory  and  methods  of  producing  virus  were  thoroughly 
investigated  with  the  result  that  the  board  introduced  the  use  of 
glycerinized  virus.  The  following  is  a  description  of  the  method  em- 
ployed.2 The  vims  made  by  this  board  has  in  the  hands  of  the  writer 
given  better  results  than  any  he  has  ever  used  : 

Maryland,  Public  General  Laws  (1888),  Vol.  I.  p.  786,  Chapter  257  of  L872, 
Sec.  II  : 

"The  siatc  vaccine  agent  is  hereby  required  to  take  all  steps  accessary  to  repro- 
duce from  the  cow  true  vaccine  virus,  for  the  use  of  physicians  residing  and  prac- 
ticing medicine  and  surgery  iu  the  state,  and  slmi!  furnish  none  more  than  four  re- 
moves from  the  cow,  if  practicable,  and  none  thai  lias  not  been  produced  under  his 
own  supervision  and  direction;  provided,  thai  he  maj  take,  use  and  furnish  suoh 
vims  furnished  t<>  him  l>>   any   physician  entrusted   by  him   to  procure    the  same; 

audi  virus  noi  to  be  taken  from  the  arm  "i'  a  <liil<!  less  than  three  nths  old;  and 

the  s;ml  agent  skill  reporl  annuallj  to  the  governor,  the  particulars  of   Ins  expendi- 
tures, and  other  matters  connected  with  the  duties  of  Ms  agency." 

\.w  Fork    Reporl  of  Board  of  Health  (1896),  p.  235. 


584  COMMUNICABLE    DISEASES. 

"A  ted  heifer  calf  about  two  months  old,  in  good  flesh  and  health,  is  placed 
upon  a  bench  in  a  special  operating  room  and  strapped  on  its  side  with  one  hind  leg 
fastened  vertically  against  the  back  of  the  bench.  The  area  between  the  thighs, 
covering  about  ten  inches  square  and  including  the  teats,  is  shaved  and  washed 
with  soap  and  water,  with  hydrogen  peroxide  solution,  and  finally  with  sterilized 
water  and  then  dried  witli  sterilized  absorbent  cotton.  On  the  area  so  prepared, 
one  hundred  spots  are  then  scarified,  each  from  a  quarter  to  half  an  inch  square. 
The  blood  is  washed  away  with  sterilized  water,  and  when  the  bleeding  has  entirely 
ceased  virus  is  rubbed  on  each  spot  very  thoroughly  for  some  minutes;  the  calf  is 
then  returned  to  its  stall.  It  is  examined  on  the  third  and  following  days,  and  when 
the  vesicles  are  seen  to  be  at  the  proper  stage  of  development,  which  is  usually  on 
the  sixth  day.  the  calf  is  again  placed  upon  the  bench  and  the  whole  shaved  area 
washed  twice  with  sterilized  water  and  once  again  with  peroxide  of  hydrogen 
solution.  All  microscopic  dirt  and  crust  is  removed  and  every  scarification  is 
cleansed  as  thoroughly  as  possible;  then  with  a  sterilized  curette  each  scarification 
is  scraped  and  every  particle  of  pulp  removed  into  a  sterilized  glass  dish.  The  pulp 
taken  is  weighed,  comminuted,  and  mixed  with  a  measured  amount  of  chemically 
pure  glycerin,  by  being  passed  between  glass  rollers  on  which  the  glycerin  flows. 
There  is  thus  produced  a  brown  syrupy  homogeneous  emulsion,  which  is  then 
drawn  by  a  filter  pump  into  sterilized  glass  tubes,  which  when  full  are  sealed  in  the 
flame  at  both  ends.  Each  of  these  tubes  holds  about  twenty  cubic  centimeters. 
Capillary  tubes  of  the  mixture  are  prepared  at  the  same  time.  The  greatest  pre- 
cautions  are  taken  to  insure  cleanliness  in  the  production  and  preservation  of  t  he 
virus.  All  instruments  and  receptacles  are  sterilized,  and  the  operations  of  inocu- 
lation and  collection  are  made  as  nearly  aseptic  as  possible. 

"  Before  the  virus  from  any  animal  is  used,  first,  the  animal  is  sent  to  autopsy  and 
its  organs  are  examined  by  a  veterinarian  for  any  evidences  of  disease;  second,  two 
samples  of  the  virus  are  given,  one  to  the  bacteriologist  and  the  other  to  the 
medical  tester  of  virus,  and  no  virus  is  issued  unless  the  reports  of  the  pathologist, 
bacteriologist  and  clinical  tester  are  all  satisfactory.  The  clinical  test  consists  in 
the  inoculation  of  the  virus  by  scarification,  in  three  places  on  each  of  five  children 
who  have  never  been  previously  vaccinated.  There  is  thus  a  case  test  of  five  and  an 
insertion  test  of  fifteen  points,  and  unless  the  virus  gives  one  hundred  per  cent,  suc- 
cess in  each,  that  is,  unless  there  are  fifteen  vesicles  formed  as  a  result  of  the  inser- 
tion, the  virus  is  not  used. 

•■  When  there  is  need  for  virus,  the  contents  of  a  large  tube  are  forced  into  a  steril- 
ized burette  and  from  that  drawn  off  in  measured  amounts  into  small  sterilized 
vials,  of  which  there  are  two  sizes. one  containing  one-fifth  of  a  cubic  centimeter  for 
ten  vaccinations,  and  the  other  one  cubic  centimeter  for  fifty  vaccinations.  These 
vials  are  corked  with  sterilized  rubber  stoppers.  If  capillary  tubes  are  needed,  the 
virus  is  allowed  to  flow  into  a  sterilized  glass  box,  which  is  closed  by  a  glass  cover 
pierced  by  a  hole  which  just  admits  a  capillary  tube.  One  tube  after  another  is 
then  passed  through  this  opening  into  the  virus  and  sufficient  virus  drawn  into  each 
tube  for  one  vaccination." 

It  is  not  sufficient  that  laws  shall  require  that  persons  exposed  to 
smallpox  shall  be  vaccinated,  or  that  this  shall  be  required  of  school 
children,  or  that  general  compulsory  laws  shall  be  upon  the  statute 
books.  It  is  necessary  that  some  one  shall  see  to  it  that  these  laws  are 
enforced, 'and  it  is  also  necessary  that  some  public  officer  shall  be  en- 
trusted with  the  actual  work  of  vaccinating,. at  least  so  far  as  the  poor 
are  concerned.  All  of  this  work  naturally  falls  within  the  province  of 
the  board  of  health.      Sometimes  these  powers  and  duties  are  explicitly 


COMMUNICABLE    DISEASES.  585 

imposed  upon  it.  but  often  they  are  assumed  in  the  general  grant  of 
sanitary  power.  Some  of  these  duties  are.  however,  occasionally  thrown 
upon  other  officials. 

in  states  where  there  is  no  statutory  requirement  for  vaccination 
for  school  children,  but  where  the  authority  to  make  such  a  rule  is 
given  to  the  loeal  government,  it  is  sometimes  not  the  board  of  health 
that  has  this  authority  but  the  school  board.  This  is  so  in  Connecticut, 
Maine,  New  Jersey.  Ohio  and  St.  Louis,  it  would  seem  to  be  much 
more  logical  tor  the  board  of  health  to  decide  such  a  matter,  and  more 
logical  still  for  the  compulsory  vaccination  of  school  children  to  he  in- 
sisted on  by  state  law  if  it  is  allowed  at  all.  For  if  it  is  useful  and 
proper  in  one  community,  it  is  in  all:  hut  perhaps  if  public  sentiment 
does  not  permit  of  a  state  law  it  is  after  all  wise  to  let  such  cities  and 
towns  as  desire  the  protection  of  their  school  children  by  vaccination. 
insist  upon  it. 

The  enforcement  of  school  vaccination  law  must  primarily  rest  with 
the  school  officials,  teachers,  superintendents  and  boards  of  control. 
This  is  directly  provided  for  in  most  of  the  laws,  as  in  California.  Dela- 
ware. Florida,  Maryland,  New  Hampshire.  New  York,  .Massachusetts, 
and  in  Indiana.  Illinois,  and  Iowa,  where  the  regulation  is  made  by  the 
Btate  board  of  health,  that  board  can  call  upon  the  school  authorities  to 
enforce  it.  Sometimes  it  is  the  teacher  who  is  required  by  the  statute 
to  enforce  the  law  by  excluding  the  un vaccinated.  .More  often  it  is  the 
school  hoard  or  school  committee  who  are  supposed  to  have  full  con- 
trol of  the  teachers.  In  Maryland1  the  statute  directs  that  no  teacher 
shall  admil  an  unvaccinated  child  and  also  that  no  trustee  shall  admit 
such.  Practically  it  is,  of  course,  upon  the  individual  teachers  that  the 
labor  and  responsibilitj  of  enforcing  this  law  must  fall. 

Manifestly,  the  onh  proper  way  for  the  teachers  to  see  that  the  law 
is  obeyed  is  to  require  from  each  child  a  certificate  from  some  physician 
or  officer  that  the  child  is  vaccinated  within  the  meaning  of  the  law. 
The  teacher  of  course  is  not  usually  competent  to  determine  this  fact. 
The  Rhode  Island  law  requires  this  certificate  which  must  he  from  ;i 
** practicing  pyhsician."     Maryland    also    requires  ;i   doctor's  certificate. 

.Most   of  the  states  have    no  statute    law     on   the  suhject    hut   a  number    of 

cities  have  rules.  Thus  in  Cleveland  and  other  Ohio  cities  there  must 
he  a  physician's  certificate.  In  Omaha  and  Chicago  the  certificate  must 
be  from  the  health  commissioner  or  some  licensed  physician.  In  Den- 
ver il  must  he  from  the  health  commissioner  or  some  physician  recog- 
nized h\  him.  In  Minneapolis  it  must  he  from  a  resident  physician,  and 
in  Fitchburg  it  must  he  from  the  hoard  of  health. 

1  Maryland,  Public  General  Laws  |  1888),  Vol.  I.,  p.  786,  Art  81. 


58G  COMMUNICABLE    DISEA  SES. 

The  most  explicit  directions  concerning  the  certificate  are  not  found 
in  any  statute  or  municipal  rule  but  in  the  regulations  of  the  Illinois 
state  board  of  health.1 

In  Chicago2  a  certificate  is  not  to  be  given  unless  the  cicatrix  is 
"  not  less  than  one-third  inch  in  diameter,  depressed,  dead  white  in 
color,  characteristically  pitted,  and  perfect  in  outline."  The  value  of  the 
character  of  the  cicatrix  as  an  evidence  of  the  character  of  the  vacccina- 
tion  is  accepted  by  the  above  rules  as  it  is  by  most  physicians,  but  that  a 
very  "  bad  "  cicatrix  may  result  from  a  typical  vaccinal  vesicle  is  shown 
by  recent  observations  of  the  board  of  health  of  New  York."3 

Different  forms  of  vaccination  certificates  are  shown  in  Appendices 
106-109.  In  Maryland  the  vaccination  certificate  must  give  the  source  of 
the  virus  used.4  Of  course  a  physician  cannot  give  a  certificate  of  vaccina- 
tion immediately  after  performing  the  operation,  and  as  the  teacher  usu- 
ally desires  some  proof  that  the  child  has  attempted  to  comply  with  the 
law,  a  limited  permit  is  sometimes  issued,  as  in  New  York  City. 

In  many  places  the  teacher  simply  asks  to  see  the  certificate  and 
destroys  it  or  gives  it  back  to  the  pupil.     This  loose   method  invariably 


1  "  Before  being  admitted  as  a  pupil  in  any  public  school,  every  child  must  pre- 
sent to  her  or  his  teacher,  a  certificate  signed  by  a  legally  qualified  physician  stating 
(1)  Name;  (2)  Age;  (3)  Residence;  (4)  Date  of  Vaccination — as  near  as  may  be; 
(0)  Date  of  Examination,  accurately;  and  (7)  Result,  as  shown  on  the  child's 
person. 

"  The  date  of  examination  and  the  result,  as  shown  on  the  person  of  the  child,  are 
matters  which  the  physician  must  testify  to  of  '  his  own  knowledge.1 

"  Children  over  the  age  of  fourteen  years  (approximately,)  must  present  certifi- 
cates showing  that  they  have  been  vaccinated,  or  re-vaccinated,  as  the  case  may  be, 
subsequent  to  this  age. 

"  A  certificate  from  a  legally  qualified  physician  that  a  given  child  is  protected 
by  a  previous  attack  of  smallpox  or  varioloid;  or  that  it  would  be  dangerous  at  the 
present  time  to  vaccinate  a  given  child;  or  that  such  insusceptibility  has  been  dem- 
onstrated as,  in  itself,  amounts  to  protection  —  shall  be  accepted  by  school  author- 
ities in  lieu  of  the  '  satisfactory  evidence '  required  by  this  order. 

"  Legally  qualified  physicians  may  obtain  the  Scholars'1  Certificate  blanks  from 
teachers,  school  directors,  or  other  officers  of  public  instruction;  from  county  clerks: 
or  by  mail,  direct  from  the  Secretary's  office  at  Springfield. 

"  Returns  of  Vaccination  Certificates  (Form  No.  52)  should  be  made  on  or  before 
the  1st  of  January  of  each  year.  These  should  contain  the  names,  (and  all  other 
information  indicated  on  the  return)  of  every  child  in  attendance  who  has  not  been 
previously  accounted  for.  Such  information  is  not  necessary  concerning  the  scholars 
who  have  previously  complied  with  the  requirement;  but  it  is  desired  that  the  total 
number  of  such  scholars  in  attendance  be  reported  upon  the  Return.  All  Returns 
should  be  made  through  the  County  Superintendent,  who,  after  examination,  will 
forward  them.''1 

-  Chicago,  Report  of  Department  of  Health  (1895-6),  p.  101. 

3  City  of  New  York,  Report  of  Department  of  Health  (1890),  p.  241. 

4  Maryland,  Report  of  State  Board  of  Health  (1898),  p.  21. 


CO  MMl  WI(  \  1 JJ  L  E    I)  I  SEA  SES.  :,  s  7 

results  in  a  lax  enforcement  of  the  law.  Teachers  should  he  required 
to  keep  a  record  of  the  vaccinal  condition  of  all  pupils  for  the  inspec- 
tion of  the  superintendent  or  health  officer.  This  is  required  by  the 
Rhode  Island  statute:  hut  it  is  to  lie  feared  that  in  most  cases  the  school 
vaccination  laws  are  not  well  enforced  unless  a  lively  interest  and  super- 
vision is  maintained  by  the  health  department.  This  is  not  the  case  in 
the  writer's  own  city,  but  from  his  own  knowledge  there  are  many  towns 
in  his  state  where  the  law  is  not  well  enforced.  Reports  of  other  cities 
sometimes  show  that  the  school  department  would  he  very  lax  if  not 
assisted  by  the  health  department  as  appears  from  the  reports  of 
Ghicago,  Pittsburgh,  [leading,  Rochester,  St.  Louis,  and  Qtica.  In  New 
Jersey,  in  1898,1  of  471. ol  7  enrolled  children  in  the  schools.  106,879 
were  unvaccinated.  In  Chicago,  in  1N!>4,2  the  commissioner  of  health 
found  70,000  unvaccinated  children  in  an  enrollment  of  189,000.  It 
was  also  found  that  a  number  of  unvaccinated  children  were  attending 
school  on  a  certificate  which  was  given  by  some  physician  either  care- 
lessly or  with  wilful  intent  to  evade  the  law. 

There  seems,  however,  to  be  no  reason  why  school  authorities  should 
not  enforce  the  law.  In  Providence  the  superintendent  of  schools  sees 
that  the  law  is  obeyed  so  that  there  are  practically  no  unvaccinated 
children  in  school  and  this  without  urging  on  the  part  of  the  health 
department    whose    sole    province    is    to    offer  free    vaccination    at    its 

office. 

If  vaccination  is  to  he  required  for  admission  to  school,  it  is  both 
just  ;iinl  necessary  that  free  vaccination  should  he  afforded  for  those 
who  cannot  pay.  As  a  matter  of  practice  in  the  vaccination  of  school 
children,  public  vaccinators  are  not  apt  to  enquire  too  closely  as  to  the 
financial  resources  of  parents,  hut  vaccinate  every  child  that  can  he 
reached.  The  family  physician  cannot  fairly  complain  that  he  has  losl 
a  fee.  if  he  has  not  taken  the  trouble  to  urge  the  vaccination  of  his  clients' 
children  before  they  reach  the  scl 1  age. 

Many  of  the  state  laws  provide  for  such  gratuitous  vaccination.  In 
California,  Connecticut,  and  New  York,  the  school  authorities  are  to 
provide  lor  the  vaccination.  In  California  the  trustees  annually  or  when 
required  h\  the  state  board  "I  health  must  advertise  by  posting  in  two 
places  thai  provision  has  been  made  lor  the  five  vaccination  of  those  too 
poor  to  pay.  The  trustees  are  also  required  to  make  an  annual  census 
of  ;ill  unvaccinated  children  of  school  age,  and  to  provide  vaccination 
for  all  such  and  give  certificates,  the  cosl  t<>  he  paid  out  of  the  common 
school  moneys.     In  Connecticul  and  New   York  'he   i \    i^  to  come 

1  \rw  Jersey,  Report  "i  State  Board  of  Health  (1808),  p.  33. 
*  Chicago,  Report  of  Department  of  Health  (1894),  p.  it:;. 


588  ( 'OMMl  WICA BLE   DISEA SES. 

from  the  same  source.  In  New  York  the  school  officers  may  appoint 
a  vaccinating'  physician  (they  are  required  to  furnish  vaccine  in  some 
manner)  and  fix  his  compensation.  The  school  officers  shall  enumerate 
the  mi  vaccinated  children  of  school  age  in  their  districts,  and  shall  send 
such  as  are  unable  to  pay  to  the  aforesaid  physician  who  shall  vaccinate 
and  give  a  certificate.  The  school  trustees  shall  in  their  annual  report 
state  the  number  of  vaccinated  and  unvaccinated  children  in  their  dis- 
tricts. 

In  all  the  other  states  in  which  statutory  provision  is  made  for  free 
vaccination  it  is  the  city  or  township  which  is  to  provide  and  pay  for  it, 
and  often  it  is  the  board  of  health  or  health  officer  that  is  to  vaccinate. 
I j i  .Maine.  Michigan,  New  Hampshire,  Vermont,  and  Virginia,  the  town- 
ship is  empowered  to  provide  vaccination,  but  is  not  required  to  do  so, 
except  in  Vermont  on  order  of  the  state  board.  It  is  required  of  the 
local  government  in  Delaware,  Florida,  Kentucky,  Maryland,  Massa- 
chusetts, New  Jersey,  Ohio,  and  Rhode  Island.  In  Delaware  the  trustees 
of  the  poor  for  each  hundred  designate  some  physician  who  is  to  vac- 
cinate all  poor  children  who  apply  and  give  them  certificates.  In  Mary- 
land if  no  physician  has  been  regularly  appointed  public  vaccinator,  a 
child  unable  to  pay  may  apply  to  any  physician  who  may  vaccinate  and 
on  making  an  affidavit  of  the  facts,  can  collect  a  lee  of  fifty  cents  from 
the  town.  In  New  Jersey  much  the  same  plan  is  followed.  The  school 
census  shall  show  whether  each  child  is  vaccinated,  and  if  a  child  is 
unvaccinated  and  in  the  opinion  of  the  school  authorities  is  unable  to 
pay,  a  permit  is  given  for  the  child  to  go  to  any  physician,  and  such 
physician  may  vaccinate,  and  by  presenting  to  the  township  such  per- 
mit with  the  endorsement  that  the  vaccination  was  successful,  shall 
receive  fifty  cents. 

In  Rhode  Island  the  towns  are  required  to  appoint  vaccinating  phy- 
sicians and  fix  the  fee.  The  physicians  are  to  give  due  notice  of  public 
vaccination  and  are  to  record  in  a  book  the  name  of  each  child  vaccin- 
ated and  deposit  the  same  with  the  town  clerk.  The  clerks  may  charge 
fees  for  copies,  i.  e.,  certificates  of  vaccination.  Almost  always  the  cer- 
tificates are  given  by  the  physician  and  the  records  are  not  often  con- 
sulted. 

Such  are  the  school  laws  and  the  statutory  provisions  for  their 
enforcement.  Let  us  see  what  the  cities  and  townships  do  in  executing 
them. 

In  a  lew  cases,  as  shown  above  in  Maryland  and  New  Jersey,  the 
statute  provides  for  the  vaccination  of  the  poor  by  any  physician,  and 
in  Scranton  a  similar  rule  is  in  force,  only  the  physician  is  to  collect 
from  the  city  his  regular   fee:  but   most   cities  and   townships  appoint 


( ■  OMMl  XIi  \  1 BL  E    D  TSEA  S  ES.  ;,  s  < i 

one  or  more  physicians  as  public  vaccinators  who  are  to  do  all  the 
gratuitous  vaccination.  In  small  communities  the  health  officer  fre- 
quently adds  tn  his  other  duties  that  of  public  vaccinator. 

The  charter  of  the  City  of  New  York.  Sec.  1225,  provides  expressly 
for  the  appointment  by  the  hoard  of  health  of  such  vaccinators.  In 
Fall  River1  the  clerk  of  the  hoard  of  health,  who  is  not  a  physician,  dues 
the  vaccinating  under  the  direction  of  the  city  physician. 

There  are  three  general  ways  in  which  these  vaccinators  may  accom- 
plish the  object  desired. 

First.  Due  notice  may  lie  given  that  the  vaccinator  will  he  at  a 
certain  place  at  a  certain  time  to  vaccinate.  In  country  places  and 
small  towns  this  is  very  frequently  the  doctor's  office  at  the  doctor's 
office  hours;  the  doctor,  of  course,  taking  the  precaution  to  provide 
himself  with  a  sufficiency  of  virus  at  the  beginning  of  school  terms  when 
his  services  are  most  in  demand.  In  large  communities  the  vaccination 
is  usually  done  at  the  hoard  of  health,  if  its  office  is  at  some  convenient 
place.  In  Cincinnati  the  physicians  to  the  poor  vaccinate  at  their 
offices.  In  Providence  public  vaccination  is  every  Friday  at  -  v.  m., 
except  during  July  and  August.  In  Syracuse  vaccination  is  done  at 
the  City  Hall  two  days  in  the  week.  The  rules  of  the  San  Francisco 
hoard  of  health  require  thai  the  health  officer  shall  offer  tree  vaccination 
each  day  and  advertise  the  time  and  place  in  two  papers.  New  York 
City,  Brooklyn,  and  St.  Louis  have  live  vaccination  daily  at  the  central 
office  of  the  health  department,  and  Chicago  formerly  did,  but  this  lias 
been  given  up  in   that  city  because  it   was  believed  to  he  harmful  to 

crowd  together  so  many  children  as  appeared  at  such  times.2  In  Pitts- 
burgh, on  the  other  hand,  the  health  officer  recommends  that  the  vac- 
cination at  the  schools  he  given  up,  and  that  free  public  vaccination 
he  held  twice  each  year  in  each  ward.  In  those  cities  where  a  number 
of  vaccinating  physicians  are  appointed  for  house  to  house  work,  they 
are  usually  also  required  to  vaccinate  those  who  come  to  their  offices. 
The}  must  in  Philadelphia  have  in  front  of  their  office  -  Vaccine 
Physician.  Ward  ."     In  Providence  tree  vaccination  except  dining 

outbreaks  of  smallpox  is  taken  advantage  of  almost  exclusively  03  chil- 
dren   under   School    age    or    those    ahoiit    to    cuter    school.       The    liuuiher 

vaccinated   in    1899   was   2,863,  which    is  probabl}  not  much  under  the 

number  of  new   children  entering  the  schools  that  year. 

A  second  method  of  securing  the  vaccination  of  school  children  and 
at  tin-  same  time  aiding  in  the  enforcement  of  the  law  is  lor  the  public 
vaccinator  to  visit  each  school  and  vaccinate  all   unvaccinated    children. 


!  Fall  River,  Report  oi  Department  of  Health  (1895),  p.  12. 

■  Chicago,  Report  of  Department  ol  Health  (1896),  pp.  :;  :m<l  '.'7. 


590  (  OMMl  XI<  ABLE    DISEA  SES. 

One  difficulty  with  this  method  is  that  it  interrupts  to  some  degree  the 
routine  of  school  work.  Another  is  that  it  is  liable  to  cause  friction 
and  trouble  with  parents.  The  latter  may  seriously  object  to  having 
the  public  vaccinator  perform  the  operation.  As  such  parents  are 
violating  the  law  by  sending  their  unvaccinated  children  to  school, 
they  have  no  moral  ground  for  complaint  against  the  vaccinator  who 
makes  them  conform  to  the  law,  but  that  does  not  prevent  their  making- 
talk,  and  talk  of  such  kind  is  bad,  particularly  if  there  is  already  much 
of  an  an ti -vaccination  sentiment  in  the  community.  In  Brooklyn  this 
school  vaccination  resulted  in  a  suit  against  the  health  department  and 
the  vaccinator  by  an  aggrieved  parent,  but  with  a  final  decision  in  the 
supreme  court  against  the  plaintiff.1 

This  method  of  vaccinating  school  children  has  recently  been 
adopted  in  Chicago  in  place  of  free  vaccination  at  the  city  hall.  It  is 
also  followed  in  St.  Louis,  Buffalo,  Brooklyn,  Pittsburgh,  Syracuse  and 
many  other  cities,  and  is  also  frequently  adopted  in  small  towns  and 
country  districts.  In  St.  Louis  there  are  six  vaccinators  who  visit  the 
parochial  as  well  as  the  public  school.  In  Buffalo  and  Newton,  Mass., 
the  city  physicians  do  this  work.  The  medical  inspectors  of  schools  do 
some  vaccinating  in  the  schools  of  Boston. 

Lastly  there  ma}T  be  employed  house  to  house  visitation  for  the  pur- 
pose of  finding  and  vaccinating  all  unvaccinated  school  children  ;  but 
this  method  is  usually  adopted,  not  exclusively  for  this  purpose,  but  to 
enforce  general  compulsory  vaccination  laws,  or  in  the  absence  of  such 
laws  to  secure  by  persuasion  as  immune  a  population  as  possible. 
Such  house  to  house  vaccination  is  not  usually  carried  on  except  in  the 
case  of  outbreaks  or  threatened  outbreaks  of  smallpox.  In  a  few  cities, 
however,  it  is  employed  as  a  regular  routine  every  year.  Among  cities 
which  do  this  may  be  mentioned  Baltimore,  Charleston,  Philadelphia, 
and  Wilmington.  In  Baltimore  and  Philadelphia  there  is  one  public 
vaccinator  for  each  ward,  and  in  Wilmington  there  are  four  vaccination 
districts  and  one  physician  for  each  district.  The  rules  governing  these 
vaccinators  in  Philadelphia  are  given  below. - 

1  Brooklyn,  Report  of  Department  of  Health  (1895),  p.  114. 

2  Philadelphia,  Rules  of  the  Board  of  Health  (1895),  Sees.  290,  294,  295: 

"  The  vaccine  physicians  shall  each  furnish  the  board  of  health  quarterly  with  a 
list  alphabetically  arranged  of  the  names,  ages,  birthplaces,  residences  and  occu- 
pations (and  when  children,  of  the  occupation  of  their  parents)  of  the  persons 
whom  he  may  have  successfully  vaccinated.  In  making  up  the  list,  place  the 
"  primary"  and  "secondary"  cases  (re-vaccinations)  on  separate  sheets. 

"The  vaccine  physicians  are  required  to  send,  every  montfi,  to  the  chief  clerk  of 
the  board  of  health,  an  approximate  statement  of  the  number  of  successful  opera- 
tions. 

"It  shall  be  the  duty  of   the  vaccine  physician  to  call  on  each  and  every  family 


COMMUNICABLE    DISEASES.  59] 

In  Wilmington  the  vaccine  physicians  who  receive  a  salary  of  $100 
per  annum  are  to  make  quarterly  visits  through  their  districts.  All 
persons  vaccinated  by  them  must  be  seen  twice  after  the  insertion  of 
the  matter,  and  the  name,  age.  color  and  residence  of  each  person  vac- 
cinated must  be  reported  to  the  council  at  the  end  of  each  year.1 

There  are  twenty-three  vaccine  physicians  in  Philadelphia,  and  in 
1894  and  in  1895  they  vaccinated  about  30,000  persons  each  year.  In 
L896  about  18,000  were  vaccinated.2  In  Baltimore  in  1897  the  twenty- 
two  vaccinators  made  33,733  calls  and  vaccinated  12,905  persons,  of 
whom  10,188  had  not  been  vaccinated  before.  They  gave  10,447  cer- 
tificates.3 In  1899  thirty  extra  vaccinators  vaccinated  60,000  persons. 
In  Chicago  in  IS'.1*  ^'»(i  physicians  vaccinated  1^7.402  persons  at  a  cosl 
for  services  and  virus  of  $12,397.66.4  In  New  York  house  to  house 
visits  are  made  every  year  through  the  tenement  house  districts,  ten 
vaccinators  being  employed. 

Vaccinators  must,  of  course,  keep  accurate  records  of  all  their  work. 
These  records  may  be  kept  in  a  large  permanent  record  hook  if  the 
work  is  done  at  an  office,  or  in  small  memorandum  hooks  if  it  is  done 
from  house  to  house.  In  the  District  of  Columbia  a  separate  slip  is 
sent  in  for  each  person  and  the  slips  for  each  vaccinator  for  a  week  are 
filed  in  a  properly  endorsed  envelope. 

The  payment  made  to  public  vaccinators  varies.  They  rarely 
receive  a  regular  salary  for  such  work  exclusively.  In  Baltimore  the 
salary  is  $900  per  annum,  in  Chicago  $1,000,  in  St.  Louis  $75  per 
month,  in  New  York  City  $1,200,  in  Brooklyn  $1,000,  in  Syracuse 
$500,  and  in  Wilmington.  Del..  $100.  Sometimes  they  are  paid  a  fee 
lor  each  successful  vaccination,  though  often  it  is  for  each  person  vac- 
cinated. In  Mississippi  the  fee  is  twenty  cents  for  the  lirst  300,  fifteen 
cents  tor  all  over  300  and  up  to  500,  and  twelve  and  one-half   cents  for 

all  over  500.  In  Providence  and  Reading  the  fee  is  twenty-five  cents 
and  in  Providence  the  vaccinator  furnishes  virus  (humanized).  In 
that  city,  in  the  house  to  house  vaccinating  in  1885,  fifteen  cents  was 
paid,  which  is  entirely  too  little.     In  Delaware,  Maryland,  New    Jersey, 

residing  in  the  ward  or  wards  for  which  he  maj  be  elected,  and  inquire  whether 
any,  and  if  any,  what  members  thereof  may  be  Liable  to  smallpox  <lisc;i-,r.  ami  if  he 
find  any  person  or  persons  so  liable,  he  shall  offer  gratuitously  his  services,  as  vac- 
cine physician  <>!'  the  ward,  t"  vaccinate  Buch  person  or  persons.  The  vaccine 
physician  shall  receive  forty  cents  for  each  ami  ever;  i :ase  of  su<  cessful  vaccination 
performed  in  any  part  of  the  City  of  Philadelphia." 

Wilmington,  Ordinances  of  9  February,  I860,  and  28  December,  1882. 
Philadelphia,  Bepori  of  Bureau  of  Health  (1896),  p.  55. 
Baltimore,  Bepori  of  Health  Department  (1897),  p.  61. 
'Chicago,  Bepori  of  Health  Department  (1897-8),  p.   19. 


5  < )  2  C  OMMUNICABLE   B  ISM  A  sKs. 

Philadelphia,  and  Pittsburgh  the  fee  is  fifty  cents.      In    Scranton  the 

vaccinator  receives  his  usual  office  fee. 

Methods  of   Vaccination. 

For  the  following  facts  the  writer  is  indebted  almost  entirely  to  the 
kindness  of  Dr.  William  N.  Swift,  of  New  Bedford,  who  collected  the 
data  for  a  paper  read  before  the  Massachusetts  Medical  Society,  1  June, 
1894. 

Formal  rules  for  vaccinators  are  found  in  only  a  few  cities,  as  Boston, 
Philadelphia,  and  Chicago. 

Form  of  Virus.  As  has  been  said,  bovine  virus  has  formany  years 
been  almost  the  only  virus  used  in  the  United  States.  Sometimes  in 
epidemics,  owing  to  the  difficulty  of  getting  a  sufficiency  of  this  virus, 
it  has  been  necessary  to  fall  back  upon  the  humanized,  but  more  often 
the  reverse  has  proved  true  and  the  bovine  has  proved  of  great  value  in 
a  sudden  outbreak  because  a  considerable  quantity  could  be  immedi- 
ately [inrch ased  of  the  producers.  The  great  advantage,  however,  of 
the  bovine  virus  is  that  it  effectually  does  away  with  the  reason  for  any 
popular  complaint  as  to  the  danger  of  the  transmission  of  syphilis  or 
other  human  disease.  Until  very  recently  most  of  the  bovine  virus  used 
was  furnished  on  ivory  points,  the  tips  of  which  are  coated  with  lymph 
which  flows  after  removing  the  surface  of  the  eruption  on  the  animals 
inoculated.  These  points  are  usually  furnished  in  metallic  cases  con- 
taining ten  each.  Single  points  are  sold  in  envelopes.  In  some  cases,  and 
this  is  a  better  way,  the  points  are  sold  in  glass  bottles,  and  in  others 
they  are  wrapped  in  paper  and  rubber  or  other  protecting  covering. 
When  sent  out  in  metal  they  should  first  be  wrapped  in  cotton. 

Very  recently  a  large  amount  of  virus  has  been  furnished  in  capil- 
lary tubes.  This  method  has  become  popular  because  of  the  great 
advantage  possessed  by  virus  which  is  mixed  with  from  forty  per  cent, 
to  sixty  per  cent,  of  glycerine.  Such  virus  soon  becomes  nearly  or  quite 
sterile,  and  unless  infection  takes  place  during,  or  subsequent  to  the  in- 
oculation, always  gives  rise  to  a  typical  Jennerian  vesicle.  Alms  on 
points  on  the  other  hand  is  very  apt  to  be  infected  with  pus  producing 
organisms.  This  glycerinized  virus  is  usually  sent  out  in  capillary 
tubes.  These  tubes  are  generally  hermetically  sealed  at  both  ends  but 
sometimes  they  are  sealed  with  wax.  The  national  vaccine  establish- 
ment at  Washington  sends  out  glycerinized  lymph  in  small  parafine 
vessels,  into  each  of  which  an  ivory  point  is  sealed  with  parafine.  Mul- 
ford  &  Co.  have  a  similar  contrivance  made  of  glass  and  sealed  with 
parafine. 

Most  of  the  lymph  tubes  contain  enough  for  one  vaccination  only, 
but  the  Lancaster  Company  put  up   tubes  containing  enough  for  ten, 


COMMUNICABLE    DISEASES.  593 

twenty,  and  fifty  vaccinations.  Some  of  the  makers  furnish  a  small 
rubber  tube  for  attaching  to  each  capillary  tube  so  that  the  virus  may 
be  blown  out.  The  Welker  Company  furnishes  a  large  rubber  bulb 
for  that  purpose,  the  Mulford  Company  a  smaller  bulb  (1-2  inch  in 
diameter). 

The  Xew  York  City  board  of  health  also  sends  out  virus  in  glycer- 
inized  sterile  vials  corked  with  sterilized  rubber  stoppers.  These  are  of 
two  sizes,  one  containing  0.2  c.  c.  for  ten  vaccinations  and  the  other 
1.  c.  c.  tor  fifty  vaccinations. 

Humanized  virus  was  until  recently  used  almost  exclusively  by  the 
health  department  in  Providence  and  was  employed  also  somewhat  in 
Philadelphia.  Sometimes  small  quills  are  charged  from  the  vesicle  on 
the  eighth  day,  and  are  usually  used  the  same  day,  but  more  often 
crust-  ;ue  employed.  The  crusts  are  prepared  by  trituration  and  the 
powder  is  made  into  a  paste  with  a  little   glycerine  and  water. 

Implements  for  Inoculation.  Probably  most  of  those  who  make  use 
of  ivory  points  use  the  point  itself  for  scarifying.  If  care  is  taken  to 
have  sterile  points  this  does  away  with  any  danger  of  infection  such  as 
might  come  from  a  lancet.  The  tise  of  the  point,  however,  is  a  little 
more  painful  than  the  use  of  the  lancet,  so  that  the  latter  is  preferred  by 
many.  Another  instrument,  a  simple  scarifier,  is  sometimes  used  by 
public  vaccinators  and  is  occasionally  furnished  by  the  producers  of 
virus. 

Since  the  use  of  virus  in  liquid  form  has  become  more  popular, 
needles  are  quite  frequently  used  and  are  very  generally  furnished,  one 
for  each  inoculation.  This  has  been  the  practice  in  New  York  City, 
Denver,  St.  Paul,  and  .Minneapolis.  The  use  of  separate  needles  or  of  the 
ivory  points  for  puncture  or  scarification,  provided  they  are  surgically 
clean  as  they  can  readily  lie  made,  easily  solves  the  problem  of  aseptic 
instruments.  For  those  who  prefer  a  lancet,  it  is  not  so  easy  to  secure 
asepsis.  ( >f  t  he  ninety-nine  cities  which  replied  to  Dr.  Swift's  enquiries 
only  Cambridge,  Chicago,  I'tica,  Newton,  Newburyport,  Mass..  Peters- 
burg, Y;i..  and  St.  Paul  reported  that  the  instruments  were  sterilized. 
Cambridge,  Chicago,  and  St.  Paul  stated  thai  when  a  scarifier  was  used 
it  was  heated  after  each  operation,  and  in  Newton  the  Lancel  is  thor- 
oughly boiled  before  use  and  then  dipped  in  boiling  water  for  five  min- 
utes after  each  vaccination. 

Cleansing  the  Arm.  Thirty-nine  of  the  ninety-nine  cities  reported 
thai     the    arm     was    washed    before    vaccination,  but    in    not     more    than 

twenty-eighl    was  it   claimed   thai   the   practice  was  constant.     Several 

state  thai    the  arm  was  washed    with   water,  and    one  or    two  that   it    was 

washed  with  soap  and  water.     In  Asbury  Park  one  person  prepares  the 


594  COMMUNICABLE   I)  I  SEA  SES. 

arm  by  washing  and  another  vaccinates.  Bangor,  Me.,  reported  that 
the  arm  was  washed  with  soap  and  water  followed  by  a  ten  per  cent, 
solution  of  carbolic  acid.  In  Lewiston,'  Me.,  it  is  washed  with  carbolic 
acid  or  corrosive  sublimate.  In  St.  Paul  a  five  per  cent,  carbolic  acid 
solution  is  used.  One  of  the  Boston  vaccinators  used  a  one  to  five 
thousand  solution  of  corrosive  sublimate,  and  in  Council  Bluffs  a  one 
to  two  thousand  solution  is  used  which  is  then  washed  off  with  sterile 
water.  In  Minneapolis  listerine  is  used,  and  in  Fitchburg,  at  times. 
creolin.  In  Elizabeth,  N.  J.,  Milwaukee,  and  New  Bedford  the  arm  is 
washed  with  alcohol.  In  Chicago  the  rule  is  that  vaccinators  shall 
refuse  to  vaccinate  a  dirty  arm  or  a  person  with  dirty  clothing.  In  all 
cases  they  are  instructed  to  thoroughly  wash  the  arm  before  vaccinating. 

From  the  above  it  may  fairly  be  assumed  that  while  in  about  a  third 
of  the  larger  cities  of  the  United  States  some  attempt  is  made  to  wash 
the  dirt  from  the  arm  to  be  vaccinated,  this  precaution  is  even  in  those 
cities  neglected,  and  there  is  usually  very  little  sincere  effort  made  to 
secure  a  really  aseptic  skin. 

Methods  of  Inoculation.  By  far  the  most  common  method  is  to 
scarify  a  portion  of  the  surface  and  rub  in  the  virus.  Minneapolis  was 
the  only  city  which  reported  that  puncture  which  was  done  with  a 
needle  was  the  routine  method  employed.  The  skin  is  drawn  tight  and 
a  good  sized  needle  used.  It  is  now  rarely  done  in  that  city.  A  lancet 
is,  however,  sometimes  used.  The  New  York  City  board  of  health1 
recently  made  a  series  of  tests  to  determine  which  was  the  best  way  to 
vaccinate,  by  scarification  or  by  puncture.  These  scarifications  were 
about  three-eighths  of  an  inch  square  and  made  with  a  needle,  and  the 
puncture  was  made  by  placing  a  drop  of  virus  on  the  point  of  a  lancet 
and  inserting  it  obliquely  into  the  skin.  It  was  found  that  the  former 
method  was  more  certain  to  result  in  inoculation  and  the  latter  was  freer 
from  chance  infection,  but,  on  the  whole,  was  not  so  desirable  as  scarifica- 
tion. 

In  scarifying  all  operators  agree  that  it  is  very  desirable  not  to  draw 
blood,  but  only  to  scrape  off  the  outer  layers  of  the  epidermis.  Troy  and 
Providence  reported  that  the  scarifications  cover  one-half  square  inch. 
New  York  City  has  after  careful  experiment  decided  upon  three-eighths 
of  an  inch.  In  Wilmington,  Del.,  the  prescribed  size  is  one-fourth  inch, 
and  in  Boston  one-eighth  inch.  All  agree  upon  the  skin' over  the  inser- 
tion of  the  left  deltoid  as  the  best  place  to  vaccinate,  but  an  inspection 
of  many  arms  vaccinated  by  many  operators  would  lead  one  to  think 
that  few  are  particular,  and  that  almost  anywhere  on  the  outside  of  the 


1  New  York  City,  Report  of  Board  of  Health  (1896),  p.  241. 


(  nynirxKABLE  disk.  i  ses.  595 

arm  will  do.  Some  persons  insist  on  being  vaccinated  on  the  thigh. 
When  quills  or  ivory  points  are  used  they  are  first  moistened,  and  no 
city  reported  using  sterile  water  for  this.  In  Troy  the  skin  is  moistened 
at  the  point  of  scarification.  The  virus  is  then  rubbed  into  the  abrasion, 
When  liquid  virus  is  used  it  may  be  worked  in  with  the  lancet  or 
needle  :  but  a  number  of  producers  send  out  little  smooth  flattened 
sticks  to  be  used  for  this  purpose.  Tests  made  by  the  New  York  board 
of  health  showed  that  it  was  very  essential  to  rul»  the  virus  into  the 
point  of  scarification  very  thoroughly.  When  it  was  merely  smeared 
on  it  was  much  less  likely  to  take.  Jersey  City  reported  that  the  skin 
is  draw  n  tight  and  the  virus  is  rubbed  in  for  three  minutes.  In  Chicago,' 
Providence,  and  doubtless  in  many  other  cities  the  virus  is  rubbed  into 
the  scratches  which  are  drawn  open  by  keeping  the  skin  tense. 

It  has  been  claimed  by  many  that  it  is  better  to  have  a  number  of 
points  of  inoculation,  and  such  is  very  generally  the  practice  in  European 
countries.  In  the  ninety-nine  cities  investigated  by  Dr.  Swift,  the 
number  of  insertions  is  as  follows: 

"In  fifty-one  cities  it  is  the  custom  to  vaccinate  at  one  point;  in 
twenty-six  cities  at  two  points:  in  eleven  cities  at  one  or  two  points; 
in  three  cities  at  three  points:  in  one  at  four  points;  in  one  at  five 
points;  in  one  at  one  to  four  points:  in  one  at  two  to  five  points,  anil 
in  two  the  answer  was  variable. 

••The  cities  where  it  is  tin-  custom  to  vaccinate  atone  point  include 
Chicago,  New  fork,  San  Francisco,  Philadelphia,  Washington,  New 
Orleans,  Brooklyn,  Detroit,  Xew  Haven,  Portland,  Me.,  Richmond,  Va., 
Lowell  and  Lynn,  Mass. 

"It  is  the  custom  to  vaccinate  at  two  points  in  Boston,  St.  Louis, 
Milwaukee,  Pittsburgh,  Pa.,  Worcester,  Mass.,  Savannah,  Ga. ;  at  three 
points  in  Providence.  In  St.  Paul,  .Minn.,  two  t<>  five  insertions  are 
made,  and  at  Minneapolis,  Minn.,  five  insertions  were  formerly  made, 
but  at  present  usually  only  one." 

After   Treatment.      All  agree  that   the  arm  should  be  dry,  that   is,  the 

exuded  lymph  or  blood  should  have  coagulated  before  i he  sleeve  is 
drawn  over  it.  This  Is  required  rather  to  prevenl  the  rubbing  off  of 
the  virus  than  to  prevent  the  rubbing  in  of  septic  matter.  The  only 
objei  'ion  to  glycerinized  virus  is  that  it  dries  so  bIowIj  that  the  patients 

are  kept  waiting  a  long  time  and  on  this  accounl  the  public  vaccinators 

in    Boston  decline  to  use  it. 

In  twenty-six  of  ninety-nine  cities,  protection  of  the  point  of  inocu- 
lation or  of  the  vesicle  is  Bometimes  resorted  to  and  in  most  of  these  it 

is  the  rule.       Iii   I  but  fold,   Milwaukee,  and    New    York  <it\   a    loose  soft 

cotton  or  linen  bandage  is  used  to  protect  from  the  harsher  sleeve,  and 


596  COMMUNICABLE   DISEASES. 

in  the  latter  city  it  is  sewed  into  the  sleeve.  In  St.  Paul  this  is  used 
only  when  colored  underclothes  are  worn.  It  is  probable  that  this  is 
more  often  advised  than  actually  supplied.  In  Lewiston,  Me.,  and 
Utica  a  bandage  of  sterile  gauze  is  used.  In  Allegheny,  Bangor,  Du- 
buque, Grand  Rapids,  Harrisburg,  Lowell,  and  Rockport,  111.,  court 
plaster,  adhesive  plaster,  or  isinglass  plaster  have  been  used  immediately 
over  the  point  of  inoculation.  In  Allegheny  the  court  plaster  is  curved 
over  the  vesicle  to  protect,  being  attached  only  at  the  edges.  In  Coun- 
cil Bluffs  a  corn  plaster  is  put  over  the  point  of  inoculation  and  protected 
by  a  bandage.  Newton  covers  the  insertion  with  oil  silk  or  gutta 
percha  and  fastens  the  edges  with  collodion.  In  Providence  various 
methods  of  protecting  the  vesicle  were  tried,  such  as  large  corn  plasters, 
wire  cao-es,  and  absorbent  cotton  fastened  with  collodion.  None  of 
these  were  very  satisfactory,  but  the  latter  was  the  best.  The  vaccina- 
tor in  Wilmington,  Del.,  describes  his  method  of  protection  as  follows : 

"  Cut  two  pieces  of  carbolized  gauze  each  ten  layers  thick,  one  and  one-fourth 
inches  wide  and  two  inches  long.  In  one  of  these  pieces  cut  an  ellipse  one  and  one- 
quarter  by  three-quarters  inches  and  place  the  piece  of  gauze  on  the  arm  so  that  the 
opening  comes  over  the  wound.  Place  the  other  piece  of  gauze  over  this  and  strap 
the  whole  on  to  the  arm  with  three  strips  of  adhesive  plaster." 

A  similar  method  is  followed  in  Lancaster,  Pa.  In  Chicago  and 
New  Bedford  a  "  loose  sterile  pad  "  is  applied  to  the  arm  after  vaccina- 
tion. Mulford  &  Co.  have  recently  put  upon  the  market  perforated 
paper  shields  with  gummed  edges  which  adhere  to  the  arm.  The}'  are 
curved  so  as  to  raise  them  above  the  vesicle.  They  are  used  extensively 
and  seem  to  serve  the  purpose  well.  Parke,  Davis  &  Co.  furnish  an 
aluminum  shield,  and  there  is  also  a  transparent  celluloid  shield  on  the 
market. 

Brief  directions  for  the  care  of  the  arm  are  sometimes  given  the 
child  at  the  time  of  vaccination.1 


1  New  York  City : 

Directions  to  be  Observed  after  Vaccination. 

"  Leave  the  arm  bare,  or  cover  it  with  a  thin,  loose  sleeve  of  Calico  or  Muslin. 
Do  not  use  a  woolen  sleeve,  or  put  a  linen  band  around  the  arm,  as  they  irritate,  and 
prevent  vaccination  from  becoming  perfect.  If  the  arm  becomes  much  inflamed 
after  the  tenth  day,  do  not  poultice  it,  but  keep  it  covered  with  a  cloth  wet  with 
lukewarm  water. 

"  If  any  bad  effects  appear  to  follow  vaccination,  notify  this  office,  and  a  physi- 
cian will  be  sent  to  attend  the  case  free  of  charge." 

Providence : 

"Don't  rub  or  scratch  or  hurt  the  vaccine  sore.  If  the  skin  over  it  becomes 
broken,  get  a  few  cents'  worth  of  subnitrate  of  bismuth  to  dust  on  the  sore  so  that 
it  will  not  stick  to  the  sleeve. 

"  Don't  put  a  cloth  around  the  arm  or  any  kind  of  ointment  on  the  sore." 


COMMUNICABLE   Diseases.  597 

The  card  on  which  the  Providence  directions  are  printed  has  upon 
it  the  number  of  the  entry  of  the  vaccination  in  the  record  book  and  is 
used  by  pupils  as  a  temporary  school  permit. 

Contra-indications  to  Vaccination. 

There  are  certain  conditions  under  which  it  is  unwise  to  perform 
vaccination  and  these  are  well  set  forth  in  the  directions  to  vaccinators 
in  Chicago:1 

•■  Vaccination  being  the  artificial  production  of  a  constitutional  disease,  it  is, 
manifestly,  of  the  greatest  importance  that  the  individual  whom  it  is  proposed  to 
subject  to  its  influences  should  be  in  as  good  health  as  is  fairly  attainable.  There- 
fore, weak,  feeble  or  sickly  infants,  those  presenting  evidence  of  some  disorder  of 
nutrition  or  of  functional  disturbance,  as  from  dentition,  indigestion,  etc.,  or  suffer- 
ing from  diarrhea  or  other  bowel  affection  or  presenting  chafed  or  abraded  cutane- 
ous surfaces  on  any  portion  of  the  body,  or  any  form  of  cutaneous  eruption;  or  dur- 
ing the  period  of  weaning  —  should  not  be  vaccinated  except  in  the  presence  of 
smallpox  contagion.  Acute  febrile  diseases  and  intestinal  and  cutaneous  —  especially 
vesicular  —  affections  tend  to  modify  and  complicate  the  vaccinal  action,  and  these 
conditions,  therefore,  warrant  the  postponement  of  the  operation  until  they  have  sub- 
side'!. On  the  other  hand,  there  are  many  chronic  diseases  of  a  grave  character, 
syphilis,  for  example,  which  do  not  interfere  with  vaccination,  nor  contra-indieate 
the  operation.  This  is  especially  true  of  scrofula  and  consumption,  diseases  which 
have  been  favorably  affected  to  a  very  marked  degree  by  the  introduction  of  vaccina- 
tion. Scrofulous  subjects,  however,  or  those  exhibiting  a  pre-disposition  to  that 
cachexia,  should  not  be  vaccinated — except  in  cases  of  emergency  —  during  the  first 
year  or  two  of  life.  Sound  judgment  dictates  that  they  be  protected  during  this 
early  period  of  development  from  any  serious  constitutional  disturbance  —  and  the 
same  may  be  said  of  those  exhibiting  a  marked  phthisical  or  tuberculous  pre-dis- 
position. 

■•  ('ndt  r  ordinary  circumstances,  neither  the  menstrual  period,  gestation  or  lacta- 
tion offers  am  obstacle  to  vaccination;  but  cases  will  occasionally  present  themselves 
in  which  some  disturbance  or  complication  of  these  functions  may  dictate  its  tem- 
porary |>ost  ponement. 

"  The  existence  of  erysipelas,  diphtheria,  or  scarlet  fever  on  the  premises  or  in 
the  immediate  vicinity  renders  great  care  necessary,  if,  indeed,  il  should  not  posi- 
tively forbid  the  operation.  Recenl  exposure  to  the  infection  of  these  diseases  also 
makes  it  advisable  to  postpone  until  after  the  period  of  incubation. 

"As  already  intimated,  however,  there  are  few,  if  any,  conditions  which  would 
justify  negleci  or  even  postponement  of  vaccination  in  the  presence  of  the  smallpox 
contagion. 

"Within  the  above  limitations  vaccination  should  be  performed  during  the  first 

few  months  alter  birth        except   in  the  presence  Of  smallpox,  when  it  should  he  per- 
formed   iis  SO  nil  11  s  jiiissilih." 

The  success  iii  vaccinating  depends  very  much  upon  the  care  and 
skill  of  the  vaccinator  i-\cw  when  tin'  besl  virus  is  furnished.  The 
report  of  the  Now  York  City  board  of  health  in  1874  •">.  page  L20, 
shows  how  much  tin-  skill  of  vaccinators  varies  and  also  ho\*  good  men 
improve.     Several  men  who  onlj  had  ;i  percentage  of  perfect  results  in 

1  Chicago,  Report  oi  Health  Department  (1895  6),  p.  101. 


598  COMMUNICABLE   DISEASES. 

primary  vaccinations  of  about  75  per  cent,  during  the  first  three  months, 
rose  to  98  per  cent,  and  even  100  per  cent,  within  a  short  time,  while 
one  man  had  an  average  for  several  months  of  only  80  per  cent,  perfect 
results.  The  percentage  of  success  in  24,395  primary  vaccinations 
was  86.65.  In  1896  with  the  new  glycerine  virus  there  were  1,500 
consecutive  vaccinations  without  a  single  failure.1 

Circulars  of  information  concerning  vaccination  are  sometimes  dis- 
tributed and  in  many  places  serve  a  very  useful  educational  purpose, 
but  in  many  other  localities  the  only  result  would  be  calling  out  a  flood 
of  anti-vaccination  literature,  and  scientific  arguments  have  no  influence 
with  the  public  in  the  face  of  an  unscientific  harangue. 

Antitoxin. 

The  free  distribution  of  antitoxin  by  boards  of  health,  at  least  in  the 
larger  cities,  has  been  very  common  throughout  the  United  States.  This 
is  doubless  due  to  the  example  set  by  the  board  of  health  of  New  York 
City.  This  board  by  its  investigation  of  the  cultural  method  of  diag- 
nosis and  the  use  of  antitoxin  in  diphtheria  became  convinced  of  the 
great  worth  of  both,  and  determined  to  introduce  their  use  in  this 
country.  To  do  this  both  had  to  be  made  free,  and  considerable  effort 
was  made  by  the  board  of  health  to  secure  the  confidence  of  the  medical 
profession  in  them.  It  may  not  at  first  be  apparent  why  the  health 
department  should  distribute  antitoxin  any  more  than  any  other  remedy  ; 
but  there  are  several  reasons  why  it  should  do  so.  In  the  first  place  it 
is  expensive  and  the  poor  cannot  afford  to  pay  for  it,  and  most  cases  of 
diphtheria  are  among  the  poor.  It  is  true,  aid  for  the  poor  should  usu- 
ally be  furnished  by  the  poor  department,  but  it  is  much  more  conven- 
ient for  the  physician  to  get  his  antitoxin  from  the  health  department 
than  from  the  poor  department.  In  fact,  he  probably  never  would  have 
been  able  to  get  it  from  the  poor  department.  Antitoxin  should  be 
used  promptly,  and  there  is  less  red  tape  in  the  health  department.  The 
physician  brings  his  culture  to  the  health  department  and  gets  his 
antitoxin  promptly  for  the  asking.  The  health  department  should  assist 
the  physician  as  much  as  possible.  Below  are  named  some  of  the  cities 
which  early  began  the  free  distribution  of  antitoxin.2 

None   at   all   was   supplied   hi   Troy    until    1900,    and   in    Buffalo, 


1  New  York  City,  Report  of  Board  of  Health  (1896),  p.  237. 

2 Atlanta,  Baltimore,  Boston,  Bridgeport,  Brookline,  Mass.,  Cambridge,  Chicago, 
District  of  Columbia,  Concord,  X.  II.,  Denver,  Fitchburg,  Hartford,  Haverhill, 
Mass.,  Lowell,  New  Orleans,  Newton,  Mass.,  Paterson,  Pittsburgh,  Portland,  Me., 
Providence,  Rochester,  Salem,  Mass.,  St.  Louis,  San  Francisco,  Syracuse,  and  Wil- 
mington, Del. 


COMMUNICABLE   DISEASES.  599 

Rochester,  Utica,  Albany,  Hartford,  and  New  Haven,  the  amount  is  not 
large  for  the  ability  of  the  patient  to  pay  is  carefully  questioned.  In 
other  cities  this  is  not  looked  into  with  so  much  care  lest  the  patient 
meanwhile  die,  hence  larger  amounts  are  given  away. 

At  first  circulars  of  information  setting  forth  the  value  of  antitoxin 
were  distributed,  but  such  are  not  now  necessary.  In  the  larger  cities, 
stations  were  established  for  the  distribution  of  the  material,  usually  the 
same  drugstores  as  those  at  which  diphtheria-culture  outfits  were  kept. 
In  tin*  smaller  cities,  however,  it  is  often  given  out  only  at  the  health 
department  or  at  the  house  or  office  of  the  health  officer,  medical  inspec- 
tor, or  bacteriologist,  and  even  in  as  large  a  city  as  Pittsburgh  this  is  the 
practice.  Most  cities  supply  antitoxin  on  the  same  conditions  that  it  is 
furnished  in  New  York  City.1 

The  amount  of  antitoxin  furnished  physicians  for  their  own  use  and 
the  amount  used  by  the  medical  inspector  of  the  health  department, 
varies  much  in  different  cities.  Probably  no  greater  efforts  have  been 
made  to  encourage  the  use  of  this  remedy  and  to  supply  it  through 
municipal  inspectors  than  in  New  York,  Chicago,  and  Baltimore.  In 
Chicago,  particularly,  a  large  amount  of  antitoxin  has  been  administered 
by  the  inspectors  of  the  health  department.  From  5  October,  1895,  to 
31  March,  1896,  1.771  cases  were  thus  treated  by  these  officers.  In 
New  York  City,  in  1896,  about  three  times  as  many  cases  were  treated 
by  municipal  as  by  private  physicians,  but  since  then  the  hitter  have 
used  it  more  and  more.  In  most  cities  most  of  the  administration  is 
done  by  private  physicians,  the  serum  being  furnished  by  the  health 
department.  In  Providence,  at  tirst  a  syringe  was  furnished  by  the 
department,  bu1  this  was  of  course  soon  found  to  be  impracticable  as 
well  as  unnecessary.  The  form  of  application  blank  used  in  Chicago 
is  shown  in  Appendix   1  1  0. 

In  other  cities  a  very  simple  written  application  only  is  required 
which  may  be  \\>^A  as  a  voucher. 

'"First.  The  Healtb  Department  will  send  a  Medical  inspector  to  administer 
antitoxin  upon  the  request  of  the  attending  physician.  According  t"  the  wishes  of 
tin-  attending  physician  the  Inspector  will  fit  I  in-  to  I  lew  his  directions  or  will  use  his 
own  judgment  in  the  injection  ■•!  the  antitoxin.  When  physicians  wish  to  have  the 
Department  Inspector  administer  antitoxin  they  should  telephone  the  request  to  the 
laboratory. 

"Second.  'I' he  Healtb  Department  will  furnish  antitoxin  free  to  any  physician  who 
needs  it  for  a  case  of  diphtheria,  in  which  payment  for  the  remedy  is  a  hardship,  on  the 
condition  that  he  will,  at  the  completion  of  his  attendance  on  the  case,  till  out  and  send 

to  t  he  Division  of  Bacteriology,  on  1  dan  Us  I'n  in  is  lied  lor   I  he  purpose,  a  lull  report  of 

the  case.  These  blanks  will  he  found  at  the  depots  where  the  antitoxin  is  to  be 
obtained. 

(Third,     'the  Health  Depart m  will  sell  antitoxin  to  those  who  can  afford  to 

purchase  it." 


600  COMMUNICABLE   DISEASES. 

Most  cities  require,  or  at  least  did  require,  a  clinical  report  of  each 
case  treated,  to  be  made  by  the  attending  physician.  Blanks  for  this 
are  furnished  by  the  department.  That  used  in  Baltimore  is  shown  in 
Appendix  111.  In  Providence  no  form  of  this  kind  is  used  but  en- 
quiry is  made  by  the  medical  inspector  concerning  each  case  of  diph- 
theria reported  and  if  antitoxin  is  administered  it  is  noted,  together 
with  the  date  of  administration,  upon  the  permanent  record  of  the  case. 
In  Pittsburgh  a  card  is  used  to  record  the  bacteriological  findings  and 
the  antitoxin  data  for  each  case.     See  Appendix  112. 

Most  cities  purchase  the  antitoxin  which  they  use  and  distribute, 
but  a  few  produce  it.  This  is  done  in  New  York,  Pittsburgh,  Phila- 
delphia, St.  Louis,  and  Newark,  and  was  formerly  done  in  Hartford  and 
Boston.  For  a  very  large  city  like  New  York  or  Philadelphia  it  is 
doubtless  more  economical  to  produce  antitoxin  than  to  purchase  it.  In 
New  York  City  it  is  estimated  that  it  costs  to  produce  60,000  c.  c.  of 
300  unit  strength  about  $2,200,  which  is  much  less  than  it  could  be 
purchased  for.  But  in  order  to  get  a  high  grade  product  it  is  necessary 
to  continuously  employ  the  very  best  scientific  talent  and  the  varying 
fortune  of  political  life  is  not  conducive  to  the  success  of  the  city  in 
this  direction,  and  it  is  perhaps  well  that  more  cities  do  not  at  present 
undertake  it.  In  New  York1  in  1896  there  were  fifteen  horses  in  use 
for  furnishing  antitoxin  and  from  them  were  obtained  from  11-1  bleedings 
17,853  vials  of  antitoxin  ranging  in  strength  from  150  to  500  units  per 
cubic  centimeter. 

In  Pittsburgh2  two  horses  are  kept,  though  one  furnishes  all  the 
serum  required.  In  1899  there  were  obtained  and  used  2,145  vials  of 
serum  of  2,000  units,  some  of  which,  however,  was  used  in  neighboring 
communities.  The  cost  was  about  •$ 3,000.  The  method  employed  in 
that  city  may  be  found  in  the  report  for  1895.3 

In  Newark4  in  1897  five  horses  were  used  for  obtaining  serum. 
There  were  obtained  1,726  bottles,  of  which  1,321  were  used  in  Newark 
and  268  sold  outside  the  city  for  which  -$318.90  was  received.  The 
cost  of  the  care  of  the  horses  during  this  time  was  $1,286.07. 

In  St.  Louis  in  18975  three  horses  were  kept  and  11,645  c.  c.  of 
antitoxin  produced  containing  150  units  to  the  c.  c. 

Considerable  objection  has  been  made  by  private  producers  to  the 
action  of  boards  of  health  in  selling  their  product.     In  New  York  City 


1  New  York,  Board  of  Health  Report  (189G),  p.  220. 

2  Pittsburgh,  Report  of  Bureau  of  Health  (1898),  p.  124. 

3  Pittsburgh,  Report  of  Bureau  of  Health  (1895),  p.  116. 

4  Newark,  Report  of  Department  of  Health  (1897),  pp.  49  and  63. 

5  .St.  Louis,  Report  of  Department  of  Health  (1897),  p.  49. 


( ' OMML  'XI<  - 1  B  L E    DISK,  i  SJEH.  601 

the  board  of  health  has  sold  its  antitoxin  through  the  drug  stores 
allowing  the  druggists  a  ten  per  cent,  profit.  Considerable  amounts 
are  sold  to  other  cities,  notably  Chicago.  An  effort  was  made  to  pre- 
vent this  by  a  legislative  act  but  it  was  not  successful.  The  charter 
of  New  York  City  permits  such  sale  and  the  proceeds  are  to  be  devoted 
to  laboratory  uses.1  A  similar  right  is  given  to  local  boards  of  health 
in  Xew  Jersey.'-  To  the  New  York  City  board  of  health  is  due  the 
chief  credit  for  the  introduction  into  this  country  of  the  use  and  manu- 
facture of  diphtheria  antitoxin.  Furthermore  this  board  because  of  its 
researches  was  enabled  to  make  a  much  higher  grade  of  antitoxin  than 
was  ever  made  be  tore.  The  manufactures  of  antitoxin  in  this  country 
would  not  have  had  a  market  or  been  able  to  manufacture  the  remedy 
if  it  had  not  been  for  the  Xew  York  board  of  health  ;  but  it  is  entirely 
characteristic  of  a  trade  to  turn  about  and  strike  at  the  scientific  men 
to  whom  it  owes  its  being. 

There  has  been  very  little  done  in  the  way  of  state  supervision  of 
the  manufacture  and  sale  of  antitoxin.  In  New  Jersey  the  state  board 
of  health  may  prohibit  the  sale  of  antitoxin  found  to  be  impure  and 
inert  (see  page  581).  In  Wisconsin3  and  Connecticut'  it  is  unlawful  to 
sell  antitoxin  without  the  owner's  name.  In  New  York'  the  state  board 
of  health  requires  that  antitoxin  must  be  stamped  before  it  is  offered 
for  sale  by  the  manufacturers  and  samples  are  freq nently  tested  to  deter- 
mine whether  they  come  up  to  the  required  standard.  In  several  states, 
however,  the  state  board  of  health  lias  taken  upon  itself  the  task  of 
testing  the  various  antitoxins  for  sale.'1 

In  California  in  18957  the  state  board  of  health  was  authorized  to 
distribute  antitoxin  through  the  state  university.  In  Massachusetts 
the  state  board  of  health  has  for  several  years  manufactured  antitoxin 
and  distributed  it  throughout  the  state  through  the  medium  of  the 
local  boards. 


\.  u  Fork,  Chapter 378  of  1897,  Sec.  1226. 

\.  w  Jersey,  chapter  180  of  1895. 
'  Wisconsin,  Chapter  r>'.i  of  1897. 
*  Connecticut,  Chapter  252  of  1895. 

\rw  fork,  State  Board  of  Health  Report  (1898),  p.  5. 

Ohio,  Report  sum-  Board  <>f  1 1 < -;i  i 1 1 1  (1897),  p.   137.     Pennsylvania,  Report  of 
State  Board  of  Health  (1896),  pp.  29  and  208. 

i  alifornia,  Chapter  39  of  1895. 


CHAPTER  XII. 

COMMUNICABLE  DISEASES 

(concluded). 
Hospitals  axd  Quarantine. 

HOSPITALS  for  the  care  of  communicable  diseases  are  essential  for 
their  control.  It  is  well  nigh  useless  to  attempt  to  enforce  isola- 
tion unless  means  are  provided  in  hospitals  for  the  proper  isolation  of 
the  many  cases  which  are  sure  to  develop  under  conditions  where  their 
isolation  at  home  is  impossible.  It  is  not  only  for  the  welfare  of  the 
community,  but  also  for  the  welfare  of  the  patient  that  such  hospital 
accommodation  should  be  provided.  Many  cases  of  communicable  dis- 
ease cannot  receive  in  their  homes  the  care  that  they  require,  and  often- 
times travellers,  tramps,  and  inmates  of  asylums  and  general  hospitals  are 
attacked  with  communicable  disease,  and  most  of  such  cases  should  be 
for  their  own  good  at  once  removed  to  a  suitable  isolation  ward. 

Local  governments  are  permitted,  and  in  some  cases  required,  by 
statute  to  erect  and  maintain  such  hospitals.  Cities  often  have  the 
authority  to  establish  hospitals,  and  such  authority  unless  it  is  limited 
by  the  proviso  that  the  hospitals  are  to  be  for  the  poor,  carries  with  it 
the  power  to  establish  hospitals  for  the  care  of  communicable  disease. 
Such  general  authority  to  establish  hospitals  is  given  to  the  city  coun- 
cils of  cities  and  boards  of  trustees  in  the  cities  and  villages  of  Illinois.1 
Sometimes,  as  in  Maine,  Minnesota,  and  South  Carolina,  it  is  provided 
that  communicable  disease  hospitals  may  be  established  in  emergencies. 
In  other  states,  as  Alabama,  Colorado,  Georgia,  Maryland,  Michigan, 
Massachusetts,  New  Jersey,  Virginia,  Wyoming,  and  in  special  acts  for 
various  cities,  no  such  restrictions  are  placed  on  the  authority  given. 
In  Michigan  such  authority  is  specifically  given  to  the  inhabitants  of 
townships.  In  New  Jersey2  towns  or  townships  may  unite  in  the  estab- 
lishment of  such  hospitals  and 

"the  total  expenditure  for  lands  and  buildings  for   hospital  purposes  shall  not 
exceed  one-tenth  of  one  per  centum  of  the  total  sum  of  assessment  for  one  year,  for 


1  Illinois,  Annotated  Statutes  (1896),  Chapter  24,  Sec.  26.     Seventy-seventh. 


CO  MM  CXI<\  1 B  L  E    DISEA  SES. 


003 


Fig.  4.">. 

Smallpox  Hospital  at  Asbury  Park.      Cost,  $544.35.      Prom  Report  oJ  State  Board  of  Health  of 

\i-u  Jersej .  1896. 


Fig.   in. 
Smallpos  Hospital,  Pawtuoket,  i.\  i      <  ot 


604  COMMUNICABLE   DISEASES. 

the  purpose  of  taxation   in  such  corporated  town,  as  shown  by  the  duplicate,  or 
other  records  of  assessments  for  the  previous  year.'1 : 

In  a  few  states  the  establishment  of  communicable  disease  hospitals 
is  required  by  statute.  The  Massachusetts  law  enacted  in  1701  is  still 
on  the  statute  books,  but  is  probably  intended  to  be  enforced  only  in 
the  emergency  of  a  serious  outbreak.2  This  law  has  been  copied  by 
Colorado,  Minnesota,  and  Michigan,  but  in  the  latter  state  is  applicable 
to  smallpox  only.  In  Massachusetts3  the  authorities  are  by  an  old  law 
empowered  to  seize  buildings  for  hospital  use,  and  this  is  sometimes 
done  even  at  the  present  time,  as  in  Cambridge,  where  a  dwelling  was 
in  1899  seized  for  a  diphtheria  hospital.  A  similar  provision  is  found 
in  the  charter  of  the  City  of  New  York4  and  in  Colorado,  Maine,  Michi- 
gan, and  Wyoming.  In  Virginia  town  councils  and  justices  of  the 
peace  may  establish  temporary  hospitals  and  may  seize  land  for  that 
purpose,  but  damages  must  be  paid  as  appraised  by  commissioners 
appointed  under  the  law.  A  more  recent  Massachusetts  law  provides 
that  hospitals  shall  be  established  in  cities  when  deemed  necessary  by 
the  local  board  of  health:5 

"  In  any  city  in  which  no  suitable  hospital  accommodations  have  been  provided 
for  the  care  and  treatment  of  persons  suffering  from  contagious  diseases  dangerous 
to  the  public  health,  the  board  of  health  of  such  city  may  address  a  communication 
to  the   mayor  thereof,  stating  that   in   the  opinion  of  said  board  the  safety  of  the 

1  New  Jersey,  Public  Laws  (1S95),  p.  590. 

2  Massachusetts,  Public  Statutes  (1882),  Chapter  80,  Sec.  75.  (First  enacted  25 
June,  1701  (Chapter  9).  See  Acts  and  Resolves,  Province  of  Massachusetts  Bay, 
Vol.  I.,  p.  469): 

"  When  a  disease  dangerous  to  the  public  health  breaks  out  in  a  town,  the  board 
shall  immediately  provide  such  hospital  or  place  of  reception  for  the  sick  and  in- 
fected as  is  judged  best  for  their  accommodation  and  the  safety  of  the  inhabitants, 
which  shall  be  subject  to  the  regulations  of  the  board;  and  the  board  may  cause  any 
sick  and  infected  person  to  be  removed  thereto,  unless  his  condition  will  not  admit 
of  his  removal  without  danger  to  his  health,  in  which  case  the  house  or  place  where 
he  remains  shall  be  considered  as  a  hospital,  and  all  persons  residing  in  or  in  any 
way  concerned  within  the  same  shall  be  subject  to  the  regulations  of  the  board  as 
before  provided.'1 

3  Massachusetts,  Public  Statutes  (1882),  Chapter  80,  Sec.  43: 

"  Two  justices  of  the  peace  may,  if  need  be,  make  out  a  warrant  directed  to  the 
sheriff  of  the  county  or  his  deputy,  or  to  any  constable,  requiring  them  under  the 
direction  of  the  board  to  remove  any  person  infected  with  contagious  sickness,  or  to 
impress  and  take  up  convenient  houses,  lodging,  nurses,  attendants  and  other  neces- 
saries, for  the  accommodation,  safety  and  relief  of  the  sick." 

4  New  York  City,  Chapter  378  of  1897,  Sec.  1170: 

"  .  .  .  It  shall  have  power  to  take  possession  of  and  occupy  for  temporary 
hospitals  any  building  or  buildings  in  said  city,  during  the  prevalence  of  an  epidemic, 
if  in  the  judgment  of  the  board  the  same  may  be  required,  and  shall  pay  for  private 
property  so  taken  a  just  compensation  for  the  same.     .     .     ." 

5  Massachusetts,  Chapter  511  of  1894. 


(  OMJIUXK  \  IBLE   BISEA  SES.  605 

inhabitants  of  the  city  demands  that  suitable  hospital  accommodations  should  be 
provided  for  the  reception  and  treatment  of  persons  suffering  from  such  diseases, 
other  than  smallpox  and  those  of  a  venereal  nature.  The  mayor  shall  forthwith 
transmit  such  communication  to  the  city  council,  and  the  city  council  shall  forth- 
with order  such  hospital  accommodations  to  be  provided,  and  shall  make  the  neces- 
sary appropriations  therefor." 

In  Massachusetts  it  is  provided  that  the  hospital  for  communicable 
disease  shall  be  within  the  township  limits,  but  in  Michigan  and  New 
Jersey  it  may  be  otherwise  ;  though  in  Xew  Jersey,1 

"  when  such  lands  are  situate  out  of  the  limits  of  any  such  incorporated  towns 
as  acquire  title  to  the  lands,  then  before  using  such  lands  for  hospital  purposes  for 
persons  having  contagious  diseases,  there  should  be  obtained  the  consent  of  the 
township  committee  or  other  governing  body  of  the  township  or  other  municipality 
within  the  limit  of  which  such  lands  lie  and  such  hospital  is  erected,  that  the  miiiic 
may  be  used  for  the  purpose  aforesaid." 

In  Colorado  and  Massachusetts2  no  hospital  of  this  kind  is  to  be 
established  within  100  feet  of  an  inhabited  dwelling  house  within  an 
adjoining  town  without  the  consent  of  the  town.  In  Xew  Mexico  no 
pest  house  is  to  be  established  within  one  mile  of  an  inhabited  house. 
In  the  District  of  Columbia  a  communicable  disease  hospital  may  not 
be  within  300  feet  of  any  other  building.  In  California  it  is  forbidden 
any  person  to  establish  or  keep  a  pest  house  in  any  city,  town  or  vil- 
lage, and  a  similar  law  is  found  in  Montana.  In  this  connection  may 
he  mentioned  the  laws,  relies  of  olden  times,  which  are  still  found  in 
some  states,  as  Maine,  Kansas,  Michigan,  and  Pennsylvania  (referring 
to  Philadelphia),  and  which  forbid  inoculation  with  smallpox. 

While  a  hospital  for  communicable  disease  may  be  of  great  value 
when  used  merely  by  those  who  voluntarily  take  advantage  of  its  oppor- 
tunities, yet  to  make  them  really  efficient  in  the  prevention  of  such  dis- 
eases, it  is  accessary  often  to  remove  to  them  forcibly  persons  who 
would  not  voluntarily  go.  Laws  authorizing  this  are  found  in  a  large 
dumber  of  states  and  also  in  the  ordinances  of  many  cities.  The  earliest 
I < >tin  of  the  law  is  found  in  Massachusetts1  dating  back  to  1797,  and 
simply  gives  the  board  of  health  authority  to  remove  cases  to  -a 
separate  house  or  otherwise."  In  New  York  City4  the  hoard  of  health 
-may  remove  or  cause  to  be  removed  to  a  proper  place,  to  be  l»\  it 
designated,  anj  person  Bicfc  with  any  contagious,  pestilential  or  infec- 
tions disease" 

Most  of  the  laws.  lio\\c\er,  limit  the  power  of  removal  to  those  eases 
in  which  it  can  he  done  without  danger  to  the  patient,  ami  il   is  usually 

1  \.'u  Jersey,  Public  Laws  (1895),  p.  590. 

Massachusetts,  Public  Statutes,  <  hapter  B0,  Sec.  72. 

Massachusetts,  Public  Statutes  (1882),  Chapter  80,  Sec.  i". 
1  \.w  y/ork,  Chapter  878  of  L897,  Sec.  1170. 


606  COMMUNICABLE   DISEASES. 

provided  that  if  he  is  not  removed,  the  house  in  which  he  remains  ma}T 
be  treated  as  a  hospital.  In  Minnesota  when  the  patient  is  in  a  boarding 
or  lodging  house,  crowded  room,  vessel  or  car  he  may  be  removed  by 
force.  In  Atlanta  a  patient  with  scarlet  fever  shall  not  be  removed  to 
the  hospital  unless  isolation  is  impracticable  at  home.1  In  Pennsylvania 
cities  of  the  second  class2  the  officers  appointed  for  that  purpose  are  to 
remove  to  the  hospital  all  persons  sick  with  infectious  disease,  but  only 
with  the  consent  of  the  attending  physician.  In  Bridgeport3  the  removal 
to  the  hospital  shall  be  made  only  when  the  attending  physician,  if  there 
is  one,  shall  certify  in  writing  that  the  removal  of  such  person  is  neces- 
sary for  the  preservation  of  the  public  health.  When  a  patient  is 
allowed  to  remain  at  home,  in  order  to  ensure  the  maintenance  of  isola- 
tion, authority  is  often  given  to  place  guards  about  the  house,  thus  to 
ensure  control  as  in  a  hospital. 

In  most  of  the  laws  authority  is  given  to  remove  persons  "  sick  " 
with  the  prescribed  diseases,  but  in  some  laws,  as  those  of  Maine,  Massa- 
chusetts, Michigan,  and  New  Hampshire,  the  law  applies  to  persons 
"  infected,"  and  in  Massachusetts  "  who  have  recently  been  infected,"' 
and  in  Bridgeport  "  who  shall  be  suspected  of  being  infected."  In 
most  of  the  statutes  the  board  of  health  alone  is  given  the  power  to 
cause  removal  to  a  hospital,  but  in  Wilmington,  Del.,  two-thirds  of  the 
board  are  necessary.  Some  of  the  ordinances  give  the  power  to  other 
officers.  Thus  in  Chicago,  Denver,  Omaha,  and  St.  Louis  it  is  the 
health  commissioner,  in  Philadelphia,  the  assistant  medical  inspector,  in 
Newark  and  Yonkers  the  health  officer. 

When  communicable  disease  occurs  in  a  penal  institution,  it  was 
feared  that  there  might  be  a  conflict  of  authority  between  the  sanitary 
and  other  officials,  and  special  provision  has  in  several  states  been  made 
for  such  cases.  The  Massachusetts  law4  has  been  in  substance  followed 
by  Colorado,  Maine,  Michigan,  Mississippi,  and  Washington.  The  suc- 
ceeding section  provides  that  the  presiding  officer  of  the  board  of  health 


1  Atlanta,  Rules  and  Regulations  of  Board  of  Health,  Sec.  151. 

2  Pennsylvania,  Chapter  258  of  1895,  Sec.  26. 

3  Bridgeport,  Ordinances  (1892),  Chapter  14,  Sec.  3. 

4  Massachusetts,  Public  Statutes  (1882),  Chapter  80,  Sec.  49: 

"  When  a  person  confined  in  a  common  jail,  house  of  correction  or  workhouse, 
has  a  disease  which,  in  the  opinion  of  the  physician  of  the  board,  or  of  such  other 
physician  as  it  may  consult,  is  dangerous  to  the  safety  and  health  of  other  prisoners 
or  of  the  inhabitants  of  the  town,  the  board  shall  by  its  order  in  writing  direct  the 
removal  of  such  person  to  some  hospital  or  other  place  of  safety,  there  to  be  pro- 
vided for  and  securely  kept  so  as  to  prevent  his  escape  until  its  further  order.  If 
such  person  recovers  from  the  disease,  he  shall  be  returned  to  said  prison  or  other 
place  of  confinement." 


CO  MMUNIi  \  1  B  L  E    D  TSEA  S  E  S.  6  ( >  7 

shall  report  his  action  to  the  court.  The  Massachusetts  law  also  for- 
bids any  city  or  town  officer  to  send  to  the  state  almshouse  any  person 
suffering  with  a  disease  dangerous  to  the  public  health.' 

While  municipalities  generally  have  ample  authority  to  establish  and 
maintain  hospitals  for  the  care  of  communicable  diseases,  and  may 
remove  patients  to  them  by  force  if  necessary,  yet  such  hospitals  have 
not  been  very  generally  established  even  in  our  larger  cities.  In  this 
respect  the  towns  of  the  United  States  are  far  behind  those  of  England. 
Provision  is  made  for  smallpox  much  oftener  than  for  the  other  com- 
municable diseases  because  public  opinion  is  very  decided  about  the 
desirability  of  removing  this  disease  to  a  hospital.  Yellow  fever  is 
another  disease  in  which  isolation  is  demanded  by  the  public,  but  as  it 
usually  occurs  at  the  south,  and  during  warm  weather,  tent  treatment  is 
very  generally  employed  and  there  is  less  need  of  permanent  hospital 
buildings  than  at  the  north.  Most  of  the  larger  cities  are  provided 
with  some  sort  of  a  hospital  for  the  reception  of  smallpox  patients,  and 
indeed  a  considerable  number  of  quite  small  places  have  Bucb  hospitals: 
but  some  large  cities  are  not  so  provided.  Thus  there  is  no  such 
provision  at  Omaha.  Albany,  Portland,  Ore.,  and  in  1899  Columbus  and 
Fall  River  were  caught  by  an  outbreak  and  were  obliged  to  hurriedly 
erect  hospitals,  and  not  long  since.  Reading  and  Harrisburgh  passed 
through  a  similar  experience. 

Many  of  the  smallpox  hospitals  are  popularly  and  even  officially 
known  as  -pest  houses,"  and  the  name  from  one  point  of  view  is  not  a 
bad  one.       It   is.    perhaps,  the    rule    to   find   these  pest  houses  utterly  ltn- 

adapted  for  the  use  to  which  they  are  put.  Every  hospital  should  be 
cheerful,  sunny,  comfortable,  well  heated  and    ventilated,  and  provided 

with  a  plentiful  water   supply.       For    communicable    disease    hospitals  it 

is  particularly  desirable  that  everything  shall  be  as  attractive  as  possi- 
ble, in  order  that  patients  nia\  willingly  go  to  them.  Too  many  of 
these  hospitals  are  Lacking  in  all  these  qualities.    The  typical  pest  house 

is  located  in  a  desolate  oul  of  the  way  place.  It  can  be  reached  only 
by  a  considerable  journej  Over  a  bad  and  seldom  travelled  road.  It  is 
often    old,  and    consists  of    a    small    low     shed-like  Structure    with  a  lew 

I rly  arranged   rooms,  or  perhaps,  a  single  room.     It  is  not  plastered. 

and  has  no  cellar,  and  is  heated,  or  not  heated,  by  ;i  Stove,  The  water 
supply  is  obtained  from  an  out  id'  door  pump,  and  the  plumbing  consists 
of  an  iron  sink.     The  furniture   usually  corresponds.     That  the  picture 

is  not  exaggerated,  the  writer  knows,  for  he  has  spent  a  Long  winter 
night  with  a  smallpox  patient  in  just  such  a  building.  The  following 
figure  illustrates  one  of  these  buildings  : 

1  Massachusetts,  Public  Statutes  (1882),  Chapter  86,  Sec.  25. 


008  COMMUNICABLE   DISEASES. 


Fig.  47. 

Smallpox  Hospital  at  Lincoln,  R.  I..    A  town  of  10,000  inhabitants. 

It  is  not  to  be  wondered  at  that  patients  and  their  friends  resort  to 
every  deception  to  conceal  the  disease,  in  order  that  they  may  not  be  car- 
ried to  such  a  place.  Some  of  these  buildings  were  put  up  by  com- 
mittees of  citizens  long  before  the  establishment  of  boards  of  health. 
They  have  remained  because  they  have  been  so  rarely  used  that  the  im- 
portance of  better  things  has  not  been  realized.  As  a  rule  only  the  poor 
are  carried  to  them,  and  they  have  not  influence  enough  to  cause  a 
change.  If  a  well-to-do  patient  is  carried  to  one,  as  happened  in  the 
District  of  Columbia  not  long  since,  when  an  official  in  the  Department 
of  the  Interior  was  attacked  with  smallpox,  a  new  building  speedily 
results.  Excellent  hospitals  for  smallpox  are  now  to  be  found  in 
Chicago,  Cincinnati,  Cleveland,  the  District  of  Columbia,  Milwaukee, 
and  a  number  of  other  cities.  It  is  to  be  hoped  that  the  day  of  the 
pest  house  is  waning. 

The  location  of  a  smallpox  hospital  is  often  a  matter  of  some  diffi- 
culty. Usually  it  is  located  in  the  outskirts  of  the  city  and  sometimes 
in  a  neighboring  community.  In  New  York  and  Boston  it  is  upon  an 
island.  In  Providence  it  is  on  a  point  projecting  into  the  harbor  and 
entirely  isolated,  except  in  hot  weather  when  the  adjoining  grounds  are 
used  as  a  pleasure  resort,  In  St.  Louis  it  is  twelve  miles  up  the  river 
and  can  be  reached  only  over  a  most  execrable  road,  and  in  Cleveland  it 
is  quite  inaccessible.  The  plans  and  elevation  of  some  of  these  hospi- 
tals are  here  shown. 


' ' OMMUNICA BLE    D isK.  I  HE '& 


609 


-'  5  -1 

-  *   s 


'    -    i 


/.     -   ~ 


r    —   ' 


610 


COMMUNICABLE    DISK  A  sEs. 


HAMLIN      AVENUE 


u 


FUTURE    TEMPORARY  WARDS 
IN    EVENT    OF   ^r-JALLPOX     CPIOEMIC 


i    i 
I    i 

!  !  i 

!  '  i 

v  L_..._m;__.j 


BLOCK       PLAN 


CHICAGO       CITY 
ISOLATION     HOSPITAL 


3CALC       f      ' 


LAWN  DALE    AVENUE 
1    !(..     49. 


((>  .1/11/ 1  TNI  CA  I!  L  E    D  rs  E.  1  8  E8. 


611 


FIRST  FLOOR  PLAN 
CHICAGO  CITY 
ISOLATION    HOSPITAL. 


Fig.  r>0. 


(312 


0  OMMUNIt  ABLE   I)  I  SEA  s  ES. 


Fig.  51. 

Smallpox  Hospital  at  Muncie,  Iml..  built  in  1S93,  at  a  cost  of  about  $1,000.     From  Report  of  Indiana 

State  Board  of  Health,  1893. 


I ii  New  Orleans  the  city  does  not  maintain  the  smallpox  hospital, 
but  patients  are  cared  for  by  contract  at  the  rate  of  $3,000  a  year  up  to 
fifty  patients,  and  #25  per  patient  for  all  in  excess  of  that  number. 

Next  to  smallpox  in  importance  as  requiring  hospital  accommoda- 
tions are  diphtheria  and  scarlet  fever.  Of  course  measles,  chicken  pox, 
whooping  cough,  typhus,  and  other  diseases  do  sometimes  require 
hospital  attention  but  it  is  only  in  the  largest  cities  that  provision  for 
several  diseases  is  absolutely7  necessary.  The  most  pressing  need  is  for 
the  treatment  of  diphtheria  and  scarlet  fever,  but  by  far  too  many  cities 
have  no  municipal  hospital  for  these  diseases.1 

It  is  rare  indeed  that  the  health  officials  are  to  be  blamed  for  the 
absence  of  hospital  facilities.  Nearly  every  health  report  from  the 
cities  mentioned  clearly  sets  forth  the  need  of  such  a  hospital  and 
urges  the  council  to  make  the  necessary  appropriation.  The  council 
however  remains  apathetic  till  after  a  time  some  prominent  person  is" 
endangered  by  the  absence  of  proper  facilities  when  the  hospital  is  at 
once  erected. 


1  Among  such  cities  may  be  mentioned:  Buffalo,  Chicago,  Cincinnati,  Cleveland, 
Dayton,  Fall  River,  Fitchburg,  Haverhill,  Lowell,  Oakland,  Cal.,  Pittsburgh,  Fort- 
land,  Rochester,  Sacramento,  St.  Paul,  San  Antonio,  San  Francisco,  Seattle,  Somer- 
ville,  Taunton,  and  Toledo. 


COM  Ml  XI<  \  I  />'  L  E    I>lsh\  1  SES. 


613 


'        D        • 
•       G.S.       • 

-   Office.   * 


<? 


?.'•■-■ 
= 


Bath 
Rooms. 

- 


*        D 


Gentlemen's  Ward. 


*       * 


No.  l. 


vk       o  ■ 


Si  |,   ,,  Ward  for  the  new 


.      ■!'■■-■. 

-L 


Kitchen. 

<;.  B. 


cases  ami  sick 

IIIH'S. 


~  2  ~ 
-  -'■'  - 


Well, 
o 


FIG. 


Plan  "i  Hospital  al  Muncie,  End. 


Explanations.    Ba<  b  arm  ol  this  cross  was  hit  Feel  long  and  18  feel  wide. 

\.i.,u  No.  2  Indicates  the  direction  ol  guard-house,  200  feel  fr hospital.    [twasSxri,  proi  ided 

■ ith  a  Btore. 

.\itmu  No.  i  Indicates  1 1 1 « -  direction  of  the  disinfection  station,  200  feel  from  hospital, 

I »  indicates  common  doors. 

s.  i>.  D.  Indicates  sliding  double  <l b. 

•    •    •    inilu  ;ilc-~  \\  inilou  -.. 

< ; .  8.  inii Icates  gas  Bto^ es. 

i    w.  C.  Ind  nit'  -  ladies'  watei  closet 

< ,    W.  C.  Indicates  gentlemen's  water  closet 


014 


OOMMUWK  A  BLE    1)1  SEA  SES. 


.     *  z. 

4      -    .- 


CO  MMl TNI  t  \  i BLE    I)  I  SEA  SES.  i ;  ]  5 

Then  there  are  some  cities  which  have  no  municipal  hospitals  for 
the  care  of  communicable  diseases  but  send  such  eases  to  private  in- 
stitutions to  which  are  paid  a  certain  amount  per  patient,  or  a  lump  sum 
annually.  This  method  is  not  usually  satisfactory  to  the  sanitary 
officials  for  several  reasons.  First,  it  greatly  facilitates  dealings  with 
the  family  of  the  sick,  and  often  prevents  much  friction,  if  the  manage- 
ment of  the  patients  is  controlled  by  the  same  health  officials  who  send 
the  patients  to  the  hospitals.  In  private  hospitals  there  is  of  course  no 
such  control.  Second,  if  regular  board  is  paid  for  each  patient,  there 
is  a  tendency  for  health  officials  to  economize  by  not  sending  as  many 
patients  to  the  hospitals  as  they  might  otherwise  do.  Lastly,  the 
facilities  for  the  care  of  the  patients  especially  as  regards  isolation  are 
not  usually  as  good  in  private  hospitals,  or  in  fact  in  any  general  hos- 
pital as  they  are  in  hospitals  designed  especially  for  that  purpose.  The 
following  shows  some  of  the  cities  which  have  only  the  facilities  above 
referred  to.  the  amount  paid  for  the  service  and  the  hospital  to  which 
the  patients  are  sent  : 

Buffalo Buffalo  <  teneral  Hospital $4  per  \*  eek 

Cambridge Cambridge  Hospital 20  per  week 

Chicago Cook  County  Hospital  (paupers  only) ...  no  charge 

Hartford •                                               :;  pej  week 

Hoboken,  \.  J St.  .Mary's  (under  twelve  years) 3  per  week 

(over  twelve  years) 5  per  week 

Newport,  R,  I Newport  Hospital 14  per  \\  eek 

Newt  mi.  Mas^ Newton  Hospital I4.ii7  per  week 

Pittsburgh Mercy   1  [ospital 14  per  week 

Providence Rhode  Island  Hospital1 15  per  week 

Rochester 12  per  week 

Wilmington County  Hospital  (paupers  only) no  cha  rge 

Bloonitield,  \.  .J Mountainside  Hospital '.»  per  week 

Mont chtir.   N.  .1 Mountainside  Hospital to 

Verona,  S.J Mountainside  Hospital 18  per  week 

Of  the  above  hospitals  those  in  Cambridge,  Newton  and  Providence 
have  small  hut  fairly  well  arranged  isolated  buildings  for  the  care  of 
their  communicable  disease  cases,  and  in    Wilmington,  Del.,  the   county 

hospital    is    said    to    afford    good    facilities.  Init    iii  most  of   the  cities  the 

arrangements  made  arc  entirely  inadequate  andc paratively  few  cases 

are  senl    to  the  hospital.       Iii  some  instances  the  wards  are  in    the    same 

building  with   the   genera]   wards.     The   health  department   in  almost 

even,   instance  is  \er\  desirous  for  the  establishment  of  an  independent 
hospital. 

A  lew  cities  which  have  no  real  provision  for  such  cases  yel  occa- 
sionally send  a  patient   with  scarlet   fever  or  diphtheria  to    their   general 

1  In  this  citj   tin-  building   was  constructed  bj  Hie  Rhode  Island  Hospital  with 
monej  appropi  iated  h\  t  he  i 


516  COMMUNICABLE   DISEASES. 

hospitals  when  it  happens  that  the  removal  of  such  a  patient  from  the 
street  or  railroad  car  is  absolutely  necessary.  The  patient  will  then  be 
cared  for  in  a  small  ward  or  room  set  apart  temporarily  or  permanently 
for  that  purpose.  That  is  almost  all  that  is  done  in  Cincinnati  and 
Louisville  and  indeed  in  some  of  the  cities  mentioned  on  the  preceed- 
ing  page.  In  other  cases  separate  wards  are  built  in  connection  with 
the  general  hospitals  to  which  the  city  patients  are  sent.  Such  sepa- 
rate wards  are  found  in  Hartford,  Minneapolis,  St.  Paul  and  Provi- 
dence. 

Undoubtedly  the  best  arrangement  is  for  the  city  to  build  and 
maintain  a  separate  hospital  for  the  care  of  communicable  disease  as 
this  is  the  surest  way  to  secure  complete  isolation.  There  may  be  no 
objection  to  having  the  building  on  the  grounds  of  a  general  hospital,, 
and  heat  and  light  may  be  advantageously  furnished  from  the  general 
plant.  The  writer  however  believes  that  it  is  unwise  to  have  any  other 
connection  if  it  can  be  avoided.  This  is  the  result  of  his  experience  in 
Providence  where  the  medical  attendance  and  some  other  service,  and 
the  kitchen,  are  in  common  for  the  contagious  wards  and  the  general 
hospital.  This  opinion  is  concurred  in  by  the  officers  of  the  hospital 
who  only  entered  into  this  arrangement  as  offering  the  best  means 
available  at  the  time  for  the  care  of  such  cases. 

The  following  places  have  what  are  practically  independent  munici- 
pal hospitals  for  the  care  of  communicable  disease  other  than  smallpox 
(chiefly  diphtheria  and  scarlet  fever) :  Alleghany,  Atlantic  City,  Asbury 
Park,  in  conjunction  with  the  adjoining  township  of  Neptune  ;  Bridge- 
port, Boston,  Brooklyn,  Brookline,  Denver,  District  of  Columbia,  Eliza- 
beth, N.  J.,  Grand  Rapids,  Mich.,  Jersey  City,  Lynn,  Memphis,  Mil- 
waukee, Morristown,  N.  J.,  New  York,  Paterson,  Pittsfield,  Mass., 
Philadelphia,  Portland,  Me.,  Spokane,  Springfield,  Mass.,  Syracuse, 
Trenton,  N.  J.,  Utica,  Waltham  and  Worcester.  Denver  and  Memphis 
have  a  series  of  cottages  or  small  houses  for  an  isolation  hospital  :  in 
the  latter  city  there  are  eight  of  these  cottages  and  in  the  former  seven. 
The  total  capacity  of  the  Denver  cottages  is  forty-six. 

Rules  for  the  administration  of  communicable  disease  hospitals  may 
be  found  in  the  report  of  the  commissioner  of  health  of  Milwaukee  for 
the  year  ending  April,  1894,  and  in  the  report  of  the  Worcester  board 
of  health  for  1896.  The  cost  of  maintaining  communicable  disease 
hospitals  varies  as  the  size  of  the  hospital  and  the  number  of  patients 
vary.  In  Denver  in  1898  there  were  treated  seventy-nine  cases  of 
diphtheria,  twenty-seven  of  scarlet  fever  and  fifty-four  of  other  dis- 
eases, mostly  measles,  at  a  cost  of  $5,800.  In  Lynn  in  1899,  fifty-three 
cases  of  diphtheria  and  seventeen  of  scarlet  fever  were  treated  at  an  ex- 


C OMMUNIL \  J  BLE    1)1  SEA  SMS.  6 1 7 

pense  of  84,878.01.  In  Paterson  in  180s.  102  patients  and  eighteen 
well  mothers  who  went  with  their  children  cost  $5,097.93,  including 
repairs  and  the  payment  of  $300  to  the  attending  physician,  in  Brook- 
line,  .Mass..  in  1899,  sixty-eight  cases  of  diphtheria   and   twenty-one  of 

scarlet  fever  cost  #4,113.39.  The  cost  of  running'  the  dwelling  which 
was  seized  for  a  hospital  in  Cambridge  in  1899  was  $265.60  per  week, 
and  during  December  twenty-eight  patients  were  treated  there.  In 
Boston  in  1898,  1,517  patients  were  treated  at  the  Boston  City  Hospi- 
tal, contagious  division,  at  a  cost  of  $71,687.34.  In  Springfield,  Mass., 
in  1900,  thirty-seven  patients  were  cared  for  at  an  expense  of  $2,500. 
In  Worcester  in  1899  203  patients  cost  about  87,000. 

Municipal  hospitals  for  communicable  disease  are  designed  primarily 
for  the  use  of  the  poor  or  persons  of  moderate  means,  whose  homes  are 
not  ample  enough  for  the  proper  isolation  of  the  sick.  It  is  true  that  pri- 
vate rooms  arc  usually  added  to  the  hospital  which  may  be  hired  by  persons 
of  more  means,  but  who,  for  one  reason  or  another,  desire  to  make  use 
of  the  facilities  tor  isolation  afforded  by  a  hospital.  Municipal  hospitals 
do  not  ordinarily  need  to  offer  all  the  luxuries  which  the  rich  would 
have  in  their  own  homes,  and  it  has  been  deemed  advisable,  at  least  in 
New  York  City,  to  establish  a  hospital  which  would  more  nearly  fulfill 
the  demands  of  wealthy  people.  The  Minturn  Hospital  for  scarlet  fever 
and  diphtheria  was  built  in  1896,  1))'  private  subscription,  though  upon 
land  owned  by  the  city  and  near  to  the  municipal  hospital  used  for  the 
Bame  diseases.      A  similar  hospital  is  proposed  for  Philadelphia. 

One  serious  difficulty  which  is  usually  encountered  in  providing  hos- 
pitals for  the  care  of  communicable  diseases  is  the  securing  of  the  uec- 
essar}  site.  The  public  is  much  more  apt  to  be  frightened  by  imaginary 
than  by  the  real  dangers  of  communicable  diseases.  There  is  no  reason 
why  a  contagious  disease  hospital  should  not  be  so  conducted  that  there 
would  be  no  danger  in  ha\  ing  it  in  the  midst  of  a  built  up  block  :  indeed 
it  oii'jht  always  to  he  conducted  in  just  that  manner:  but  the  public  are 
afraid  <>l  it.  and  want  it  in  the  middle  of  a  ten  acre  lot.  and  that  far  aw  ay 
from  all  habitations.  There  is  of  course  great  difficulty  in  securing  such 
a  location,  and  it  is  unfortunate  to  place  a  hospital  so  far  out  in  the 
suburbs  that  ever}  patient  has  to  have  a  long  ambulance  ride.  Some- 
times the  opposition  to  the  location  of  the  hospital  takes  the  form  of  an 
appeal  to  the  council  by  which  the  appropriation  is  defeated,  and  some- 
times 1>\  an  appeal  to  the  courts  resulting  in  an  injunction.  In  the  Dis- 
fcricl  of  <  'olumbia  such  object  ion  was  made  iii  I  895  to  the  local  ion  of  a  con- 
tag  OUS  hospital  that  (  'oligress  was  induced  to  enact  that   lio  BUCh   hospital 

should  be  built  within  300  feet  of  any  building  ow  ned  1>\  a  private  indi- 
vidual or  any  other  party  than  t he  one  erecting  the  building.    As  the  health 


618 


COMMUNICABLE   DISEA  SES. 


officer  of  the  district  has  shown,  this  would  require  a  fifteen  acre  lot  for  the 
hospital,  which  would  make  it  far  too  expensive.  Finally  Congress 
forced  the  building-  of  the  new  contagious  wards  on  the  grounds  of  two 
private  hospitals,  threatening  to  refuse  further'  appropriation  for  their 
support  unless  this  was  done.  This  is  often  the  best  solution  of  the 
site  problem,  for,  provided  the  contagious  ward  is  separate  and  has  an 
entirely  independent  service,  there  can  be  no  possible  danger  to  the  gen- 
eral wards.  Often  the  contagious  hospital  can  be  so  placed  without 
exciting  any  opposition,  and  again  it  can  be  so  placed  notwithstanding 
opposition.  A  number  of  illustrations  are  given  of  communicable 
disease  hospitals  with  plans  and  cost  of  construction. 

Some  of  the  large  cities  have  good  hospital  facilities  for  the  care  of 
communicable  diseases,  notable  among  which  are  New  York,  Brooklyn, 
Philadelphia,  Boston  and  the  District  of  Columbia,  In  New  York, 
Boston  and  the  District  of  Columbia  brick  buildings  of  considerable 
size  are  provided  while  in  Brooklyn  and  Philadelphia  one  story  wooden 
pavilions  are  made  use  of.  In  Boston  nearly  $300,000  was  expended 
on  the  buildings  for  communicable  diseases  which  are  under  the  man- 
agement of  the  city  hospital.  A  plan  of  these  buildings  is  shown  in 
Fig.  55.  In  the  District  of  Columbia  less  extensive  buildings  but  yet 
structures  built  of  brick  and  well  planned  are  worthy  of  study  of  all 
who  contemplate  building  hospitals  of  that  character. 


£>JT    PAf/l/ON  CeMTHAl   BU/IDINC 

Fig.  54. 

Isolation  Hospital,  Portland,  Me.      Cost,  »2,150.      A  nmeli    more  commodious   hospital   is  now 

under  construction. 


( 'OMMUNIi '.  1 B  L  K    DISEA  SES. 


619 


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l'lan  of  the  Worcester  Hospital  for  Communicable  Diseases.      From  electrotype  loaned  by  the  Worcester  Busi 


ltd  ..i  Health. 


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621 


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COMMUNICABLE   DISEA  SES. 


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C  OMMUNKJA BLE   DISEA  SES. 


Fig.  6b'. 

Communicable  Disease  Hospital,  Trenton.     Cost  of  building,  $2,449.51 ;  furnishings,  .¥400.31. 
From  Report  of  State  Board  of  Health  of  New  Jersey.  1896. 


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Fig.  64. 
Plan  of  Communicable  Disease  Hospital,  Trenton. 


COJIJirXIf  ABLE    2)1  SEA  SES. 


627 


Fig.  o.">. 

Hospital  for  Communicable  Diseases,  Syracuse.     House  purchased  and  remodeled  and  ward  added. 
Changes  cost  111,146.57.     From  Report  of  Health  Officer,  1S96. 


scAut.  .rfrccr.  nR5T   FLOOR    PLAN. 

Pig.  86. 

Plan  of  the  Communicable  Disease  w  ards  at  the  Cambridge  Hospital.      From  Report  ol  the 
State  Board  ol  Health  ol  Massachusetts,  188  , 


628 


V  OMMUNICABLE   DISEA  SES. 


Fig.  GT. 
Hospital  for  Communicable  Diseases,  Lynn.      Cost,  $5,500. 


Ambulances. 

If  a  hospital  is  provided  for  the  care  of  communicable  diseases  it  is 
very  necessary  that  some  suitable  vehicle  should  be  provided  to  trans- 
port patients  to  it.  Patients  with  scarlet  fever  and  diphtheria  should 
not  be  carried  in  hacks  or  any  other  public  conveyance ;  neither  is  it 
proper  to  carry  such  cases  in  an  ambulance  used  for  general  purposes. 
A  city  or  town  which  maintains  a  "pest  house,"  and  there  are  still 
many  such,  probably  has  no  ambulance,  but  trusts  to  luck  in  hiring 
some  old  express  wagon  whenever  smallpox  chances  to  appear.  If  a 
city  has  sufficient  intelligence  to  provide  a  decent  hospital  for  the  com- 
moner communicable  diseases,  some  sort  of  ambulance  is  usually  pro- 
vided to  be  used  exclusively  for  such  cases.  Yet  the  writer  knows  of 
a  city  of  100,000  inhabitants  which  built  a  contagious  hospital  at  a 
cost  of  •$ 25,000  and  then  hired  by  the  hour  an  undertaker's  wagon  to 
remove  patients  to  it.  Another  city  of  even  larger  size  carries  its  com- 
municable disease  patients  in  its  general  ambulance. 

The  following  account  of  the  ambulance  service  for  the  smallpox 
hospital  in  St.  Louis  is  by  the  superintendent  i1 

"  I  have  seen  no  later  than  a  year  ago,  a  patient  brought  to  this  institution  in 
what  was  at  one  time  an  ambulance;  but  from  the  appearance  it  presented  at  the 
time  referred  to,  it  had  evidently  been  used  as  a  chicken  roost,  so  full  of  chicken 
dirt  was  it.  In  this  so-called  ambulance  there  was  not  even  a  pillow,  not  a  blanket, 
in  fact  nothing,  not  even  a  seat,  unless  the  patient  chose  the  floor;  fortunately  the 
patient  was  not  very  sick  at  the  time,  so  he  managed  to  balance  himself  on  the  end 
gate  of  the  wagon  for  fifteen  miles." 


1  St.  Louis,  Report  of  Health  Commissioner  (1896-7),  p.  179. 


COMMUNICABLE   DISEASES. 


629 


In  providing  an  ambulance  for  communicable  diseases  three  things 
should  be  borne  in  mind.  First,  the  ambulance  should  be  so  constructed 
that  it  may  be  easily  disinfected,  and  second,  it  should,  if  possible,  be  so 
arranged  that  patients  may  sit  up  in  it,  as  many  persons  a"re  perfectly 
able,  and  prefer  to  ride  in  that  way  ;  third,  it  should  not  be  forbidding 
in  appearance. 

Doubtless  other  cities  have  a  special  ambulance  for  communicable 
disease,  but  the  following  is  a  list  of  some  which  are  shown  by  their 
health  reports  to  be  so  provided.  Brookline,  Mass.,  District  of  Colum- 
bia, Cambridge,  Trenton,  Grand  Rapids,  Milwaukee,  Minneapolis,  Xew 
Haven,  Charleston,  Xew  York  City,  Utica,  Philadelphia,  Boston,  Brook- 
lyn. Providence,  Buffalo,  Taunton,  Trenton,  Newton,  Mass.,  Paterson, 
Lynn,  Chicago  and  Pittsburgh. 

In  Xew  York  City,  Chicago  and  Utica  cabs  are  used  for  conveying 
many  contagious  cases.  In  Xewton  a  rockaway  lined  with  rubber  is 
employed. 


Fig.  68. 
Ambulance  for  Communicable  Diseases,  Providenci  .     Cost,  $500. 


Ambulances  should  be  disinfected  after  each  use,  but  this  is  in  many 
cities  not  done.  The  ambulance  is  simpi}  kepi  clean  and  washed  oul 
occasionally  with  corrosive  sublimate  or  Bprayed  with  formalin,  as  in 
Minneapolis,  St.  Paul  and  Providence,  or,  in  one  city  at  Least,  fumigated 


630  COMMUNICABLE   DISEASES. 

with  sulphur.  All  cities,  however,  change  the  blankets  and  movable 
bedding  after  each  trip  and  wash  it  or  steam  it.  In  Boston  and  Cam- 
bridge a  rubber  covered  mattress  is  used  which  is  washed  with  bichloride 
after  each  trip. 

An  ambulance  should  be  in  readiness  to  respond  promptly  to  all 
calls,  but  in  small  cities  where  the  calls  are  infrequent  it  is  not  feasible 
to  do  this  in  all  cases.  Thus  in  Paterson,  although  the  city  has  a  hos- 
pital and  an  ambulance  it  owns  no  horse,  and  one  has  to  be  hired  for 
each  occasion.  In  large  cities  like  Xew  York  and  Boston  of  course  the 
ambulance  is  kept  ready  to  respond  at  a  moment's  notice.  There  ap- 
pears to  be  no  rale  in  regard  to  the  attendance  of  a  physician  on  the 
ambulance.  One  goes  with  every  trip  in  Xew  York  but  not  in  Boston. 
In  Boston  a  ward  attendant  in  a  white  duck  suit  accompanies  the 
driver.  In  Providence  a  physician  goes  only  in  severe  cases.  The 
driver  wears  a  long  linen  duster  over  his  ordinary  suit. 

Quarantine. 

The  word  quarantine  is  used  with  varying  significance  in  sanitary 
literature.  The  term  was  originally  applied  to  the  detention  of  a 
vessel  having  on  board  communicable  disease;  but  it  has  come  to  be 
applied  to  any  restriction  placed  upon  the  communication  of  infected 
with  uninfected  persons  or  things.  In  the  opinion  of  the  writer  it 
would  be  well  to  restrict  this  use  of  the  word  to  the  interference  with 
communication  between  infected  and  uninfected  localities,  countries, 
states,  towns,  villages,  etc.  The  detention  of  an  individual  in  a  house 
or  hospital  is  a  matter  requiring  such  totally  different  procedure  that 
it  is  well  to  designate  it  by  another  term,  such  as  isolation. 

Quarantine  also  lias  two  natural  divisions,  maritime  and  inland. 
The  conditions  of  trans-oceanic  and  coastwise  commerce  are  so  different 
from  those  of  communication  on  land,  or  even  on  inland  waters,  that  it 
is  well  to  make  these  divisions  of  the  subject. 

Maritime   Quarantine. 

The  first  colonial  quarantine  law  was  passed  in  Massachusetts  in  1699, 
and  during  the  next  century  every  colony  had  laws  of  this  kind  on  its 
statute  books.  Up  to  the  time  of  the  establishment  of  the  national 
board  of  health  in  1879,  maritime  quarantine  was  entirely  in  the  hands 
of  the  states  which,  however,  frequently  delegated  it  to  the  seaports 
within  their  borders.  The  federal  government  doubtless  has  authority 
to  maintain  quarantine,  and  it  then  for  the  first  time  attempted  to  do  so. 
After  this  board  was  abolished,  quarantine  powers  were  conferred  upon 


(  OMMUNIt  \  1 BLE    DI8EA  SES. 


631 


I   - 


632  COMMUNICABLE   DISEASES. 

the  marine  hospital  service.  At  present  there  is  very  little  direct  fed- 
eral legislation  in  regard  to  quarantine,  but  rules  have  been  formulated 
by  the  secretary  of  the  treasury  which  must  be  obeyed  before  vessels 
can  enter  at  the  custom  house.  Local  quarantines  very  generally  enforce 
these  rules  and  also  act  under  state  laws  and  rules  of  their  own.  The 
federal  government  through  the  medium  of  the  marine  hospital  service 
has  established  the  following  quarantine  stations :  Reedy  Island, 
Delaware  Breakwater,  Cape  Charles,  Cape  Fear,  South  Atlantic, 
Brunswick,  Tortugas,  Gulf  Island,  San  Diego,  San  Francisco,  and  Port 
Townsend.  The  rules  are  promulgated  and  the  stations'  established 
in  accordance  with  the  Act  of  Congress  approved  15  February,  1893. 
This  act  also  gives  the  secretary  of  the  treasury  authority  to  make 
rules  in  regard  to  the  procedure  of  masters  and  owners  at  foreign  ports 
and  enlists  the  consular  service  in  the  aid  of  the  marine  hospital  service. 
Medical  officers  of  this  service  are  also  detailed  from  time  to  time  to  in- 
fected foreign  ports  to  assist  in  seeing  that  infected  vessels  are  not 
allowed  to  sail  for  United  States  ports. 

It  is  the  belief  of  many  and  shared  by  the  writer,  that  maritime 
quarantine  should  be  exclusively  in  the  hands  of  the  federal  government, 
but  at  present  it  is  not,  and  it  is  existing  conditions  that  are  here  con- 
sidered. Most  of  the  quarantines  are  maintained  by  local  governments 
while  some  of  the  most  important  are  exclusively  state  organizations. 
The  federal  government  cannot  supersede  any  of  these  except  on  their 
volition,  but  it  can  and  does  insist  on  minimum  requirements  which 
must  be  uniform  at  all  ports  of  entry. 

All  of  the  seaboard  states  have  laws  in  regard  to  maritime  quaran- 
tine, but  their  treatment  of  the  subject  varies  considerably.  In  the  New 
England  states  and  Delaware,  Georgia,  Maryland,  New  Jersey,  and 
Wasliington,  the  administration  of  quarantine  is  practically  left  to  local 
officers,  that  is,  to  officers  appointed  by  seaport  cities.  In  all  these 
states  except  Georgia  the  board  of  health  or  health  officer  is  given  quar- 
antine power,  but  in  Georgia  this  is  conferred  upon  the  municipal 
governments.  In  the  other  states  the  state  exercises  more  or  less  execu- 
tive power.  In  New  York  the  health  officer  of  the  port  of  New  York, 
in  most  respects  the  most  important  quarantine  officer  in  the  country,  is 
appointed  by  the  governor.  He  must  be  a  physician  of  ten  years' 
experience,  skilled  in  quarantinable  diseases,  and  his  term  of  office  is 
four  years.  In  Pennsylvania  the  control  of  quarantine  is  vested  in  a 
state  board  consisting  of  a  member  appointed  by  the  College  of  Physi- 
cians and  Surgeons,  one  by  the  Maritime  Exchange,  of  the  secretary  of 
the  state  board  of  health,  of  the  health  officer  of  Philadelphia,  of  the 
quarantine   physician   appointed  by  the   mayor  of  Philadelphia,  and  a 


COMMUNICABLE   DISEASES.  633 

member  appointed  by  the  governor  of  Pennsylvania.  In  Virginia  the 
governor  appoints  the  quarantine  officer  at  Newport  News  and  his  term 
of  office  is  two  years  ;  but  for  the  protection  of  Norfolk  and  Portsmouth 
the  state  has  established  a  board  of  quarantine  commissioners  for  Eliza- 
beth River,  three  of  whom  are  appointed  by  the  city  council  of  Nor- 
folk, three  by  the  city  council  of  Portsmouth,  and  one  by  the  judge  of  the 
"county  court  of  Norfolk  County.  In  South  Carolina  the  state  board  of 
health  controls  quarantine  and  the  quarantine  officers  are  appointed  by 
the  governor.  The  quarantine  officer  at  Charleston,  the  chief  port,  has 
a  salary  of  *1,800  and  is  nominiated  by  the  state  board  of  health.  In 
Florida,  also,  the  state  board  of  health  has  full  control  of  quarantine  and 
the  local  officers  are  its  agents.  When  this  law  went  into  effect  the  two 
counties  of  Escambia  and  Franklin  were  allowed  to  maintain  a  separate 
health  and  quarantine  organization,  but  this  arrangement  has  recently 
been  abandoned.  In  Alabama  the  quarantine  of  Mobile  is  administered 
by  a  board  established  by  special  act  and  known  as  the  quarantine  board 
of  Mobile  Bay.  It  consists  of  the  president  of  the  board  of  revenue  and 
road  commissioners  of  Mobile  County,  the  mayor  and  health  officer  of 
Mobile,  the  president  of  the  Chamber  of  Commerce  and  the  president  of 
the  Medical  Association  of  Mobile,  and  the  probate  judge  and  the  health 
officer  of  Baldwin  County.  In  Mississippi  and  Louisiana  the  state 
board  of  health  has  charge  of  quarantine,  and  in  Texas  the  state  health 
officer.  In  Oregon  the  governor  appoints  local  quarantine  officers  of 
whom  there  are  four.  In  North  Carolina  the  entire  quarantine  has  been 
transferred  to  the  marine  hospital  service. 

It  is  thus  seen  that  in  New  York,  South  ( larolina,  Florida,  Mississippi, 
Louisiana,  Texas,  and  <  )regon  maritime  quarantine  is  directly  admin- 
istered by  state  officials,  while  in  the  other  states  administration  is  in 
the  hands  of  local  officials,  though  sometimes,  as  at  Philadelphia,  Eliza- 
abeth  River,  Va.,  and  Mobile  Bay,  Ala.,  a  special  hoard  is  created  to  be 
made  up  of  certain  of  the  neighboring  officials. 

Besides  the  above  evidences  of  state  control,  in  Maine.  New 
Hampshire,  and  Alabama  the  state  hoard  of  health  is  authorized  to 
establish  quarantine,  and  if  its  arrangements  are  in  conflicl  with  Local 
regulations,  the  latter  musl  give  way.     In  Alabama,  Georgia,  Louisiana, 

Maryland,  Rhode  Island,  and  Texas  the    governor  also  has  authority     to 

proclaim  quarantine.  It  is  thus  seen  thai  while  in  a  considerable  num- 
ber of  seaports,  including  such  important  ones  as  Boston,  Baltimore,  and 
San  Francisco,  quarantine  is  a  local  affair,  yel  in  the  main  there  is  a 
disposition  to  consider  it  a  function  of  the  state  rather  than  of  the  Local 
government. 


634  COMMUNICABLE   DISEASES. 

There  is  a  very  considerable  amount  of  statutory  legislation  in  regard 
to  quarantine  and  also  not  a  few  ordinances  made  by  the  seaport  cities 
themselves.1  There  are  also  a  good  many  rules,  orders,  and  proclama- 
tions issued  under  authority  by  various  quarantine  officials,  all  of  which 
go  to  make  up  the  volume  of  quarantine  legislation.  Much  of  the  statu- 
tory legislation  is  very  old,  dating  back  to  the  eighteenth  century.  Its 
phraseology  is  apt  to  be  peculiar  and  many  of  its  provisions  are  obso- 
lete. It  often,  too,  deals  with  details  which  might  well  be  left  to  the 
quarantine  officer.     Many  of  these  acts  sadly  need  revision. 

Several  of  the  states  in  the  interior  lying  upon  navigable  lakes  or 
rivers,  have  copied  some  of  the  quarantine  provisions  of  the  seaboard 
states  in  regard  to  the  detention  of  vessels.  Among  such  are  Kentucky? 
Ohio,  West  Virginia,  Michigan,  and  also  the  cities  of  Chicago  and 
St.  Louis,  but  the  conditions  are  so  different  from  what  prevails  on  the 
sea  coast  that  these  regulations  rather  belong  to  the  subject  of  inland 
quarantine.  Among  the  subjects  covered  by  quarantine  legislation  are 
the  following : 

Authority  t<>  declare  quarantine.  The  authority  to  decide  what 
vessels  shall  be  detained  and  to  order  them  into  quarantine  is  some- 
times conferred  upon  the  governor,  as  in  Alabama,  Georgia,  Maryland, 
Rhode  Island,  Texas  and  Louisiana,  and  more  often  upon  the  state 
board  of  health  as  in  Florida,  Louisiana,  Maine,  Massachusetts,  New 
Hampshire,  South  Carolina,  and  Texas  ;  but  it  is  usually  given  to  the 
local  authority.  This  authority  is  granted  in  all  states  except  Penn- 
sylvania, Florida,  Mississippi,  Louisiana  and  Texas.  More  rarely  the 
statute  attempts  to  specify  the  vessels  that  shall  be  subject  to  quaran- 
tine. This  is  more  often  found  in  the  older  laws,  as  those  of  Connecti- 
cut, Delaware,  Maine,  New  Hampshire,  New  Jersey,  New  York,  North 
Carolina  and  South  Carolina,  though  it  is  sometimes  found  in  some  of 
the  newer  laws.  Thus  in  Connecticut  it  is  every  vessel  having  sick- 
ness on  board ;  in  Delaware  any  "  vessel  having  on  board  more  than 
forty  persons,  or  any  one  sick  with  any  infectious  disease,  or  coming 
from  any  sickly  port."  Infected  vessels  or  those  suspected  to  be,  or 
vessels  from  any  infected  port,  are  common  expressions  in  statutes  and 
local  regulations.  In  San  Francisco  in  addition  to  the  above,  "  vessels 
with  decaying  cargoes  or  which  have  unusually  foul  or  offensive  holds  " 
are  subject  to  quarantine.     The  section  given  below  is  an  example  of  a 


1  Among  the  latter  which  the  writer  has  examined  are  those  of  Bath,  Boston, 
Baltimore,  Bangor,  Fall  River,  Gloucester,  Jersey  City,  New  York  City,  Mobile, 
New  Bedford,  New  Haven,  Newport,  Philadelphia,  Providence,  Provincetown,  San 
Francisco,  and  Wilmington,  Del. 


COMMUXICABLE    DISEASES.  635 

modern  and  specific  statutory  declaration  of  quarantine.1  An  example 
of  a  governor's  proclamation  of  quarantine,  that  of  the  governor  of 
Texas  may  be  found  on  page  847,  PuUic  Health  Reports,  United  States 
marine  hospital  service  1900.  Many,  if  not  most  of  the  definitions  as 
to  what  vessels  are  subject  to  quarantine  are  found  in  local  regula- 
tions, and  this  subject  will  be  further  considered  in  connection  with 
quarantine  administration. 

Authority  to  make  rules  in  regard  to  quarantine  is  conferred  upon 
the  state  sanitary  officials  in  South  Carolina,  Florida,  Alabama.  Mis- 
sissippi, Louisiana,  and  upon  the  governor  in  Texas  ;  but  in  most  of  the 
states  the  seaport  towns,  or  the  local  boards  of  health,  or  the  quaran- 
tine boards  have  such  authority  and  have  very  generally  taken  advan- 
tage of  it. 

The  board  of  health  in  Charleston  can  make  quarantine  rules  but 
only  under  the  direction  of  the  state  board  of  health.  In  New  York 
the  health  officer  of  the  port  of  Xew  York  in  addition  to  his  other 
duties  and  his  ''control"  of  quarantine  "shall  in  the  presence  of  im- 
minent danger  of  winch  lie  shall  be  the  judge,  take  the  responsibility  of 
applying  such  additional  measures  as  may  be  deemed  indispensable  for 
the  protection  of  the  public  he'alth."2 

Provisions  are  sometimes  made  for  the  publication  of  these  regu- 
lations. In  Rhode  Island  they  must  "be  published  in  one  or  more 
newspapers,  published  in  the  state  within  or  nearest  the  town  w  herein  " 
they  w»-re  adopted.  In  Alabama  the  quarantine  board  of  Mobile  Bay 
is  to  provide  the  towboat  captains  and  pilots  with  rules  printed  in 
English,  Spanish,  German  and  French,  and  these  officers  are  to  furnish 
them  to  the  masters  of  incoming  vessels.  A  similar  requirement  is 
made  of  pilots  in  Louisiana,  Maine  New  Hampshire,  South  Carolina 
and  Washington,  and  in  New  Hampshire  the  town  authorities  arc  to 
notify  the  commanders  of  neighboring  forts  and  ask  their  assistance  in 
notifying  \<ssels  to  anchor  at  quarantine. 

Duties  of  Masters.  Most  of  the  statutes  and  nearly  all  of  the 
local   regulations  require  that  vessels  subject  to  quarantine,  or  infected 

I  N.-w  F/ork,  Revised  Statutes  i  1896),  p.  24  L6  |  Public  Health  Law,  Sec  I L0): 

II  Every  vessel  arriving  al  tin-  port  of  New  Fork  from  an;  place  where  a  quaran- 
tinable  disease  existed  at  the  time  of  departure,  or  which  shall  have  arrived  at  any 
such  place  ami  proceeded  therefrom  to  New  Sfork,  or  on  board  of  which  during  the 
voyage  any  case  of  any  such  disease  sliall  have  occurred,  shall  remain  ;n  quarantine 
until  tli<  health  officer  grants  a  permit  tor  the  discharge  of  such  vessel  or  cargo  or  both. 
Everj    vessel  arriving  at  the  port  of    New   Fori   from  any  foreign  port,  and  everj 

vessel  from  ;i  domestic  port   (in  the  ordinary  passage  from  which  they  pass   south  of 

Gape  Henlopen,  arriving  between  the  first  day  of  May  and  the  firsl  day  of    Novem 
hen.  shall    .     .    .    be  subject  to  visitation.11 

\eu  Fork,  Revised  statutes  (1896),  Public  Health  Law,  Sec.   101. 


<336  COMMUNICABLE   DISEASES. 

vessels,  or  vessels  from  infected  ports,  or  other  specified  classes  of 
vessels,  shall  come  to  anchor  at  the  quarantine  grounds,  or  as  close  to 
the  quarantine  grounds  as  possible,  or  as  soon  as  a  safe  berth  can  be 
reached.  In  Rhode  Island  where  provision  is  made  for  the  appoint- 
ment of  a  sentinel,  the  master  is  liable  only  when  he  refuses  to  anchor 
after  being  hailed. 

Some  of  the  states,  as  New  Hampshire,  North  Carolina,  and  Wash- 
ington, require  the  master  to  report  to  the  quarantine  officer  or  other 
local  authorities  if  his  vessel  is  infected.  In  New  Hampshire  he  is  to 
report  if  any  person  on  board  is  or  has  been  sick  with  any  infectious 
disease,  or  if  there  are  any  goods  on  board  which  may  be  infected. 
Most  of  the  state  laws  require  the  master  to  give  to  the  quarantine 
officer  information  desired  bj  the  officer.  Sometimes  the  law  requires 
him  to  make  a  truthful  statement,  and  in  other  cases  he  may  be  put 
under  oath  by  the  quarantine  officials.  Sometimes,  as  in  the  Massa- 
chusetts law  which  was  passed  in  1797,  seamen  and  passengers  may 
also  be  put  under  oath.1  In  Georgia  the  master  is  required  to  deliver 
up  all  his  books  and  papers,  and  in  New  York,  Florida  and  Virginia  to 
show  his  bill  of  health.  Often  a  general  provision  is  introduced  that 
the  master  shall  conform  to  all  the  provisions  of  the  law,  and  that  fail- 
ure to  obey  any  of  them  shall  subject  him  to  the  prescribed  penalty. 

Duties  of  Pilots  and  Toivboat  Captains.  Pilots  and  the  masters  of 
tow  boats  may  be  responsible  for  the  failure  of  a  vessel  to  come  to 
anchor  at  quarantine,  and  as  these  persons  are  in  a  position  to  be  well 
informed  as  to  quarantine  rules,  and  are  more  easily  controlled  by  the 
quarantine  officers,  it  often  happens  that  they  are  by  law  made  respon- 
sible for  its  enforcement.  The  duties  of  pilots  in  notifying  masters  of 
vessels  of  the  quarantine  regulations  has  already  been  alluded  to. 
Their  other  duties  and  responsibilities  are  explicitly  set  forth  in  the 
South  Carolina  law  given  below.2 


1  Massachusetts,  Revised  Statutes  (1882),  Chapter  80: 

"  Sec.  63.  A  master,  seaman,  or  passenger,  belonging  to  a  vessel  on  board  of 
which  any  infection  then  is  or  has  lately  been,  or  is  suspected  to  have  been,  or 
which  has  been  at  or  has  come  from  a  port  where  an  infectious  distemper  prevails 
that  may  endanger  the  public  health,  who  refuses  to  make  answer  on  oath  to  such 
questions  as  may  be  asked  him  relating  to  such  infection  or  distemper  by  the  board 
of  health  of  the  town  to  which  such  vessel  may  come  (which  oath  any  member  of 
the  board  may  administer),  shall  forfeit  a  sum  not  exceeding  two  hundred  dollars; 
and  if  not  able  to  pay  said  sum,  he  shall  suffer  six  months1  imprisonment.11 

2  South  Carolina,  Revised  Statutes  (1893) : 

"  Sec.  1005.  It  shall  be  the  duty  of  each  pilot  belonging  to  either  of  the  said 
ports  to  use  his  utmost  endeavors  to  hail  every  vessel  he  shall  discover  entering  the 
port,  and  to  interrogate  the  master  of  such  vessel  in  reference  to  all  matters  nec- 
essary to  enable  such  pilot  to  determine  whether,  according  to  the  provisions  of  the 


COMMUNICABLE   DISEASES.  637 

The  regulations  of  Mobile  Bay  require  that  pilots  and  officers  and 
crews  of  towboats  shall  not  board  infected  vessels,  but  shall  direct  thern 
to  the  quarantine  station,  and  the  pilot  on  boarding  all  other  vessels 
must  hoist  a  flag  at  half  mast  at  the  fore  until  visited  by  the  quarantine 
officer.  In  Georgia  and  South  Carolina  the  pilot  must  not  board  an  in- 
fected vessel.  In  Louisiana  the  rules  of  the  state  board  of  health  require 
that  pilots  are,  on  boarding,  to  hand  the  master  a  printed  form,  and 
the  latter  shall  fill  out  in  writing  the  names  of  the  crew  and  passengers, 
and  answer  truthfully  the  questions  therein,  and  return  the  same  with 
the  bill  of  health  to  the  quarantine  officer.  Several  of  the  laws  stipu- 
late that  pilots  who  have  boarded  a  vessel  shall  not  leave  it  until  a  per- 
mit is  granted.  The  rules  of  Providence,  Newport,  and  Louisiana  make 
similar  provisions  in  regard  to  customs  officials,  and  the  San  Francisco 
rules  require  them  to  lie  disinfected  and  vaccinated  as  are  others.  The 
Louisiana  statute  specifically  forbids  the  masters  of  towboats  to  receive 
passengers  or  freight. 

Communication  with  Vessels  hi  Quarantine.  The  object  of  placing 
vessels  in  quarantine  is  to  prevent  disease  passing  from  them  to  the 
shore.  Hence,  prohibition  of  intercourse  between  infected  vessels  and 
the  shore  is  the  most  important  part  of  quarantine  legislation.  Most  of 
the  laws  provide  that  no  person  shall  go  ashore  from  a  vessel  in  quaran- 
tine without  a  permit  from  the  quarantine  officer;  and  in  Alabama, 
Georgia,  North  Carolina,  Rhode  Island,  and  Virginia  such  person  may 
be  arrested  and  returned  to  the  vessel  or  confined  on  shore.     When  the 

preceding  sections,  such  vessel  is  subject  to  quarantine  or  examination  by  the 
quarantine  officer. 

"Sec.  1006.  If,  from  the  answers  obtained  to  such  inquiries,  it  shall  appear 
that  such  vessel  is  subject  to  quarantine  or  examination  by  the  health  officer, 
according  to  the  preceding  sections,  the  pilot  shall  immediately  give  notice  to  the 
master  of  the  vessel  that  he,  his  vessel,  his  cargo,  crew,  and  passengers  are  subject 
to  such  examination,  and  that  he  must  proceed  and  anchor  said  vessel  at  the  quar- 
antine anchorage,  there  to  await  the  further  directions  of  the  quarantine  officer. 

11  Sec.  1007.  It  shall  be  the  duty  of  every  pilot  who  shall  conduct  into  port  a 
vessel  subject  to  quarantine  or  examination  by  the  health  officer  — 

"1.  To  bring  such  vessel  to  anchor  within  the  buoys  marking  the  quarantine 
anchorage. 

"2.     To  prevent  any  vessel  or  boat  from  coming  alongside  oi  the  vessel  under 

his  charge,  and  to  prevent  anything  on  hoard  from  being  transferred  to  or  thrown 
i  n  t  < »  any  oi  her  \  BSSel  or  In, at. 

•■ ::.     To  present  to  the  master  of  the  vessel  a  printed  copy  of  this  chapter  when 

sin  h  copy  shall  have  been  delivered  to  him  for  that   purpose. 

"  4.  To  take  care  that  00  violation's  of  this  chapter  be  committed  by  any  person, 
and  to  report  such  as  shall  be  committed,  as  soon  as  maj  be,  to  the  health  officer. 

"  r>.  To  subject  himself  to  such  detention  and  delay  and  cleansing  and  purifica- 
tion as  to  his  person  and  clothing  as  shall  he  prescribed  by  the  health  officer  after 
having  boarded  or  brought  to  the  quarantine  ground  anj  vessel  subject  to  quaran- 
tine. 


638  COMMUNICABLE   DISEASES. 

ship's  company  is  thus  confined  on  board,  the  master  or  owners  are  by 
the  laws  of  South  Carolina  and  Baltimore,  made  responsible  for  their 
maintenance.  It  is  forbidden  in  many  states  to  carry  goods  on  shore 
and  very  stringent  regulations  are  found  in  New  York,1  and  in  New- 
Hampshire  and  South  Carolina  such  goods  may  be  seized  by  the  quar- 
antine officers.  In  New  Jersey  and  in  Boston  there  is  a  provision 
against  throwing  any  bedding  or  clothing  from  a  vessel  in  quarantine.2 
In  New  Jersey,  and  in  New  York  City,  rags  and  hides  may  not  be 
landed  without  a  special  permit. 

It  is  also  forbidden  persons  to  go  on  board  vessels  in  quarantine  and  in 
Louisiana,  butchers,  bakers,  stevedores,  and  runners  are  named  as  possi- 
ble offenders.  In  North  Carolina  the  master  is  liable  unless  he  informs 
the  offender  that  he  cannot  board.  Such  persons  are  also  liable  to 
detention  on  board  as  long  as  the  quarantine  officer  deems  necessary-. 
In  New  York  any  one  who  has  any  communication  or  intercourse  with 
any  vessel  at  quarantine,  or  with  any  of  the  crew  or  passengers  of  such 
vessel,  or  who  enters  the  quarantine  ground  or  anchorage  is  liable  to  the 
penalty.  In  South  Carolina,  Providence,  and  Newport,  boats  are  not 
allowed  alongside  or  to  pass  among  vessels  at  quarantine. 

New  Hampshire,  New  Jersey,  the  City  of  New  York,  Rhode  Island, 
and  Washington  provide  that  if  a  vessel  leaves  quarantine  without  permit 
she  may  be  forcibly  returned  at  the  owner's  expense,  the  costs  to  be  a 
lien  upon  her. 

Inspection.  Nearly  all  the  statutes  and  regulations  provide  for  the 
inspection  of  vessels  at  quarantine  for  the  purpose  of  determining  the 
question  of  their  infection  and  their  subsequent  treatment.  These 
laws  impose  duties  both  on  the  masters  of  vessels  and  on  the  quarantine 
officers.  The  former  are  required  to  submit  their  vessels  to  inspection, 
and  as  has  been  shown,  are  to  furnish  all  needed  information  and  show 
their  books  and  papers  and  present  their  bill  of  health.  The  quarantine 
officer  in  turn  is  required  to  inspect  vessels  "  immediately  "  or  "  as  soon 
as  possible  ;  "  but  as  a  proper  inspection  cannot  be  made  at  night,  it  is 
usually  directed  that  it  shall  be  made  between  sunrise  and  sunset- 
Some  of  the  statutes,  as  those  of  New  York,  South  Carolina,  and  Flor- 
ida go  into  some  detail  as  to  the  duties  of  the  quarantine  officer  in 
inspection,  but  usually  these  matters  are  left  to  be  incorporated  in  the 
local  rules  governing  quarantine. 

Care  of  the  Sick.  Quarantine  officers  are  generally  authorized  to 
remove  the  sick  from  the  vessel  to  the  shore,  in  order  that  they  may  be 
the  better  cared  for,  and  this  is  usually  done,  but  they  also  have  the 

1  New  York,  Revised  Statutes  (1896),  p.  2418,  (Public  Health  Law,  Sec.  131c.) 
New  Jersey,  Rule  9,  State  Board  of  Health,  29  June,  1897. 


COMMUNICABLE    DISEASES.  639 

option  of  confining  them  on  the  vessel.  In  Louisiana  the  state  board  of 
health  is  required  to  have  nurses  and  physicians  on  call  at  all  times,  and 
in  Texas  the  state  quarantine  officers  are  to  provide  for  all  persons  held 
in  quarantine.  Usually,  however,  the  laws,  especially  the  older  ones, 
require  that  the  cost  of  caring  for  the  sick  shall  be  a  charge  upon  tl it- 
vessel. 

Disinfection.  Quarantine  officers  are  usually  authorized  to  disinfect 
or  order  the  disinfection  of  infected  vessels  and  their  cargoes,  and  also 
the  ship's  company.  The  New  York  statute  is  very  explicit  as  to  what 
may  be  done.  Usually,  however,  the  details  of  disinfection  are  left  to 
the  local  officer,  it  is  usually  provided  that  the  cost  of  disinfection 
shall  be  paid  by  the  vessel;  and  sometimes  as  in  Xew  York,  the 
fee  to  be  charged  for  this  service  is  fixed  by  statute. 

Vaccination.  Several  of  the  states  as  New  York,  Xew  Jersey,  and 
South  Carolina  provide  for  the  vaccination  of  all  persons  on  board  who 
have  not  been  previously  protected  against  smallpox.  In  Xew  York  if 
they  refuse  to  submit  to  examination  or  vaccination,  they  are  to  be 
detained  at  the  expense  of  the  ship  for  the  period  of  incubation  of 
smallpox. 

Expenses  of  Quarantine.  Most  of  the  older  laws  provide  that  all  the 
expenses  of  quarantine  such  as  moving  vessels,  furnishing  the  crew  with 
subsistence,  caring  for  the  sick,  etc.,  shall  be  paid  by  the  vessel,  and 
shall  be  a  lien  upon  it  or  upon  the  cargo. 

F>e8.  It  is  usually  provided  by  law  that  fees  shall  be  charged  for 
the  inspection  of  vessels  at  quarantine  and  the  issuing  of  permits  and 
other  services,  and  these  fees  are  generally  fixed  by  statute.  In  some 
ports,  however,  no  tecs  are  charged  as  will  be  noted  in  the  following 
pages. 

Penalties.  The  penalties  provided  for  the  violation  of  quarantine 
laws  are  more  severe  than  arc  found  in  other  sanitary  laws,  those  for 
the  adulteration  of  food  only  approaching  them.  A  common  maximum 
is  $500.  In  Louisiana,  South  Carolina,  and  New  York  the  maximum 
i-  $2,000  or  twelve  months  imprisonment  for  any  violation  of  quarantine 
regulations  by  masters,  or  for  unloading  g Is.     In  Georgia  the  penalty 

for  an  infected  person  entering  the  slate  is  $500  and  imprisonment. 

Quarantine   .  1  dministration. 

Vessels  subject  to  Inspection  and  Quarantine.  The  determination  of 
liability  to  quarantine  rests  on  federal  regulations,  state  laws,  and  local 
rules.  The  older  state  laws,  many  of  which  are  still  in  Force,  required 
the  quarantine  of  all  vessels  from  infected  ports  and  all  infected  vessels, 

and  all  suspected  to  be  such.      Similar  provisions    are  found  al80  in    the 


640  COMMUNICABLE   DISEASES. 

older  local  rules.  Something  more  specific  is,  however,  necessary,  and  is 
furnished  by  the  treasury  regulations,  the  later  statutes,  governors' 
proclamations,  and  rules  of  the  more  important  state  and  local  quaran- 
tines. The  United  States  treasury  regulations  given  below  may  be  con- 
sidered the  basis  for  procedure  at  most  quarantines.1 

These  regulations  are  a  minimum  and  their  enforcement  is  secured 
through  the  assistance  of  the  customs  officers.  They  are  very  generally 
followed  except  perhaps  at  some  of  the  smaller  ports  where  there  are 
only  a  few  entries  during  the  course  of  the  year. 

These  are  the  rules  followed  throughout  New  England  and  on  the 
Pacific  coast,  except  that  at  Boston  all  vessels  from  ports  south  of 
Virginia  are  inspected  from  1  June  to  31  October,  and  also  all  vessels 
which  within  six  months  have  been  in  an  infected  port.  In  Province- 
town,  vessels  from  the  British  Provinces  are  inspected  from  1  May  to 
1  November,  and  in  New  Haven  all  the  year  round,  and  in  the  latter 
port  southern  vessels  are  inspected.  Passing  from  New  England 
towards  the  south,  more  attention  is  paid  to  the  danger  of  yellow  fever 
infection.  In  New  York,  New  Jersey,  Baltimore,  and  Virginia  vessels 
from  southern  points  are  inspected  during  the  summer.  In  New  York 
and  New  Jersey  this  applies  to  vessels  from  below  Cape  Henlopen,  in  Bal- 
timore, Cape  Henry,  and  at  Newport  News  and  Norfolk,  Cape  Lookout, 
but  in  the  latter  ports  any  vessels  which  at  any  time  within  thirty  days 
have  been  south  of  the  limit  are  inspected.  These  inspections  are  made 
only  between  1  May  and  1  November,  though  in  Baltimore  the  time 
limits  are  somewhat  elastic  according  to  the  season.  In  the  southern 
states  where  the  greatest  dread  of  yellow  fever  is  felt  and  where  this 
is  the  chief  disease  to  be  quarantined,  the  number  of  vessels  subject  to 

1"1.  Vessels  arriving  at  ports  of  the  United  States  under  the  following  conditions 
shall  be  inspected  by  a  quarantine  officer  prior  to  entry : 

"A.     Any  vessel  with  sickness  on  board. 

"B.     All  vessels  from  foreign  ports. 

"C.  Vessels  from  domestic  ports  where  cholera  or  yellow  fever  prevails  or  where 
smallpox  or  typhus  fever  prevails  in  an  epidemic  form. 

"Exceptions. — Vessels  not  carrying  passengers  on  inland  waters  of  the  United 
States.  Vessels  from  the  Pacific  and  Atlantic  coast  of  British  America,  provided 
they  do  not  carry  persons,  or  effects  of  persons,  non-resident  in  America  for  the 
sixty  days  next  preceding  arrival,  and  provided  always  that  the  port  of  departure  be 
free  from  quarantinable  disease.  Vessels  from  other  foreign  ports  via  the  excepted 
ports  shall  be  inspected. 

"D.  Vessels  from  foreign  ports  carrying  passengers  having  entered  a  port  of 
the  United  States  without  complete  discharge  of  passengers  and  cargo.  Such  ves- 
sels shall  be  subject  to  a  second  inspection  before  entering  any  other  port.  Vessels 
from  ports  suspected  of  infection  with  yellow  fever,  having  entered  a  port  north  of 
the  southern  boundary  of  Maryland  without  disinfection,  shall  be  subjected  to  a 
second  inspection  before  entering  any  "port  south  of  said  latitude  during  the  quaran- 
tine season  of  such  port." 


COMMUNIS  A  13 LE    DISK.  [  sKs.  (j^l 

the  rules  is  usually  larger  than  at  the  north,  and  the  rules  are  more 
stringent.  In  South  Carolina  the  statute  requires  that  all  vessels  from 
"infected  or  suspected  latitudes  or  ports  "*  shall  he  detained  five  days. 
hi  these  states  suspected  ports  are  those  not  known  to  he  free  from  infec- 
tion in  the  West  Indies,  Mexico.  Central  and  South  America  north  of 
Rio  de  la  Plata,  and  the  west  coast  of  Africa.  Unlike  many  other  quar- 
antines, that  of  Charleston  does  not  inspect  vessels  from  the  United  States 
unless  such  ports  are  known  to  he  infected,  or  unless  they  come  via 
these  [torts  from  a  foreign  country.  Such  vessels  are  known  as  "  via 
vessels."  In  Savannah  "  via  vessels  "  and  all  coastwise  vessels  which 
during  their  last  voyage  were  in  a  foreign  port  are  inspected.  In  Flor- 
ida all  foreign  and  "via  vessels"  are  inspected,  and  also  all  domestic 
vessels  between  1  May  and  1  November,  unless  special  license  is  given. 
Thus  at  Key  West  the  regular  Havana  steamers  are  given  certain 
exemptions,  and  at  Punta  Rassa  the  regular  steamer  from  Myers  to 
Punta  Gorda  is  not  inspected.  At  Pensacola  all  domestic  vessels  are 
inspected  during  the  summer  season.  Inspection  of  the  sponge  licet  is 
generally  required,  owing  to  the  frequent  off  shore  communication 
between  the  spongers  and  the  Cuban  fishermen.  At  Mobile  all  vessels 
are  inspected  the  year  around,  hut  a  few  locally  owned  coasters  and 
fishermen  are  exempted  by  special  permit.  All  vessels  arriving  at  the 
Louisiana  and  Texas  quarantine  stations  arc  inspected. 

It  is  of  course  the  duty  of  masters  to  make  themselves  acquainted 
with  quarantine  as  with  all  other  laws,  and  the  greater  number  of  cap- 
tains sailing  to  the  larger  and  more  frequented  ports  are  doubtless  well 
aware  of  the  regulations.  If  not  previously  informed  they  are  in- 
structed by  the  pilots.  Tow  boat  captains  also  are  instructed  as  to  the 
rides,  and  would  rarely  violate  them  by  bringing  a  vessel  beyond  the 
quarantine  grounds.  At  some  ports  in  addition  to  this,  a  signal  officer 
is  appointed  to  hail  all  vessels  and  order  to  the  proper  anchorage  all 
those  requiring  inspection.  Such  a  signal  officer  is  employed  at  Provi- 
dence. Sometimes  the  quarantine  officer  is  dependent  on  outside  in- 
formation, thus  at  Norfolk  he  is  telephoned  by  the  consignees  or  the 
pilots'  association.  At  the  more  important  ports  the  quarantine  station 
Hated  near  by  and  Commanding  a  good    view     of    the    entrance,  and 

the  quarantine  officers  are  supplied  with  boats,  or  steamers  are  con- 
stant^   on   hand,  so    thai    no  vessel  can  enter  without   being  seen. 

It  is  of  course  t he  dut  \  of  all  \essels  subjeel  to  inspection  to  an- 
chor at  the  quarantine  grounds.  These  grounds  are  frequently  marked 
hv    yellow   buoys  or  03    buoys    with   yellov   flags,  or  a  quarantine  flag, 

Usually  yellow,  is  set  in  a  prominent  place  on  the  shore  nearest  the  an- 
chorage.     When  the  vessel  coiiies  to  anchor  i he  quarantine  signal   is  to 

I! 


G42  COMMUNICABLE    DISEASES. 

be  set.  The  old  laws  of  Rhode  Island  and  South  Carolina  required  the 
colors  to  be  set  in  the  shrouds,  but  this  signal  is  now  used  for  another 
purpose,  though  the  Rhode  Island  law  remains  unaltered.  A  red  flag- 
is  the  quarantine  signal  in  Maine,  New  Hampshire,  Oregon  and  Wash- 
ington. In  Connecticut  the  statute  prescribes  white,  but  yellow  is 
the  color  used.  At  Mobile  Bay  the  ensign  is  to  be  set  at  half  mast  on 
the  fore ;  but  most  quarantine  statutes  and  the  federal  laws  prescribe 
yellow.  The  quarantine  signal  for  steamers  in  Louisiana  is  four  long 
and  one  short  blast  of  the  whistle.  At  some  of  the  smaller  ports 
vessels  are  allowed  to  come  to  the  wharf  for  inspection.  This  is  the 
custom  in  the  District  of  Columbia  and  Punta  Rassa,  Fla.,  and  is  occa- 
sionally permitted  in  Providence,  New  Haven,  Norfolk,  and  San  Fran- 
cisco. 

Inspections.  It  is  assumed  that  a  medical  man  will  make  inspec- 
tions of  vessels,  and  this  is  usually  done,  but  it  is  not  always,  except  in 
cases  of  sickness,  in  Gloucester,  Cedar  Keys,  Perth  Amboy,  the  At- 
chafalaya  station  of  the  Louisiana  state  board  of  health  and  at  some  of 
the  Florida  stations.  The  laws  generally  require  that  inspections  shall 
be  made  by  daylight,  but  sometimes  at  New  York  and  in  Louisiana  they 
are  made  at  night.  At  New  York  this  is  done  by  means  of  an  electric 
light ;  those  undergoing  the  ordeal  are  required  to  pass  directly  toward 
a  powerful  electric  light  which  shines  upon  their  faces  and  brings  the 
entire  person  under  the  eye  of  the  inspector  whose  back  is  towards  the 
light.  Only  "  liners  "  are  thus  inspected,  and  in  case  of  suspicion  they 
are  detained  until  morning. 

Means  must  be  provided  for  taking  the  inspector  to  the  vessel,  and 
at  the  great  ports  steam  vessels  are  used  for  this.  The  Boston,  New 
York,  Pennsylvania,  Baltimore,  Savannah,  Louisiana,  and  Galveston 
quarantines  have  towboats  for  this  purpose.  Some  of  these  are  large 
and  powerful  vessels  which  run  up  alongside  steamers,  which  slow  down 
for  the  purpose,  and  set  the  inspector  on  board.  The  towboat  then 
cuts  loose  and  the  two  vessels  steam  alongside  at  a  good  rate  of  speed 
so  that  commerce  is  interfered  with  as  little  as  possible  and  the  incom- 
ing vessel  frequently  is  not  obliged  to  anchor  at  all.  At  some  of  the 
smaller  cities,  as  New  Haven,  Newport  News,  and  sometimes  at  Provi- 
dence, the  quarantine  officer  makes  use  of  the  regular  towboats  of  the 
port.  Launches  are  used  at  Charleston,  Pensacola  and  some  of  the 
larger  ports.  At  the  smaller  ports  rowboats  or  occasionally  sailboats 
are  maintained  at  quarantine,  but  at  some  ports,  as  Providence,  New 
Haven  and  the  other  New  England  ports,  no  boat  of  any  kind  is  owned 
by  the  quarantine  department,  and  the  inspector  has  to  hire  a  boat  for 
the  occasion  or  trust  to  a  chance  ride  on  a  towboat. 


( ■  OMM I  Wit '.  \BIE    1)1  SEA  SES.  043 

When  the  inspector  has  boarded  the  vessel  he  immediately  makes 

his  inspection.     The  treasury  rule  requires  that 

'•  the  bill  of  health  and  clinical  record  of  all  cases  treated  during  the  voyage, 
crew  and  passengers1  lists  and  manifests,  and,  when  necessary,  the  ship's  log  shall 
be  examined.  The  crew  and  passengers  shall  be  mustered  and  examined  and  com- 
pared with  the  lists  and  manifests,  and  any  discrepancies  investigated." 

This  is  the  usual  procedure,  and  in  southern  ports  when  the  previous 
voyage  is  to  he  considered,  the  log  is  generally  examined.  Besides 
these  details  the  master  is  usually  required  to  sign  a  statement  as  to 
the  condition  of  the  vessel  and  the  health  of  the  company,  and  at  some 
ports  this  must  he  a  sworn  statement. 

The  interrogatory  used  in  Florida  is  shown  below.1 

1  Inspection  of  vessels  arriving  nt  tin- ,  18 — . 

•1.     Name  and  class  of  vessel  ?     . 

"2.     Name  of  captain  or  master  ?     . 

"3.     Tonnage  of  vessel"?     -. 

•■4.     From  what  port  is  the  vessel  you  command?     . 

•••">.     How  mafty  days  have  you  been  on  the  passage  '.'     . 

"G.     Where  bound  to  ?    . 

"  7.     At  what  port  or  ports  have  you  touched  within  the  last  ninety  days  '.' . 

"8.  Were  any  contagious  or  infectious  diseases  prevailing  at  those  ports-.'  If 
so.  name  the  ports  and  diseases.     . 

"9.     Was  any  freight,  passengers,  or  ballast  received  at  the  ports  at  which  your 

vessel  touched  '.'     . 

••  10.     Had  you  any  communication  with  another  vessel  on  your  passage-.'     . 

"11.  Have  you  received  any  passengers,  freight,  or  ballast  from  any  other 
vessel  ?    . 


■•  1"_'.      If  so.  give  particulars.     . 

"13.     Have  you  a  bill  of  health  ?    . 

'■14.  During  the  course  of  your  cruise  or  passage,  what  cases  of  disease  have 
occurred  on  board,  and  at  what  date?     . 

"15.  Have  anj  deaths  taken  place  on  board  of  your  vessel  since  you  left  the 
last    port  ?      It' so,  what  dates  and  from  what  causes-.'     . 

"16.     Are  there  any  sick  on  your  vessel  at  this  time-.'    . 

"17.  Has  yellow  fever,  smallpox,  cholera,  plague,  leprosy,  or  other  contagious 
or  infectious  diseases  ever  existed  on  this  ship  ?    . 

"18.     If  so,  when  ?    . 

••  19.     What  is  t he  number  of  officers  and  crew  ?    . 

"20.     What  is  the  number  of  passengers? 


:i.     What  is  your  cargo,  and  to  whom  consigned ?    . 

••  2-.'.     If  in  ballast,  what   is  the  character  of  the  ballast,  where  was   it  taken 

from,  and  how  many  tons  have  you  on  board? . 

Wh;it   is  the  present   sanitary    condition  of   the  vessel,  cargo,  crew,  and 

passengers?       . 

,   \IasU  r. 

8n     ii.  of  Florida,  ( 'ounty  of : 

Before  me, ,  a  notary  public  in  and  for  said  count]  and  State,  per- 
sonally came               ,  master  of   the  ,  tome  well  Known  as  the  person 

named,  who,  after  being  duly  sworn,  deposes  and  says  thai    the  statements  made 
i>\  him  i'i  answer  to  the  foregoing  interrogatories  arc  true. 

■  ■  Sworn  to  and  subscribed  he  tore  me  this  daj  of     ,  A.  I  •.  189 — . 


044  COMMUNIt  \  1 11 LE    DlsEA  SMS. 

It  is  customary  for  the  inspector,  especially  in  the  south,  to  examine 
all  parts  of  the  vessel.  In  San  Francisco  a  very  stringent  regulation 
was  adopted,  aimed  at  the  Chinese  immigants.1 

Masters  of  vessels  from  foreign  ports  are  now  obliged  to  obtain  two 
bills  of  health,  one  of  which  is  given  to  the  quarantine  officer  and  the 
other  filed  at  the  custom  house. 

The  treasury  regulations  and  also  those  of  several  states  and  cities 
require  the  inspection  and  vaccination  of  all  steerage  passengers,  and  in 
case  there  is  smallpox  on  a  vessel,  all  persons  must  be  vaccinated  unless 
they  present  evidences  of  recent  vaccination  or  smallpox,  or  else  they 
must  be  detained  for  fourteen  days. 

In  Texas  in  addition  to  the  master's  affidavit  the  passengers  are 
obliged  individually  to  make  affidavit  as  follows  : 

State  Quarantine  Station-, ,  189 — . 

I,  — -,  do  hereby  solemnly  swear  that  neither   I    nor   my  baggage  have 

been  in  any  place  infected  with  yellow  fever,  cholera,  or  smallpox  within  the  last 
twenty  clays. 

Sworn  to  before  me. 

Where  from  ?  ■ . . 

AVh ere  to  ? . 


A  record  should  be  kept  of  all  inspections,  as  indeed  of  all  other 
quarantine  work,  and  this  is  properly  done  in  all  the  larger  stations,  but 
it  is  frequently  neglected  in  the   smaller  ones. 

After  the  inspection  has  been  completed  the  vessel  is  either  sent  to 
the  infected  anchorage,  which  should  be  out  of  the  line  of  traffic,  or  else 
is  given  pratique.  As  no  vessel  can  be  entered  at  the  custom  house 
unless  it  has  complied  with  the  United  States  quarantine  regulations,  a 
certificate  to  that  effect  is  usually  appended  to  the  permit  given  by  the 
quarantine  officer.      The  form  used  in  Florida  is  shown  on  the  next  page. 


J  San  Francisco,  Regulations  of  Board  of  Health,  2u  July,  1884: 
"  The  Quarantine  Officer  and  his  assistants  shall  make  an  examination  of  every 
part  of  the  vessel  into  which  they  can  enter.  Those  places  which  can  only  be 
entered  through  manholes,  or  very  narrow  places,  shall  be  fumigated  with  sulphur 
or  chlorine,  so  as  to  make  it  impossible  that  any  person  can  remain  therein.  The 
fumigation  shall  be  so  conducted  as  not  to  injure  perishable  articles  of  cargo.  Two 
or  more  inspectors  shall,  after  all  the  Chinese  steerage  passengers  have  been  brought 
on  the  upper  deck,  commence  at  the  extreme  rear  portion  of  each  deck,  including  the 
lower  floor  of  the  engine  room  and  shaft  alley,  and  proceeding  forward  examine 
every  compartment,  stateroom,  storeroom,  partly-empty  coal  bunkers,  excepting 
specie,  mail,  and  wine  rooms,  driving  all  Chinese  steerage  passengers  they  may  lind 
<m  to  the  upper  deck;  and  all  passengers  from  the  inspected  portions  of  the  vessel 
shall  be  kept  secure  until  the  muster  is  over.  When  the  inspection  of  the  vessel  is 
completed,  the  Quarantine  Officer  shall  come  on  deck,  and,  with  the  aid  of  his  assis- 
tants, shall  count  the  Chinese  passengers,  men,  women,  and  children,  separately. 
The  white  passengers  and  crew  must  be  mustered  and  counted  first." 


C  OMMl  WI(  \  I BLE   1>  ISE.  1  SES.  | ;  4 .3 

Port  of ,  Fla., ,  ISO — . 

I  certify  that ,  of ,  from ,  has  in  all  respects  complied  with  the 

quarantine  regulations  prescribed  by  the  Secretary  of  the  Treasury,  and  that  in 
my  opinion  she  will  not  convey  quarantinable  disease.  Said  vessel  is  this  day 
granted  free  pratique. 

Hi, ill/,  [Quarantine)  Officer,  Port  of ,  Fla. 

Treatment  of  P> t*">i.«  on  Infected  Vessels.  Formerly  if  there  was  a 
case  of  contagious  disease  on  board  a  vessel  arriving  at  quarantine,  the 
vessel  with  all  on  hoard  was  kept  in  quarantine  until  every  one  had 
recovered  or  died.  Now,  owing  to  the  erection  of  hospitals  and  build* 
bags  for  suspects  at  the  more  important  quarantines,  such  barbarous 
treatment  is  rarely  necessary.  It  is  only  at  the  most  important  stations 
that  proper  facilities  are  found  for  such  work,  though  even  at  such  ports 
as  Portland,  Providence,  and  New  Haven,  smallpox  infected  vessels  that 
are  likely  to  arrive  could  he  and  have  heen  properly  handled.  Boston, 
New  York.  Baltimore,  .Mullet  Key,  Fla.,  and  the  Louisiana  station  and 
also  the  Reedy  Island,  Delaware  Breakwater,  South  Atlantic.  Tortugas, 
Gulf,  San  Francisco,  and  Port  Towns. -nd  stations  of  the  marine  hospi- 
tal service  are  equipped  for  the  care  of  the  personnel  of  the  vessel  on 
shore.  It  is  required  by  the  treasury  rules  that  if  a  vessel  has  on  hoard 
a  case  of  cholera,  yellow  fever,  typhus  or  smallpox,  all  of  the  passengers 
and  crew  shall  be  removed  to  the  shore,  the  sick  put  in  the  hospital  and 
the  well  kept  under  observation.  The  latter  should  he  segregated  into 
small  groups  between  which  there  shall  he  no  communication.  In 
smallpox  this  isolation  of  the  exposed  is  not  necessary,  provided  they 
have  heen  recently  and  successfully  vaccinated  before  exposure,  as  is 
usually  the  ease  with  most  of  the  passengers  and  crew  of  the  regular 
liners.  The  duration  of  detention  in  yellow  fever  is  ten  days,  and 
cholera  five  days  (though  in  Boston  twenty-one  days  is  required  for 
cholera),  typhus  fever  twenty  days,  smallpox  fourteen  days,  and  plague 
Bfteen  day8.  The  larger  stations  are  well  supplied  with  hospital  build- 
ings, hut  the  arrangements  for  detention  of  suspects  are  not  often  suffi- 
cient and   sometimes  it   is  necessary  in   keep  them  aboard    the  vessel. 

Special  measures  are  taken  in  regard  to  passenger  t  ral'lie  between  the 
yellow  fever  ports  of  the  Wesl  Indies  and  the  southern  states.  Accord- 
ing to  the  treasury  regulations  this  is  permitted  under  the  following 
rules  (  Treasury   Rules,  p.  -i11 »  : 

••  1  a  1     Vessels  t"  !»<■  ni  iron  and  clean  immediately  prioi  to  taking  on  passengers. 

••  (b)  The  vessel  mast  lie  at  moorings  in  the  open  harbor  and  o< .1  approach  the 
wharves,  nor  niusl  the  crew  be  allowed  ashore  a1  the  porl  of  departure. 

"(c)  111  passengers  and  crew  must  lie  immune  to  yellow  fever  and  so  certified 
bj  t  he  United  States  medical  offlcei , 

"(«/)     All  baggage  which  lias  no!   been  disinfected  at  the  port  of  departure  bj 

•  rhe  evidence  ol  Lmmunit)  which  may  be  accepted  bj  the  sanitary  inapectoi  la 

1  lint.    Proof  ol  continued  residence  in  an  endemic  focus  "t  yellow  feyei  i"i  ten  years, 

Second.    Prooi  "i  prei  lous  attack  of  yellow  ferei 


646  COMMUNICABLE   DISEASES. 

the  United  States  medical  officer,  or  which  is  not  in  bond  for  points  north  of  the 
southern  boundary  of  Maryland,  shall  be  disinfected  at  the  quarantine  at  the  port  of 
arrival;  no  bedding  or  household  effects  to  be  allowed  to  enter.1' 

The  extensive  passenger  traffic  of  the  gulf  ports  is  usually  carried 
on  in  this  manner. 

Treatment  of  Goods.  Certain  goods  under  certain  conditions  are 
not  admitted  at  all  into  the  United  States.  According  to  the  treasury 
rules,  all  rags  and  old  textiles,  old  gunny  bags  and  jute,  etc.,  collected, 
packed,  or  handled  in  any  port  where  there  is  cholera  or  yellow  fever 
or  has  been  within  thirty  days,  or  from  any  ports  where-  smallpox  or 
typhus  are  epidemic,  are  not  admitted.  Similar  articles  from  other 
places  are  only  admitted  after  disinfection  in  accordance  with  the 
treasury  rules  at  the  port  of  departure.  Jn  addition  to  this,  the  rules  of 
the  New  Jersey  board  of  health  and  the  local  health  regulations  of 
New  York  and  other  large  ports  require  that  no  rags  or  hides  shall  be 
landed  without  permit  from  the  local  health  officer.  In  New  Jersey 
where  considerable  trouble  has  arisen  from  the  careless  landing  of  bed- 
ding from  the  Atlantic  liners,  this  must  be  disinfected  with  steam.1 

If  smallpox,  cholera,  or  typhus  occurs  on  a  vessel,  all  the  personal 
baggage  or  other  personal  effects  are  disinfected,  and  at  northern  ports 
such  materials  are  not  generally  so  treated  for  any  other  diseases.  At 
the  south  all  the  baggage  accompanying  the  passenger  traffic  is  regularly 
disinfected  unless  in  bond  for  northern  points  and  all  infected  baggage 
is  labeled. 

Except  for  certain  kinds  of  goods  from  cholera  and  plague  districts 
and  in  the  case  of  vessels  from  yellow  fever  districts,  disinfection  of 
the  cargo  is  not  usually  considered  necessary.  In  southern  ports,  how- 
ever,' vessels  from  yellow  fever  ports  are  detained  for  the  disinfection  of 
their  holds  and  cargoes.  There  is  one  class  of  goods,  however,  for  which 
detention  and  disinfection  would  prove  ruinous,  viz.,  fruits  of  all  kinds. 
As  it  is  not  believed  that  these  are  carriers  of  yellow  fever,  the  fruit 
trade  is  generally  carried  on  at  southern  ports  in  accordance  with  the 
regulations  given  below  which  were  adopted  by  the  Louisiana  board  of 
health  in  1896.2 


1  New  Jersey,  Rule  4  of  State  Board  of  Health,  27  June,  1897: 

tL  No  straw  or  bedding  shall  be  landed  from  any  vessel  from  any  foreign  port  or 
from  any  infected  place  until  said  straw  and  bedding  shall  have  been  disinfected 
under  the  supervision  of  the  health  officer  of  the  port,  if  there  be  such  an  officer, 
and  if  there  be  no  such  officer  then  by  the  officer  designated  by  the  local  board  of 
health ;  said  disinfection  shall  consist  in  exposure,  in  a  closed  chamber,  to  steam  at 
a  temperature  not  less  than  240  degrees  Fahrenheit  for  a  period  not  less  than  thirty 
minutes." 

2  Lousinana,  Board  of  Health  Rules,  adopted  23  April,  1896: 

"All  vessels  engaged  in  the  tropical  fruit  trade  between  Central  American,  South 
American,  and  West   Indian    ports  and   Xew    Orleans,  will  be   allowed  to  pass  the 


<  'OMMUWIt  ABLE    BISEA  s  ES.  64 7 

It  is  believed  that  ballast  which  consists  of  rock,  sand,  earth,  and 
sometimes  even  garbage,  is  not  rarely  the  means  of  the  introduction  of 
yellow  fever,  so  that  in  southern  ports  the  disposition  of  ballast  is  a 
matter  of  considerable  importance.  The  treasury  regulations  require 
that  the  ballast  of  an  infected  yellow  fever  vessel  must  be  removed,  ex- 
cept hard  rock  which  maybe  disinfected  in  place.  The  South  Carolina 
law.  as  indeed  that  of  most  southern  ports,  requires  ballast  to  be  dis- 
charged at  quarantine  if  it  comes  from  an  infected  or  suspected  port: 
or  at  least  this  is  the  requirement  in  the  summer  time.  At  some 
stations,  as  New  York,  Mobile  and  Louisiana,  the  ballast  is  used  for  till- 
ing to  make  new  land  around  the  quarantine  grounds.  At  Fernandina 
all  ballast  must  be  discharged  under  water  and  the  Texas  ports  require 
that  it  shall  be  discharged  outside  the  bars.      If  water  ballast  is   used. 


Mississippi  River  Quarantine  Station  without  detention  longer  than  is  necessary  for 
a  thorough  inspection  (either  by  day  or  night)  by  the  quarantine  officers,  so  Ions  as 
a  properly  accredited  medical  agent  of  this  board  certifies  that  such  ports  and  places 
are  free  from  contagious  or  infectious  disease,  and  provided  said  vessels  shall 
strictly  conform  bo  the  following  conditions: 

"First.  They  shall  not  be  allowed  tobring  to  this  port  bedding  or  household 
effects  of  any  kind. 

"Second,  After  leaving  New  Orleans  said  vessels  shall  not  take  on  hoard  pas- 
sengers during  any  part  of  their  trip,  nor  shall  they  bring  passengers  to  this  port, 
except  as  herein  provided.  Cabin  passengers  only  will  be  allowed  at  the  discretion 
of  the  medical  officers,  provided  the  applicant  lias  been  a  resident  of  the  place  for 
ten  days  preceding  and  is  known  to  the  medical  officer.  This  officer  must  satisfy 
himself  that  the  applicant  lias  not  been  in  any  infected  locality  in  the  past  thirty 
days  and  that  none  of  his  effects  have  been  exposed  to  infect  ion. 

14  Third.     They  shall  carry  an  acclimated  crew,  unless  impracticable. 

"They  shall  not  touch  at  any  infected  or  suspected  port,  and  have  no  communi- 
cation with  any  vessel  during  their  voyage,  except  in   case  of  distress. 

■•  Fifth.  They  shall  only  touch  at  such  ports  or  stations  as  are  mentioned  in  their 
schedule,  which  latter  shall  be  communicated  to  the  board  of  health. 

"Sixth.     They  shall  be  required  to  make  a  full  disclosure  when  arriving  at  a 

quarantine  station  of  all  the  ports  and  places  they    have  visited  on  their  voyage. 

■•  seventh.  They  may  take  on  board  a  crew  of  laborers  known  to  be  acclimated 
and  from  some  healthy  point  where  they  permanently  reside  ami  remain,  the  crew 
being  as  nearly  as  possible  always  composed  of  the  same  men.  The  captain  or 
other  officer  may  go  ashore  for  the  purpose  of  entering  or  clearing  vessels  only, 
Any  further  communication  with  shore  or  natives  will  be  considered  a  violation  >■{ 
regulations,  and  vessels  in  default  will  be  treated  accordingly. 

"Eighth,  'l'h.se  vessels  shall  he  cleansed  and.  when  necessary,  disinfected  in 
the  cit  \  of  New  Orleans,  after  discharge  of  cargo. 

■  Ninth.  Vessels  receiving  nighl  inspection  at  quaranl  ine  will  not  be  allowed  to 
discharge  cargo  on  arrival  at  New   Orleans  until  after  a  daylight    inspection  by  the 

shipping  inspector  of  this  hoard,  and  t  he  captains,  owners,  or   agents  shall  nol  allow 

anyone  to  go  ashore  or  to  come  on  board  until  after  such  daylight  inspection. 

"Should  for  any  reason  a  fruit   port   become  infected  or  even  suspicious,  vessels 

from  that  port   will    he   liable  to  sink  additional  regulations  as  the  board  of  health 
may  adopt." 


648  COMMUNICABLE   DISEASES. 

it  must  be  discharged  at  sea  or  disinfected.  Rock  ballast  is  disinfected 
on  board  or  on  shore  by  immersion  in  a  solution  of  corrosive  sublimate, 
1  to  1,000,  or  by  the  use  of  gaseous  disinfectants,  or  by  both.  The  re- 
moval of  ballast  is  done  by  quarantine  employees  who  should  be  yellow 
fever  immunes.  A  charge  of  twenty-five  cents  per  ton  is  made  in 
Florida  ports  and  in  some  others,  but  in  Mobile  the  cost  is  somewhat 
less.      At  Savannah  it  is  twenty  cents  a  ton. 

Disinfection.  In  the  north  as  a  rule  only  infected  vessels  are  disin- 
fected, though  if  they  come  from  infected  ports  or  ports  suspected  to  be 
such,  they  may  be  disinfected  even  if  no  infection  is  known.  Thus  at 
New  York  vessels  from  yellow  fever  infected  ports  or  from  ports  where 
smallpox,  plague,  or  cholera  are  epidemic  are  disinfected.  Sometimes, 
however,  the  disinfection  is  limited  to  the  steerage  and  forecastle. 
More  rarely  is  the  hold  disinfected.  At  the  south  it  is  the  routine  in 
summer  season  to  disinfect  all  vessels  arriving  from  ports  below  north 
latitude  25°;  but,  as  has  been  said,  exceptions  are  made  for  fruiters  and 
regular  liners.  For  disinfection,  steam,  sulphur,  corrosive  sublimate 
and  formaldehyde  are  all  used.  The  requisites  for  efficient  disinfection 
are  laid  down  in  rules  issued  by  the  secretary  of  the  treasury.  Of 
course  only  the  larger  ports  have  arrangements  for  thoroughly  disin- 
fecting a  large  vessel,  though  any  well  equipped  municipal  health  de- 
partment might  disinfect  a  small  vessel  as  well  as  it  can  a  house.  For 
sulphur  disinfection  a  sulphur  furnace  with  a  fan  is  used.  By  this  means 
as  much  as  eighteen  per  cent,  sulphur  dioxide  ma}*  be  forced  into  the 
hold.  Such  furnaces  are  found  at  Portland,  New  York,  Charleston, 
Fernandina,  Mobile,  Mullet  Key,  Louisiana,  and  Sabine  Pass,  and  at 
most  of  the  federal  stations.  The  health  officer  at  New  York,  however, 
prefers  ordinary  sulphur  pots  to  the  furnace.  The  formaldehyde 
apparatus  is  that  designed  by  Kinyoun,  and  has  only  recently  come 
into  use. 

Steam  disinfecting  chambers  are  found  at  most  of  the  federal 
stations  and  at  Boston,  Portland,  New  York,  Baltimore,  Charleston, 
Fernandina,  Mullet  Key,  Pensacola,  Mobile,  Louisiana,  Sabine  Pass,  and 
Galveston.  Some  of  the  chambers  are  very  large,  that  at  Louisiana 
being  50  by  8  feet  and  that  at  Galveston  <!0  by  8.  Corrosive  subli- 
mate solution  discharged  from  a  tank  through  a  hose  is  used  for  flush- 
ing the  interior  of  vessels  at  all  the  more  important  stations.  At  the 
state  quarantine  stations  of  New  York  and  Louisiana  a  steamer  is  fitted 
up  with  a  disinfecting  plant  and  several  of  the  federal  stations,  as  Cape 
Charles,  Ship  Island,  San  Francisco  and  Tortugas,  have  such  vessels. 

Fees.  The  fees  collected  from  vessels  inspected  and  undergoing 
quarantine  have  been  a  source  of  much  trouble.  At  some  ports  the 
amount  is  very  great,  and  if  the  fees  belong  to  the  officers  in  charge  the 


COMMUNIt  A BLE   DlsEA  sEs.  g « 9 

latter  are  unlikely  to  permit  any  change  which  would  lessen  their  in- 
come. In  other  cases,  the  fees  may  go  to  the  city  with  the  same 
results.  The  fee  system  is  bad  and  has  done  much  to  prevent  im- 
provement in  quarantine  administration.  Federal  quarantine  is  free  as 
is  that  of  the  state  of  Texas,  and  the  Tacoma  and  Charleston  quaran- 
tines have  recently  been  made  free  :  but  at  most  ports  fees  are  still 
collected.     The  following  are  some  examples  of  these  fees  : 

In  Gloucester,  Mass..  $2  for  inspection  and  $3  if  a  physician  makes 
it.  In  Providence  and  South  Carolina  it  is  $3  :  in  New  Bedford,  New 
London.  New  Haven.  Port  Angeles,  $5 :  Newport  News  and  Norfolk. 
$5.  In  many  ports  the  fee  is  graded  according  to  the  size  of  the  vessel. 
In  Boston  it  is  $8  for  vessels  of  over  500  tons  and  $5  for  vessels  under 
that.  In  New  York  it  is  $5  for  foreign  vessels  and  $]  to  $3  for  coast- 
ers and  $5  extra  for  night  inspections.  In  Baltimore  the  fee  for  in- 
spection is  one  cent  per  ton  with  a  minimum  of  $2.  In  New  Jersey 
foreign  vessels  are  $5,  domestic  S3,  and  domestic  sailing  vessels  $1. 
The  inspection  fees  in  Savannah  are  $15  for  steamers.  $10  for  ships  or 
barks.  $7.50  for  brigs  or  schooners.  In  Florida  steamers  are  $10,  three 
and  four  masted  vessels  $7.50,  two  masters  $5,  sloops,  $3.  In  Louisi- 
ana ships  are  $20;  barks,  $17  ;  brigs,  $10;  schooners,  $7.50.  Disin- 
fection fees  also  vary  according  to  the  size  of  the  vessel.  In  New  York 
1 1  it-  \  are  from  $5  to  $50 ;  in  South  Carolina,  $10  to  $68  ;  in  Florida. 
$20  to  $60;  in  Louisiana.  $17.50  to  $130.  At  Key  West  the  fee  for 
disinfecting  a  trunk  is  fifty  cents,  a  valise,  twenty-five  cents.  In  Boston 
when  passengers  are  bathed  $]  is  charged  for  each  bath.  Twenty-live 
cents  is  charged  for  vaccinations  in  Boston,  and  in  Portland,  Ore.  also, 
t  Ins  is  the  fee. 

Inland   Quarantine. 

The  quarantine  of  one  place  against  another  by  land  as  well  as  b\ 
sea  was  practiced  in  early  colonial  times  and  was  authorized  by  the 
statutes  of  Massachusetts  and  Rhode  Island  in  the  first  part  of  the 
eighteenth  century.  Shotgun  quarantines  were  nol  unknown  and  men 
with  Loaded  flint-locks  were  stationed  outside  of  villages  to  intercept 
cases  of  smallpox  that  might  travel  that  way.  Towns  might  quaran- 
tine against  tow  1  is  either  in  the  same  or  neighboring  states,  and  front  ier 
towns  sometimes   had   special   privileges   and   duties   in   regard  to  this. 

At    present    many  laws  seem    to    recognize    a    distinction    between    inter- 
state quarantine  and  Local  quarantine  between  towns  within    the  state. 
Interstate  Quarantine.     In  IT'.1"  the  act  given  belov    was  passed  in 
Massachusetts,1  and.  Like  so  man}  Massachusetts  laws,  has  been  copied 

1  Massachusetts,  Pubic  Statutes  (1882),  Chapter  80,  Sec.  12: 
14  The  board  of  health  of  a  town  near  to  or  bordering  upon  either  of  the  neighbor- 
ing states  maj  appoint,  bj  writing,  suitable  persons  to  attend  at    places  by   which 


050  COMMUNICABLE   DISEASES. 

by  other  states,  as  Colorado,  Maine,  Michigan  and  North  Carolina,  and 
a  somewhat  similar  law  is  found  in  Kentucky.  In  this  act  the  burden 
of  interstate  quarantine  is  thrown  upon  the  frontier  towns  of  the  state. 
In  Washington  also  the  towns  alone  are  charged  with  the  duties  of  in- 
terstate quarantine  ;  but  in  all  the  states  mentioned,  except  Massachu- 
setts and  Washington,  the  state  board  of  health  also  has  authority  to 
establish  quarantine  against  the  introduction  of  communicable  disease. 
Of  course  before  the  organization  of  state  boards  of  health  it  was 
natural  that  whatever  interstate  quarantine  there  was  should  be  ad- 
ministered by  local  boards  of  health  on  the  frontier,  just  as  maritime 
quarantine  was,  and  is  in  many  cases  now,  administered  by  the  seaport 
towns  ;  but  with  the  organization  of  state  boards  of  health  it  was  seen 
that  much  more  uniform  and  efficient  action  might  be  secured  by  this 
central  authority.1 

Very  many  of  the  states  named  below  allow  the  local  governments 
within  their  borders  to  establish  local  quarantine,  and  it  can  be  readily 
seen  that  such  may  conflict  with  the  state  operations,  hence  most  of  the 
laws  provide  that  the  state  authority  shall  be  supreme.  The  best  of 
these  interstate  quarantine  laws  provide  that  the  state  board  of  health 
shall  establish  quarantine,  may  make  rules  and  regulations,  establish 
stations,  appoint  inspectors,  provide  for  the  sick,  and  disinfect,  and 
also  provide  that  all  common  carriers  shall  obey  the  rules  so  made.  A 
good  example  of  these  laws  is  that  of  New  Hampshire  given  below.2 

Some  of  the  state  laws  also  deal  directly  with  the  details  of  inland 
quarantine,  and  as  maritime  laws  require  masters  of  vessels  to  report 

travellers  may  pass  from  infected  places  in  other  states;  who  may  examine  such 
travellers  as  it  suspects  of  bringing  any  infection  dangerous  to  the  public  health, 
and  if  need  be  may  restrain  them  from  travelling  until  licensed  thereto  by  the  board 
of  health  of  the  town  to  which  they  may  come.  A  traveller  coming  from  such  in- 
fected place,  who  without  such  license  travels  within  this  state  (except  to  return  by 
the  most  direct  way  to  the  state  whence  he  came),  after  he  has  been  cautioned  to 
depart  by  the  persons  so  appointed,  shall  forfeit  a  sum  not  exceeding  one  hundred 
dollars.'" 

1  At  the  present  time  the  state  sanitary  authority  is  authorized  to  enforce  quaran- 
tine measures  against  the  introduction  of  communicable  disease  into  the  state  in 
Alabama,  Colorado,  California,  Iowa,  Illinois,  Indiana,  Florida,  Kansas,  Kentucky, 
Louisiana,  Maine,  Maryland,  Michigan,  Minnesota,  Missouri,  Mississippi,  New 
Hampshire,  New  Jersey,  North  Dakota,  Ohio,  Rhode  Island,  South  Dakota,  Ten- 
nessee, Texas,  Virginia,  Vermont  and  West  Virginia.11 

2  New  Hampshire,  Act  of  22  March,  1893: 

"  Section  1.  The  power  to  establish  quarantine  in  this  state  shall  be  vested  in 
the  state  board  of  health,  and  said  board,  whenever  it  is  regarded  necessary  to  pre- 
vent the  introduction  of  cholera,  smallpox,  or  other  epidemic  diseases  from  another 
state,  or  from  another  country,  and  to  restrict  said  diseases  if  introduced,  shall 
have  the  power  to  establish  quarantine  stations  at  such  places  as  may  be  deemed 
necessary,   and  the  said  board  shall  make  and  enforce  such  quarantine  rules  and 


COMMUNICABLE   DISEASES.  651 

cases  of  communicable  disease,  so  the  Colorado  statute  requires  train 
conductors  to  do  the  same,  and  to  hold  their  trains  subject  to  the  state 
hoard  of  health.  A  similar  law  in  regard  to  holding  trains  is  found  in 
Maine.  In  Alabama  and  some  other  states  it  is  forbidden  to  bring1  in 
communicable  disease,  and  in  North  Carolina  common  carriers  which 
bring  in  such  cases  must  take  them  out.  Under  these  laws  many  state 
authorities  have  made  sets  of  rules.  Among  such,  New  Hampshire, 
Michigan,  Florida  and  Mississippi  furnish  good  examples.  Florida  and 
Mississippi  have  a  very  elaborate  set  of  rules  including  those  approved 
by  a  conference  of  health  authorities  held  in  Atlanta,  12  April.  1898. 

Many  states  have  still  further  provided  against  the  introduction  of 
communicable  disease  by  maintaining  an  emergency  fund  which  in  the 
case  of  threatened  invasion  of  epidemic  diseases  .may  be  drawn  upon  by 
the  state  hoard  of  health  with  the  approval  of  the  governor.  This 
fund  ranges  from  $3,000  in  Tennessee  to  $50,000  in  Pennsylvania, 
though  in  the  latter  state  the  hoard  of  health  does  not  appear  to  have 
been  given  such  explicit  [towers  in  regard  to  quarantine  as  in  some 
other  states.  In  Michigan  no  limit  appeal's  to  he  set  upon  the  amount 
to  be  spent. 

The  towns  were  the  first  administrators  of  interstate  quarantine, 
and  then  with  the  organization  of  the  state  boards  of  health  the  latter 
took  on  these  powers;  but  with  the  development  of  the  idea  of  federal 
control  of  interstate  commerce,  and  the  conferring  of  quarantine  powers 
upon  the  marine  hospital   service,  a    new    factor   appeared.      By  the   act 


regulations  as  it  may  deem  best  Cor  the  public  good,  said  rules  and  regulations  to  be 
in  font'  when  approved  by  the  governor  of  the  state. 

"Sec.  2.  1 1  shall  he  the  duty  of  local  health  nflicers,  in  their  respectii  e  towns,  to 
enforce  all  rules  and  regulations  issued  by  the  state  board  of  health;  but  should  it 
become  necessary  to  establish  quarantine  stations,  for  the  purpose  of  detention, 
isolation,  disinfection,  etc.,  the  expense  of  the  same,  and  its   maintenance,   shall    he 

[»id  from  the  epidemic  fund  of  the  state.  Local  boards  of  health  may  establish 
quarantine  in  their  respective  towns,  hut  shall  report  immediately  such  action  to  the 
state  board  of  health;  ami  ii  shall  lie  the  duty  of  said  board,  as  early  as  practicable, 
to  ascertain  the  necessity  of  such  quarantine,  and  shall  either  approve  and  enforce 

the  said  quarantine,  or  declare  it    raised. 

"Sec.  ■'•■  Whenever  quarantine  is  declared,  all  railroad  and  steamboat  corpora- 
tions, and  tin' owners,  consignees,  or  assignees  of  any  railroad,  steamboat,  stag 
other  vehicle  used  for  the  transportation  of  passengers,  baggage,  or  freight,  shall 
suiiinit  to  the  quarantine  rules  and  regulations  established  by  tin-  state  board  of 
health;  they  shall  submit  to  anj  examination  required  by  the  health  authorities. 
respecting  any  circumstances  or  event  touching  the  health  of  the  crew  or  passen- 
gers, and  the  sanitary  condition  of  vehicles,  baggage,  or  freight;  and  any  person 
Who    makes    a    false   declaration    respecting    the  points    under   examination,    or   who 

violates  the  quarantine  rules  ami   regulations,  shall,   upon  conviction  thereof,  he 

lined    not    i e    than    two    hundred    dollars,    or    he    Imprisoned    not    more    than    six 

nt hs.  or  both." 


652  COMMUNICABLE   DISEASES. 

of  Congress  of  15  February,  1893,  the  secretary  of  the  treasury  was 
authorized  to  make  rules  for  preventing  the  spread  of  communicable 
disease  from  state  to  state,  and  on  27  September,  1894,  such  rules  were 
promulgated,  and  are  to  be  enforced  by  the  marine  hospital  service. 
These  rules  relate  to  cholera,  yellow  fever,  typhus  fever,  leprosy,  and 
plague.  All  outbreaks  of  these  diseases  are  to  be  reported  to  super- 
vising surgeon-general,  marine  hospital  service.  The  rules  are  mostly 
ordinary  rules  in  regard  to  isolation  and  disinfection  ;  but  a  few  have 
to  do  more  directly  with  commerce : 

"No  common  carrier  shall  accept  for  transportation  any  person  suffering  with  a 
quarantinable  disease,  nor  any  infected  article  of  clothing,  bedding  or  personal 
property. 

"The  body  of  a  person  who  has  died  of  a  quarantinable  disease  shall  not  be 
transported  save  in  hermetically  sealed  coffins,  and  by  the  order  of  the  state  or  local 
health  officer.     .     .     . 

"  Localities  infected  with  yellow  fever,  and  localities  contiguous  thereto,  should 
be  depopulated  as  rapidly  and  as  completely  as  possible,  so  far  as  the  same  can  be 
safely  done;  persons  from  non-infected  localities  and  who  have  not  been  exposed  to 
infection  being  allowed  to  leave  without  detention.  Those  who  have  been  exposed, 
or  who  come  from  infected  localities,  shall  be  required  to  undergo  a  period  of  deten- 
tion and  observation  of  ten  days  from  the  date  of  last  exposure  in  a  camp  of  pro- 
bation or  other  designated  place. 

"  Clothing  and  other  articles  capable  of  conveying  infection  shall  not  be  trans- 
ported to  non-infected  localities  without  disinfection. 

"  Persons  who  have  been  exposed  may  be  permitted  to  proceed  without  deten- 
tion to  localities  incapable  of  becoming  infected  and  whose  authorities  are  willing 
to  receive  them,  and  after  arrangements  have  been  perfected  to  the  satisfaction  of 
the  proper  health  officer,  for  their  detention  in  said  localities  for  a  period  of  ten 
days. 

"As  soon  as  the  disease  becomes  ejudemic  the  railroad  trains  carrying  persons 
allowed  to  depart  from  a  city  or  place  infected  with  yellow  fever  shall  be  under 
medical  supervision. 

"  Common  carriers  from  an  infected  district,  or  believed  to  be  carrying  persons 
and  effects  capable  of  conveying  infection,  shall  be  subject  to  a  sanitary  inspection, 
and  such  persons  and  effects  shall  not  be  allowed  to  proceed,  except  as  provided  for 
by  paragraph  2." 

Local  Quarantine.  In  a  large  number  of  states1  the  local  board  of 
health  of  the  town  or  county  is  authorized  to  establish  quarantine  and 
often  to  make  rules  and  regulations  regarding  it.  Similar  provisions 
are  found  in  numerous  charters,  as  those  of  Kansas,  Nebraska  cities,  and 
Pennsylvania,  and  in  Baltimore,  Chicago,  and  St.  Louis.  Outside  of 
these  states  probably  most  towns  and  cities  would  be  authorized  under 
their  general  grant    of  sanitary  powers  to  maintain  quarantine,  so  that 


1  Maine,  New  Hampshire,  Vermont,  Rhode  Island,  Connecticut,  Colorado,  New 
Jersey,  Delaware,  (Jeorgia,  Idaho,  Louisiana,  Michigan,  New  York,  South  Carolina, 
Texas,  Utah,  Washington,  Alabama,  North  Dakota,  .South  Dakota,  Ohio,  and  West 
Virginia. 


C  ■  031  Ml  XI C A  BLE    DI8EA  S  EJS.  6-33 

probably  every  city  is   able  to  do  this,   unless  there   is  some    adverse 

provision  in  the  statutes.  In  Florida  and  Mississippi  the  state  hoard  of 
health  only  may  establish  quarantine,  and  in  a  considerable  number  of 
other  states  local  quarantine  can  only  be  maintained  with  the  approval 
of  the  state  hoard,  as  in  Alabama,  Kentucky,  Louisiana.  Maine,  New 
Hampshire.  South  Carolina,  and  Texas. 

Very  many  cities,  both  within  and  without  the  states  above  men- 
tioned, have  forbidden  by  their  rules  the  introduction  of  communicable 
disease.  -Most  of  these  rules  are  very  general,  and  simply  require  that 
no  infected  person  or  thing  shall  come  or  he  brought  into  the  city.  The 
ordinances  of  Denver  and  <  Mnaha  require  that  conductors  shall  report 
cases  of  communicable  disease,  and  in  Denver  they  must  hold  the  train 
five  miles  from  the  city  and  telegraph.  In  Atlanta  and  Macon.  Ga.,  and 
Spokane,  conductors  must  not  bring  in  trains  when  ordered  not  to  or 
when  they  are  infected.  The  ordinances  of  Chicago  and  St.  Louis 
confer  quarantine  powers  upon  the  health  commissioner  and  authorize 
him  to  establish  inspection  after  giving  notice,  and  to  stop  trains  and 
boats  and  detain  persons.  A  number  of  southern  cities  have  adopted 
the  regulations  of  the  Atlanta  conference  referred  to  on  page  651. 

In  the  northern  states  there  is  rarely  felt  to  he  any  need  of  inland 
quarantine,  hut  occasionally  such  quarantines  are  maintained.  Thus  in 
L885,  during  the  smallpox  outbreak  in  Montreal,  several  states,  includ- 
ing Michigan  and  New  Hampshire,  and  a  number  of  cities,  quarantined 
passenger  traffic  from  Canada.  The  United  States  marine  hospital  ser- 
vice also  cooperated.  The  nearest  and  closest  connection  between 
Montreal  and  the  United  States  is  with  New  England.  As  soon  as  tin- 
states  became  alarmed  at  the  amounl  of  smallpox  in  Montreal  a  con- 
ference was  held  with  the  Canadian  authorities  and  with  the  railroads, 
and  it  was  decided  that  all  trains  to  the  States  should  he  stopped  at  the 
border  and  passengers  and  haggage  transferred.  The  marine  hospital 
service  established  an  inspection  at  this  point  and  also  a  disinfecting 
plant.  The  state  board  of  health  of  New  Hampshire,  no1  being  satisfied 
with  the  federal  sei  \  ice,  put  on  inspectors  of  its  own,  who  hoarded  every 
train  entering  the  state  from  Canada.  The  rules  given  helow  were  for 
the  government  of  these  inspectors.1 

1  ■•  l.  \!l  persons  coming  fr Canada  and  destined  t"  anj  point  in  New  Hamp- 
shire, must  be  examined  with  reference  to  vaccination,  and  :tll  such  found  unpro- 
tected, it  from  ;i  locality  infected  with  smallpox,  must  !><■  vaccinated  bj  the  inspec- 
tor or  detained  for  quarantine  at  such  place  as  the  inspector  may  designate. 

•••_'.  The  inspector  must  issue  to  nil  pi  rsons  coming  from  Canada,  whether  des- 
tined t<>  |xuuts  in  \cw  Hampshire  or  elsewhere,  tin'  railwaj  inspection  ticket,  issued 
by  this  board,  so  punched  as  to  indicate  to  the  health  officer  a1  destination  oi  nip. 
as  per  arranged  understanding  of  punch  marks,  all  the  knowledge  obtained  of  said 


654 


C  OMMUNKJABLE    DISK.  I  8  E8. 


"  The  inspector,  in  making  bis  regular  train  inspection,  ascertained 
from  what  place  the  passenger  came,  and  if  from  Montreal,  as  will  be 
seen  by  the  key,  the  letter  A  was  punched  out  of  the  ticket;  if  he  had 
checked  baggage,  the  letter  F  was  also  punched  ;  if  recently  vaccinated, 
the  letter  D  was  punched  out.  The  ticket  was  then  signed  by  the 
inspector  and  given  to  the  person  inspected,  who,  not  knowing  the 
significance  of  the  punched  letters,  regarded  the  same  as  a  clean  bill  of 

person  as  to  whether  said  person  came  from  an  infected  locality  or  not,  when  vacci- 
nated, whether  with  checked  baggage,  etc. 

"3.  For  the  information  of  local  health  authorities,  the  inspection  ticket  may  be 
issued  to  persons  coming  from  localities  in  the  state,  when,  in  the  judgment  of  the 
inspector,  such  persons  would  be  liable  to  suspicion  by  the  local  health  authorities 
at  the  point  of  destination. 

"  4.  The  inspector  will  notify  by  telegram  all  towns  and  cities  requesting  it, 
when  any  suspicious  persons  are  found  destined  for  such  towns  and  cities. 

"  5.  The  inspector  will  keep  a  record  of  all  persons  coming  from  Canada  and 
destined  to  points  in  New  Hampshire,  with  the  place  of  destination,  date,  and  other 
facts  required  by  the  inspector's  record  check,  and  of  the  number  of  inspection 
tickets  daily  issued  to  such  persons  going  to  other  states,  with  the  name  of  the 
state. 

"6.  Inspectors  will  render  a  weekly  report  to  this  board  of  the  number  of  trains 
inspected,  and  return  with  such  report  the  inspector's  record  checks  for  the  same 
week.'1 


Month. 

Railway  Inspection  Service,  State    Board  of  Health, 
New  Hampshire. 

Oct. 
Nov. 

Dec. 
Jan. 
Feb. 

Mar. 

To  be  retained  by  the  person  to  whom  given,  unless 
taken  up  by  a  health  officer  at  destination  of  trip.     This 
ticket  will  save  the  bearer  the  trouble  of  unnecessary 
inspections. 

P 
O 
pq 

< 

Ce  billet  doit  etre  retenu   par  la   personne  qu'il  est 
donne,  a  moins  qu'un  officier  de  sante  vous  le  prenne  h 
destination  du  voyage.     Ce  billet  exemptera  au  porteur 
deplaisir  d'une  inspection  non  necessaire. 

Inspector. 

Irving  A.  Watson,  Secretary. 

Day. 

1  2  :s  4  5  6  7  8  9  10  11  12  13  14  15  1G  17  IS  19  20  21  22  2:5  24  2.-.  26  27  28  20  30  31 

KEY    TO    LETTERS    ON    INSPECTION    TICKET. 

A.  From  Montreal  or  other  infected  locality. 

B.  Cannot  learn  from  what  locality  the  person  came. 

C.  Came  from  an  uninfected  locality. 

D.  Recently  vaccinated. 

E.  Has  vaccination  scar  on  arm. 

F.  Has  checked  baggage. 

Read  only  the  letters  tltat  have  been  punched. 


IRVING  A.   WATSON, 

Secretary. 


( ■  OMM  (  Wit '.  t  B  L  E    D  TSU.  1  S  A  8.  6  5  5 

health.  The  health  officers  on  the  lookout  for  such  persons  demanded 
the  inspection  ticket  at  their  point  of  destination,  and  one  punched  as 
indicated  above  would  inform  the  health  officer  that  the  person  holding 
the  same  had  come  from  Montreal  with  checked  baggage,  and  had 
recently  been  vaccinated." 

The  work  of  the  state  board  was  supplemented  by  that  of  the  local 
boards  especially  in  disinfection.  The  following  is  an  account  of  what 
was  done  in  Manchester  :J 

"The  Manchester  Hoard  of  Health  established  fumigating  rooms  in  the  railroad 
station  at  that  place,  and  maintained  a  very  thorough  system  of  fumigation  of  per- 
sons and  baggage  from  October  3  to  December  25.  The  board  was  no  respecter  of 
persons  or  conditions,  inasmuch  as  all  persons  who  had  come  from  the  province  of 
Quebec  were  regarded  as  suspicious,  and  were  required  to  register  and  be  inspected 
at  this  station.  During  the  period  named  the  board  fumigated  one  thousand,  two 
hundred  and  sixty  persons:  of  this  number  four  hundred  and  twenty-one  were 
known  to  have  conic  from  infected  districts,  and  it  was  conclusively  proven  that 
some  of  them  had  come  from  houses  where  the  disease  existed,  and  had  served  as 
nurses  for  those  ill  with  it.  The  number  of  trunks  fumigated  was  four  hundred  and 
thirty-one:  handbags,  valises,  etc.,  two  hundred  and  sixty-live:  boxes  containing 
household  goods,  provisions,  etc.,  two  hundred  and  two,  many  of  them  weighing 
from  six  hundred  to  eight  hundred  pounds  each,  constituting,  in  all.  many  tons  of 
this  class  of  goods."1 

During  the  presence  of  cholera  in  Europe  in  1892-3  great  alarm 
was  fell  in  this  country,  and  maritime  quarantine  was  made  more  strin- 
gent in  nearly  all  ports,  and  most  cities  passed  through  a  general 
cleansing.  Some  of  the  states,  especially  the  central  states,  placed  little 
confidence  in  maritime  quarantine,  as  then  administered,  particularly  in 
that  of  Canada.  In  September,  isi'i',  a  conference  of  the  state  boards 
of  health  of  the  central  stales  and  many  railroad  officials  was  held  in 
Chicago,  and  regulations  were  adopted  in  regard  to  immigrants  which 
were  subsequently  adopted  officially  by  the  various  boards  attending 
the  conference.2  These  rules  required  thai  all  immigrants  should 
obtain  from  the  quarantine  officers  at  their  port  of  debarkation  a  certifi- 
cate, Stating  their  history  in  relation  to  cholera  and  that  they  were  qo1 
infected,  and  thai  their  baggage  had  been  disinfected.  All  other  immi- 
grants should  be  held  at  state  boundaries  for  inspection  and  disinfec- 
tion. Transportation  companies  should  notify  inspectors  in  advance  of 
the  arrival  of  immigrants.  The  state  board  of  health  of  Michigan''  also 
adopted  other  rules  requiring  thai  no  carrier  should  bring  into  the  stale 
an\    immigrant  or  baggage  until    inspected    b\    an  inspector  appointed  01 

accredited  by  the  state   board.     No  baggage  was  to  be  admitted  unless 


'New  Hampshire,  State  Board  of  Health  Report  (1886),  p.  186. 
-  Michigan,  State  Board  of  II.  alth  Report  ,  L898),  p.  XXVIII. 
» Michigan,  State  Board  of  Health  Report  (1898),  p.  IAWIII. 


656  COMMUNICABLE    DISEASES. 

disinfected  by  a  Michigan  inspector:  but  baggage  was  excepted  winch 
bore  a  certificate  of  disinfection  from  an  accredited  inspector,  or  from 
a  Canadian  official,  or  which  was  known  to  have  come  from  a  non- 
infected  ship,  or  which  was  in  a  sealed  car  for  transport  through  the 
state.  The  state  board  of  health  appointed  inspectors  to  carry  out 
these  regulations  at  all  ports  of  entry.  The  following  is  a  description 
of  their  work  by  the  inspector  at  Port  Huron  •} 

"  Steerage  passengers  destined  to  stop  in  Michigan,  are  all  detained,  and  their 
baggage  is  disinfected  by  us.  There  are  two  kinds  of  steerage  passengers,  those 
who  cuiiie  by  way  of  American  ports,  and  those  by  way  of  Canadian' ports.  Those 
who  come  by  way  of  Suspension  Bridge  having  entered  the  United  States  at  either 
New  York  or  Boston,  and  are  destined  not  to  stop  in  Michigan,  their  baggage  is 
sealed  in  a  car,  and  passes  right  through  the  State;  if  destined  to  stop  in  Michigan, 
the  baggage  is  all  disinfected  on  the  American  side  at  Port  Huron.  The  baggage  of 
immigrants  by  way  of  ports,  other  than  American  ports,  is  all  disinfected  by  us  at 
Sarnia,  in  Canada.  On  both  sides  of  the  line  our  steam  disinfection  is  done  in  a  box 
car  which  has  been  especially  fitted  for  our  use.  It  is  made  of  matched  lumber  and 
then  lined  thoroughly  inside,  so  that  when  closed  it  is  practically  air-tight.  An 
engine  is  run  up  by  the  side  of  the  car,  and  the  steam  is  first  run  into  the  iron  coils 
around  the  car,  which  raises  the  temperature  to  about  120°  F.,  and  it  is  held  there 
for  about  twenty  minutes;  then  live  steam  is  turned  into  the  car,  and  the  tempera- 
ture is  run  up  to  about  220°  F.,  and  held  there  for  an  hour.  At  the  expiration  of 
this  time  the  ventilator  at  the  top  of  the  car  is  opened  to  let  the  live  steam  out  of  the 
car  gradually,  at  the  same  time  the  steam  in  the  coils  is  kept  up,  and  by  the  time 
the  things  are  ready  to  come  out  of  the  car  they  are  all  dried  by  the  heat  from  the 
coils.  All  the  baggage  except  the  leather  and  furs  is  disinfected  in  this  way;  the 
rest  is  disinfected  by  the  fumes  of  burning  sulphur,  for  which  purpose  a  regular  box 
car  is  used;  it  is  not  lined,  but  it  is  a  comparatively  tight  car.  Tilings  to  be  disin- 
fected are  all  spread  out  in  the  car,  and  then  sulphur  is  burned  for  about  three 
hours,  at  the  rate  of  three  pounds  per  one  thousand  cubic  feet  of  space,  which  is  the 
amount  recommended  by  your  board.  It  is  almost  impossible  to  go  into  the  car  for 
a  half  hour  after  the  car  has  been  opened.  The  immigrants  assist  the  inspectors  in 
this  disinfection,  by  opening  up  their  trunks  and  other  containers,  and  placing  the 
articles  of  clothing,  etc.,  on  wires  strung  in  the  car,  or  laying  them  out  on  the 
shelves.  The  containers  are  all  disinfected  by  sulphur  fumes.  I  generally  find  that 
the  immigrants  by  way  of  Boston  are  without  certificates.  We  have  issued  a  small 
card  signed  by  the  inspector,  which  states  that  the  immigrant  has  passed  the  inspec- 
tion at  Port  Huron.  The  baggage  has  attached  to  it  a  '■  sticker  "  which  states  that 
it  has  been  through  our  disinfection.  The  train  books  which  I  have  made  have 
been  of  material  aid  to  our  inspectors,  and  are  constantly  used.  All  the  facts  rela- 
tive to  the  immigrant,  which  we  can  obtain,  are  noted  in  the  train  book,  copied  into 
a  book  and  reparted  to  the  State  Board  of  Health.  Immigrants  are  released  to  pass 
on  after  receipt  of  telegram  to  that  effect  from  the  office  of  the  State  Board.1' 

Some  of  the  railroads,  as  the  Grand  Trunk,  co-operated  with  the 
state  board  and  arranged  for  disinfection  as  above,  but  the  "Soo"  road 
brought  suit  for  interference  with  its  business  at  Sault  Ste.  Marie  and 
lost  its  cause  in  the  United  States  Circuit  Court.2 


1  Michigan.  State  Board  of  Health  Report  (1893),  p.  XL1II. 

-  Minneapolis,  St.  Paul  and  Sault  Ste.  Marie  R.  R.  vs.  Board  of  Health  of  Michigan, 
I'.  S.  Circuit  Court;  Western  District  of  Michigan.  Northern  Division,  29  July,  1893. 


0  OMMl WIC  \  1 BLE   UISL\  i  SES.  657 

A  number  of  cities,  among  which  were  Chicago,  Milwaukee,  and 
Minneapolis,  established  additional  inspections  of  their  own.  In 
Chicago,1  "the  railroads  entering  the  city  placed  at  the  disposal  of  the 
health  department  their  resources  —  the  department  was  notified  of  the 
approach  of  trains  conveying  immigrants  by  telegraph,  and  in  time  that 
the  medical  and  sanitary  inspectors  could  board  trains  from  fifty  to  one 
hundred  miles  outside  the  city,  and  thoroughly  perform  their  inspection 
of  immigrants  and  their  baggage  before  the  city  was  readied. 

"  From  September  8,  1892,  when  this  quarantine  inspection  went 
into  effect,  until  December  31,  18$2,  over  20,000  immigrants  and  their 
personal  belongings  passed  through  the  hands  of  the  department  of 
health;  of  this  number  2,916  remained  in  Chicago.  The  department 
lias  a  complete  record  of  the  name,  nationality,  port  of  embarking  and 
date,  name  of  steamer,  port  of  entry  and  date  of  arrival,  number  of 
days  detained  in  quarantine,  railroads  traveled  on  from  seaport  to 
Chicago,  date  of  arrival  in  Chicago,  name  of  inspector  who  examined, 
address,  street  and  number  destined  to  in  Chicago  :  all  this  information 
lias  been  compiled  for  future  reference.  Immigrants  were  allowed  to 
proceed  to  points  beyond  Chicago  who  held  a  quarantine  certificate  for 
person  and  baggage  signed  by  a  surgeon  of  the  1'.  S.  Marine  Hospital 
service  or  the  health  officer  of  the  port  of  entry.  The  baggage  of 
immigrants  destined  to  Chicago  was  most  thoroughly  examined,  and 
often  fumigated  even  if  it  had  been  at  the  port  of  entry  :  the  officers  of 
this  department  were  determined  to  take  no  chances."' 

During  the  outbreak  of  smallpox  in  AInncie,  Ind.,  in  L893,  the  state 
board  of  health  felt  it  necessary  to  quarantine  against  that  city,  as 
shown  in  the  following  order:2 

••  •  'Jin-  Indiana  State  Board  of  Health  hereby  orders  that  no  passengers,  or  their 
ge,  be  received  on  railroad  trains  passing  through  Muncie,  this  State,  unless 
they  have  a  certificate  from  the  local  health  authorities  that  their  baggage  has  been 
properlj  disinfected,  and  that  they  have  been  successfully  vaccinated. ' 

"  Near  the  Big  Four  depot  a  box  car  was  provided  as  a  fumigating  station,  and 
here  the  contents  of  trunks,  valises  and  bundles  passed  through  a  process  of  fumi- 
gation or  disinfection  before  leaving  the  city. 

••At  the  city  postoffice  a  large  si t-iron  box  four  feci  square  ami  .six  feci  high 

was  used  to  fumigate  all  mail  leaving  the  city.  The  process  of  fumigation  lasted 
about  "iic  hour.11 

The  railroads  required  a  certificate  that  the  holder  had  been  vac- 
cinated,   and    was    free    from    infection.       It    was    said    that     man}     were 

fraudulently  obtained  and  fraudulently  used.  While  railroad  passenger 
traffic  was  almost  cniiivh  stopped,  it  was  possible  to   Leave   the  cit)    in 


1  Chicago,  Report  of  Department  of  Health  (1893),  p.  86. 

-  Indiana,  Report  •■!  Mate  I;,, aid  of  Health  1 1893),  !••  1 1  I. 


G  5  8  GOMMUNIi  A  B  L  E    DISE,  i  SE8. 

other  ways,  and  it  was  estimated  by  the  health  officer  of  Muncie  that 
probably  1,500  persons  left  the  city  in  one  way  or  another. 

Even  at  the  present  writing  absolute  quarantine  is  declared  at 
several  places  in  West  Virginia  on  account  of  the  presence  of  smallpox 
in  adjoining  regions.  The  proclamation  of  the  board  of  health  of 
Elkins,  West  Virginia,1  is  shown  below. 

At  the  south,  where  the  danger  of  yellow  fever  is  a  real  one,  the 
necessity  for  inland  as  well  as  for  maritime-  quarantine  is  felt  to  be  a 
necessity.  Wheneyer  an  outbreak  of  yellow  fever  occurs, at  any  point 
in  the  southern  states  many  localities  are  certain  to  quarantine  every 
line  of  approach  against  the  infection.  Non-infected  cities  and  counties 
consider  it  their  first  duty  to  keep  out  the  disease  and  are  the  authors 
of  shotgun  quarantine.  It  is  not  for  them  to  consider  the  welfare  of 
people  in  the  infected  districts.  It  is  the  common  practice  for  such 
communities  to  forbid  all  communication  with  the  infected  locality. 
No  persons  or  goods  can  come  in  without  the  permission  of  the  health 
officer.  But  something  must  be  done  besides  proclaim  quarantine.  Often 
notice  is  sent  to  the  infected  community  warning  travellers.  The 
transportation  companies  are  notified  and  placards  posted.  The  quaran- 
tine is  advertised  in  every  way.  To  enforce  the  quarantine  inspectors 
are  appointed  who  travel  on  all  trains  approaching  the  city,  or  meet 
boats  at  the  wharf,  or  are  stationed  at  other  approaches.  In  Augusta, 
Ga.,   in   1897,   persons  from  infected   places   were   forbidden   to  come 

I  Public  Health  Reports  (1900),  p.  516: 

"  February  9,  1900. 

II  Whereas,  the  board  of  health  of  the  city  of  Elkins  is  advised  that  smallpox 
prevails  in  many  communities  in  dangerous  proximity  to  this  city,  and  deems  it 
highly  important  that  the  disease  be  prevented  from  reaching  this  city. 

"  Therefore  it  is  ordered  by  said  board  of  health  that  from  and  after  this  date 
until  the  further  order  of  this  board,  no  person  from  the  counties  of  Gilmer,  Lewis, 
Harrison,  Calhoun,  or  Fayette,  in  this  State,  or  from  the  town  of  Buckhannon,  in 
the  county  of  Upshur,  or  the  town  of  Camden-on-the-Gauley,  in  Webster  County,  in 
this  State,  shall  come  into  or  pass  through  the  city  of  Elkins; 

"  That  no  goods  or  merchandise,  by  any  conveyance  whatever,  shall  be  brought 
into  or  taken  through  said  city  of  Elkins  from  any  place  or  territory  above  men- 
tioned ; 

"  That  no  person  now  within  the  corporate  limits  of  said  city  of  Elkins  shall  visit 
any  of  the  places  or  counties  above  mentioned  and  thereafter  return  to  said  city  of 
Elkins; 

"That  all  communication,  except  by  telephone  or  telegraph,  is  prohibited  by 
persons  now  in  the  city  of  Elkins  with  persons  in  the  counties  or  places  aforesaid,  or 
any  other  place  known  to  be  infected  with  smallpox. 

"  That  all  railroads  or  other  common  carriers  are  forbidden  to  convey  passen- 
gers, letters,  or  packages  from  any  of  the  counties  or  places  herein  mentioned,  into 
or  through  said  city  of  Elkins. 

A.  S.   Bos  worth,  M.  D., 
President  Board  of  Health  for  city  0/  Elkins.'1' 


C ■  031  Ml  WI(  \  tJBZJH    1>1  SEA  SES.  659 

within  forty  miles  of  the  cit}',  and  if  found  on  the  train  they  and  their 
baggage  were  put  off  at  the  nearest  station.  One  lot  of  freight  that 
had  been  smuggled  in  was  burned  in  the  freight  yard.  Another  lot 
which  had  been  sent  from  New  Orleans  by  way  of  Xew  York  to  avoid 
suspicion,  and  was  discovered  before  it  was  unpacked,  was  promptly 
shipped  back  again.1  In  Charleston  in  1888  several  persons  from 
Florida  who  were  caught  trying  to  enter  the  city  were  sent  to  the  laz- 
zaretto  and  detained  there  ten  days.2  In  Atlanta  in  181»7  and  189* 
the  quarantine  was  less  strict.  Train  inspection  was  maintained  as  in 
other  cities,  but  only  persons  who  were  suspiciously  sick  were  detained, 
and  others,  after  giving  their  city  addresses,  were  allowed  to  enter  the 
city.  If  the  incomers  can  show  certificates  that  they  are  from  an  unin- 
fected locality  they  are  usually  freely  admitted.  The  form  of  certificate 
given  in  Atlanta  is  shown  in  Appendix  113. 

The  state  authorities  and  the  federal  officers  have,  during  these  yel- 
low fever  outbreaks,  a  greater  responsibility  and  a  more  difficult  problem 
than  do  the  local  officers  of  either  infected  or  uninfected  cities.  Local 
health  officers  are  interested  chiefly  in  their  own  communities  and  it 
matters  little  to  them  what  becomes  of  infected  refugees.  It  is  only 
state  and  federal  officers  that  can  be  expected  to  look  after  the  interests 
of  the  infected  and  uninfected  alike  and  to  see  that  traffic  is  as  little 
interfered  with  as  possible.     .Many  local  quarantines  of  varying  strict- 

.  some  weak  and  poorly  managed,  and  others  of  the  harshest  non- 
intercourse  variety,  present  a  condition  that  is  almost    unendurable,  ami 

also  one  that  is  tar    from  accomplishing   the  end   sought  for.      Attempts 

have  been  made  to  secure  greater  uniformity  in  inland  quarantine  regu- 
lations, and  conventions  were  held  in  Atlanta  in  1898  and  in  New 
Orleans  in  1899  which  were  attended  by  local,  slate,  and  federal  health 
officers  ami  representatives  of  the  railroads,  and  regulations  were  form- 
ulated  which  were  very  generally  adopted   by  state  and   local  officials, 

and  are  in  the  main  like  those  enforced  by  the  marine  hospital  service. 
Of  course,  many  of  the  state  and  local  boards  have  additional  rules. 
Tims  the    Mississippi  state    board  of   health    after  adopting   the   rule-  of 

the  Atlanta  convention  added  others  specifying  more  fully  the  con- 
ditions for  railroad  traffic. 

[t  is  undoubtedly  safer  and  more  economical  to  control  the  spread 
of  communicable  disease  a1  a  single  point  of  origin,  than  it  is  to  guard 
against  its  introduction  into  a  thousand  uninfected  localities.  This  con- 
trol  of   the  outgo  can,    however,  only    be  accomplished   through   the 

1  Augusta.  Report  of  Board  "f  Health  (1897),  p.  _l  ti  seq. 
'Charleston,  Report  ol  Department  <>f  Health  (1888),  p.  '• 


(]60  COMMUNICABLE   DISEASES. 

agency  of  the  state  or  federal  authorities.  One  way  to  secure  uniform 
action  throughout  the  state  is  for  the  state  to  assume  entire  control  as 
in  Florida  and  Mississippi ;  another  is  to  strictly  co-ordinate  the  state 
and  local  boards  as  was  done  in  Alabama  by  the  act  of  23  February,  1899. 
Undoubtedly  the  best  results  can  be  obtained  only  when  all  three  sets 
of  officials  act  together.  In  preventing  the  outward  movement  of  infec- 
tion both  persons  and  goods  must  be  considered. 

It  is  in  general  the  policy  of  the  marine  hospital  service  when  placed 
in  charge  to  immediately  quarantine  a  town  in  which  yellow  fever  is 
reported.  This  is  at  first  temporary  pending  an  investigation  as  to  the 
fact  of  the  presence  of  the  disease  and  its  prevalence.  This  temporary 
quarantine  is  not  to  be  established :  first,  if  the  case  is  an  imported 
one ;  second,  when  the  town  is  a  large  one.  This  apparently  illogical 
exception  of  large  towns  is  made  because  (a)  there  is  less  chance  here 
of  general  infection,  (b)  there  is  less  chance  of  a  general  exodus,  and 
(c)  the  loss  to  the  large  city  is  so  great  as  to  render  it  impracticable. 
The  next  step  is  a  thorough  investigation  of  the  case  or  cases,  and  of 
all  who  have  been  exposed.  The  mortuary  records  are  studied  and 
cases  investigated  which  are  likely  to  have  been  yellow  fever  reported 
under  another  name.  If  the  infection  is  slight  and  the  foci  of  the  dis- 
ease well  under  control  the  general  quarantine  may  be  raised.  Or  if 
the  disease  is  confined  to  a  particular  section  of  the  city  that  section 
alone  may  be  quarantined  as  in  Biloxi  in  1897.  This  is  ordinarily  done 
in  the  larger  cities,  as  in  New  Orleans,  Mobile,  and  Memphis,  in  1897. 
If,  however,  infection  is  general,  absolute  quarantine  of  the  infected 
town  is  established,  as  in  Brunswick,  Ga.,  in  1893,  and  it  was  done  in 
quite  a  number  of  smaller  places.  In  Brunswick  twenty-eight  land 
guards  were  employed  and  thirty-four  water  guards  ■} 

11  The  land-guard  posts  consisted  of  three  men  each,  all  of  whom  were  required 
to  he  on  duty  at  night.  One  was  permitted  to  be  absent  during  a  part  of  the  day. 
They  were  paid  $2  per  day,  subsisting  themselves. 

"  The  posts  were  four  miles  or  more  from  Brunswick,  including  a  sufficient  area 
to  keep  me  from  the  charge  of  cooping  up  people.  The  posts  were  supplied  with 
tents  by  me.  The  water-guard  stations,  except  No.  9  at  Jekyl  Pass,  which  had  seven 
men,  consisted  of  three  men  each,  who  furnished  their  own  boats,  arms,  and  pro- 
visions,  and  received  $2.50  per  day.  The  water  duty  was  vexing,  difficult,  and  at 
times  dangerous;  but  the  duties  were  always  done  on   honor  in  spite  of  weather." 

It  is  considered  better  to  take  guards  from  the  region  to  be  protected 
rather  than  from  the  infected  region.  Absolute  quarantine  did  not, 
however,  mean  that  no  persons  should  go  in  or  out ;  but  only  that  they 


1  These  quotations  are  from  the  Report  of  Supervising  Surgeon-General  of  the 
Marine  Hospital  Service  (1893),  p.  26. 


(  OMMl  XI<  AJJ  LE    DISK.  I  SES.  661 

should   not   do  so  except   with   the   consent   of  the    surgeon   in  charge. 
Surgeon    Murray  thus  describes  the  issuing  of  passes  in  Brunswick:1 

'•  Gentlemanly,  orderly,  and  business  communication  was  freely  permitted.  Per- 
seus were  allowed  to  come  into  Brunswick  after  9  a.  si.,  and  required  to  leave  before 
3  P.  m.,  for  transaction  of  actual  and  necessary  business.  No  person  dare  say  the 
principles  of  visitation  were  not  well  known  to  him.  In  no  instance  did  disaster 
follow  tbe  simple  adherence  to  my  wishes,  and  were  I  to  conduct  a  cordon  every 
year  I  would  ever  permit  just  what  I  did  permit  this  season.  The  land  and  water 
guards  kept  records  of  all  persons  passing  in  and  refused  to  permit  them  to  return 
any  day  after  without  a  pass  from  me.  All  guards  permitted  people  to  pass  out  on 
business  errands  who  held  passes  written  by  me.  Every  pass  was  taken  up  on  first 
presentation  and  subsequently  returned  to  my  office.  Thus  country  produce  could 
come,  fish,  beef,  horses,  milk,  hay,  and  feed  could  be  procured,  and  articles  abso- 
lutely needed  on  islands  and  in  the  country  were  obtained  with  scarcely  an  idea  in 
the  minds  of  the  people  that  all  were  under  surveillance.  No  favors  were  shown  to 
anyone.  No  passes  were  given  for  fun  or  comfort.  Business  or  distress  were  the 
tin-  only  pleas  that  obtained  the  coveted  slips." 

No  harm  was  reported  as  resulting  from  these  passes  and  the  sur- 
geons of  the  marine  hospital  service  feel  that  such  communication  open 
and  above  board,  though  perhaps  somewhat  dangerous,  is  far  less  dan- 
gerous than  the  illicit  communication  which  would  otherwise  be  sure  to 
occur. 

It  is  desirable  it'  possible  to  permit  the  removal  of  till  well  persons 
from  the  infected  town.  This  is  partly  for  their  own  safety  and  partly 
for  the  community  which  they  leave.  The  fewer  people  in  the  infected 
town  if  it  is  quarantined,  the  easier  it  is  to  care  tor  them.  Then  too  it 
greatly  hinders  the  service  to  have  constantly  to  deal  with  persons  chaf- 
ing under  restraint.  Such  well  persons  are  allowed  freely  to  depart  it 
the\  are  to  go  to  regions  where  yellow  fever  can  not  prevail,  but  if  for 
yellow  fever  regions  they  must  pass  through  a  detention  camp. 

Detention  CampH  are  located  as  near  to  the  infected  district  as  a 
healthful  location  can  be  obtained.  The  location  should  be  dry  and 
there  should  be  a  good  supply  of  water.  Tents  are  \ei\  generally  used 
lor  yellow  fever  camps  and  t  he\  have  board  floors  raised  from  the  ground. 
The  following  advice  is  from  the  .Marine  Hospital  Reporl  tor  L898: 

■The  camp  consists  of  a  hollow  square,  of  which  the  buildings  form  one  side 
and  tents  t  luce.  A.  double  camp,  its  two  parts  independent,  excepl  for  a  common 
executive  office  and  kitchen  (although  not  always  feasible),  presents  the  advantage 
that  seldom  or  never  will  there  be  anj  suspicion  attached  to  Camp  No.  2,  because, 
as  a  rule,  nearh  all  sickness  has,  in  our  experience,  developed  within  tbe  first  four 
days,  and  hence  would  he  developed  in  Camp  No.  l.  This  plan  "f  a  double  camp 
would  naturally  inspire  in  i  he  people  outside  more  confidence  in  the  safety  of  camps, 

ami.  although  ti"t  at  all    a  sanitary  necessity.   may    he  expedient,  for  its  al    effect 

alone.    Such  double  camps  should  he  dh  ided,  not  only  bj  guards,  hut   bj  a  double 


These  quotations  are  from  the  Report  of  the  Supervising  Surgeon-CJeneral  "f 

the  Marine  Hospital  Service  i  ism:: i.  p.  •_'»;. 


662 


C OMMUNICABLE   DISEA  &ES. 


fence  of  barbed  wire  as  well.  The  whole  of  both  camps  should  be  surrounded  by  a 
double  barbed-wire  fence,  at  least  six  feet  in  height,  each  fence  to  have  wires  six 
inches  apart,  from  top  to  bottom,  and  the  two  fences  set  eighteen  inches  apart,  so 
as  to  render  egress  in  haste  a  matter  of  physical  impossibility.  All  refugees  in  the 
main  camp  should  be  housed  in  tents,  in  order  that  disinfection  may  be  easy  after  any 
suspicious  case  has  occurred.  Kitchen  and  dining  rooms  should  be  arranged  so  as 
to  involve  a  minimum  of  time  and  labor  in  serving  meals,  and  with  capacity  in  the 
latter  for  seating  the  whole  number  of  refugees  at  one  time.  For  purposes  of  good 
discipline,  there  should  be  provided  separate  tables  for  subaltern  officers,  such  as 
commissary,  quartermaster,  clerks,  et  al.,  in  order  that  they  may  the  better  preserve 
their  proper  authority  over  attendants;  officers  of  the  guard  may  be  included  in  the 
list  of  such  officers,  or  the  whole  guard  messed  together,  according  to  circumstances. 
It  is  not  at  all  advisable  that  the  guard,  however,  should  mess  with  the  lower  grade 
•of  attendants,  as  the  responsible  nature  of  guard  duty  is  prima  facie  evidence  of  the 
necessity  for  a  better  class  of  men  for  these  important  posts,  and  they  should  there- 
fore be  separated  when  possible. 

"In  addition  to  the  privies  located  on  the  plans  there  may  be  necessity  for  pro- 
viding a  few,  more  convenient  of  access,  for  delicate  women,  and  these  should  by 
all  means  be  dry  earth  closets  located  in  a  tent,  and  daily  emptied.  The  locations 
indicated  in  the  plan  should  not  be  considered  as  essential,  but  should  be  varied  to 
avoid  contamination  of  the  water  supply  or  for  other  sanitary  reasons. 


ik=- 


Hoa&oo =  -  ~il 


Fig.  70. 

Plan  of  Detention  Camp  established  by  the  Marine  Hospital  Service  at  Brunswick,  Ga. 
From  Report  of  Supervising  Surgeon-General,  1893. 


COMMUNICABLE   Diseases.  qq» 

•If  not  already  existent,  a  sufficient  amount  of  railroad  siding  should  be  pro- 
vided to  hold  the  necessary  cars  for  disinfection  and  commissary  purposes.  At  a 
point  most  convenient  for  this  purpose  on  this  siding  there  should  be  built  a  waiting 
and  dressing  pavilion  containing  from  four  to  six  rooms,  to  be  used  for  the  purpose 
hereinbefore  mentioned,  and  from  four  to  six  tents,  end  to  end,  for  examination, 
reception,  and  registration  of  applicants  for  admission. 

"In  addition  to  the  commanding  officer,  the  medical  staff,  and  the  hospital 
steward,  the  necessary  personnel  of  a  detention  camp  should  be: 

••(A)  Guards,  who  should  be  placed  at  intervals,  long  or  short,  according  to  the 
topography  of  the  site,  and  be  under  officers  to  be  named  hereafter. 

"•(B)  Disinfecting  force. 

"(C)  Quartermaster,  commissary,  clerks,  bugler,  telegraph  operator. 

"(D)   Cooks,  waiters,  laundresses,  scavengers,  teamsters. 

•All  persons  seeking  admission  to  a  camp  should  be  given  a  permit  by  some 
responsible  agent  in  the  infected  centre,  and  such  permits  in  any  one  day  should  in 
no  case  equal  more  than  one-eighth  of  the  total  capacity  of  the  camp.  Upon  the 
arrival  of  a  refugee  at  camp  he  should  be  at  once  examined  as  to  his  health  by  one 
of  the  inspecting  officers  detailed  for  that  purpose,  and  if  found  not  to  be  suffer- 
ing from  any  suspicious  disease  he  may  be  registered.  He  should  then  turn  in 
his  effects  for  disinfection  and  await  in  a  building  provided  for  this  purpose  the 
return  of  his  disinfected  belongings.  He  should  then  change  his  clothing  and  sub- 
mit for  disinfection  the  suit  worn  upon  arrival.  This  being  completed,  he  may 
finally  be  admitted  to  the  main  camp,  and  no  further  disinfection  required,  unless 
he  subsequently  develop  disease  in  his  own  person.  It  is  advisable  that  invari- 
able rules  should  obtain  in  all  camps,  and,  as  nearly  as  may  be,  all  persons  treated 
exactly  alike  and  concessions  made  to  none."' 

The  plan  of  the  camp  at  Brunswick  is  shown  in  Fig.  70. 

When  a  place  is  infected  it  has  of  late  years  been  the  custom  of  the 
marine  hospital  service  to  maintain  a  train  inspection  on  the  roads 
Leading  out.     The  following-  is  from  a  report  by  Surgeon  Glennon:1 

"The  object  to  be  attained  is  to  ascertain  that  no  person  ill  or  suspected  danger- 
ous is  allowed  to  depart  from  an  infected  city  or  town,  and  also  that  passengers  are 
under  surveillance   w  hile  en  route  to  destination. 

11 1  attained  the  first  object  this  year  at  Mobile  by  stationing  a  competent  physi- 
cian  at  the  union  depot  in  that  city,  w  ho  personally  examined  all  would-be  departing 
passengers  and  obtained  a  signed  declaration  of  their  residence,  non-exposure  to 
infection,  and  number  of  pieces  of  baggage.  To  this  declaration  was  attached  the 
inspector's  certificate  of  examination  of  the  bearer  and  disinfection  of  baggage.  By 
an  arrangement  with  the  railroad  companies  bos  ears  were  located  near  by,  for  dis- 
infection of  baggage,  railway  mail,  express  packages,  anil  other  matter,  ordinary 
shipping  tags  were  attached  marked  "  Disinfected,"  signed,  and  stamped  with  the 
seal  ol  t  lie  marine  hospital  service.  This  baggage  went  through  to  all  points  with- 
out  trouble,  though  I    learned  that    baggage  from  other  point-,  was  overhauled  along 

the  line. 

"The  second  object  was  attained  by  placing  a  competent  physician  upon  each 
departing  train,  to  examine  the  passengers  en  route,  who  were  persons  from  New 
oilcans  and  the  infected  Gulf  coast  towns  as  well;  memorandum  slips  were  taken 
up.  completed,  certificates  checked  up  and  passed  on  at  the  aext  relay,  the  inspector 

taking    the  return  train    at    the  most    convenient    point.      I  n  I  h  is  w  ay  a  douhle-elie,  k 

sen  ice  was  inst  it uted. 

1  Report  oi  Supervising  Surgeon  General,  Marine  Hospital  Service  (1898),  p.  362. 


0  (3  4  C  OMMTTNICABLE   VI SEA  SES. 

■  Pullman  sleeping  and  xipholstered  cars  should  be  discontinued,  except  possibly 
upon  through  trains  for  the  north.  These,  together  with  ordinary  cars,  should  be 
treated  with  the  steam  air  blast,  disinfected  at  some  central  point,  and  a  dated  certi- 
ficate of  the  fact  attached  to  each  car  before  it  is  allowed  to  return. 

"  Relays  of  train  crews  should  be  made  at  not  less  than  five  miles  from  an  infected 
city  or  town,  and  another  preferably  at  the  state  line.  It  is  not  necessary  to  transfer 
the  passengers  into  new  coaches,  the  experience  of  this  year  showing  that  they  are 
best  detained  for  observation  near  their  point  of  destination.11 

The  form  of  declaration  for  travellers  used  by  the  state  board  of 
health  of  Alabama  is  shown  in  Appendix  114. 

As  has  been  stated  in  the  preceding  pages,  local  and  state  quaran- 
tines throughout  the  south  have  frequently  forbidden  the  importation 
of  any  freight  from  an  infected  locality.  The  convention  rules  of 
Atlanta  and  New  Orleans  and  the  rules  of  the  marine  hospital  service 
permit  the  free  transportation  of  certain  classes  of  freight,  allow  other 
freight  to  be  removed  after  disinfection,  and  only  absolutely  forbid  the 
carriage  of  a  few  things,  such  as  household  furniture  and  bedding. 
Personal  baggage  must  always  be  disinfected.  In  1897  and  1898  the 
marine  hospital  service  established  an  inspection  at  many  important 
shipping  points  that  were  infected  and  passed  a  great  deal  of  freight 
that  was  very  generally  accepted  by  non-infected  cities.  In  1897  at 
New  Orleans,  4,6 26  cars  were  disinfected  Iry  drenching  with  corrosive 
sublimate  solution. 

There  has  been  much  discussion  as  to  the  damage  to  be  apprehended 
from  the  mails.  In  New  Orleans,  although  it  was  hardly  believed  to 
be  necessary,  the  marine  hospital  service  disinfected  the  letters  and 
newspapers  and  excluded  all  package  mail.  Letters  were  perforated 
and  all  mail  exposed  to  steam  for  forty  minutes  and  to  six  per  cent, 
formaldehyde  in  a  vaccuum  apparatus.1 


1  Report  of  Supervising  Surgeon-General,  Marine  Hospital  Service  (1887),  p.  628. 


CHAPTER  XIII. 

REFUSE     DISPOSAL. 
GrAKBAGE. 

MUCH  of  the  material  contained  in  the  following  pages  is  taken 
from  reports  made  in  1896  and  1897  to  the  American  Public 
Health  Association  by  one  of  its  committees.  Mr.  Rudolf  Hering, 
chairman  of  the  committee,  collected  a  large  amount  of  material  cover- 
ing nearly  one  thousand  pages  of  legal  cap.  Unfortunately  only  a  brief 
summary  was  published  in  the  transactions,  but  owing  to  the  kindness 
of  Mr.  Hering  the  writer  was  allowed  to  make  use  of  the  full  report  in 
the  preparation  of  this  volume.  The  attempt  has  been  made  to  note 
the  changes  that  have  occurred  since  189b",  and  doubtless  in  so  doing 
errors  have  crept  in.  Such  should  be  attributed  to  the  writer  and  not 
to  Mr.  Hering.  who  took  unusual  pains  to  verify  all  the  data  be  ob- 
tained.      * 

The  term  garbage  as  used  in  this  chapter  means  animal  and  vege- 
table waste  matter,  subject  to  rapid  decay,  from  dwellings,  hotels,  mar- 
kets, etc.  It  does  imt  include  slaughter-house  refuse,  dead  animals. 
night  soil,  street  sweepings,  or  anything  else.  This  appears  to  be  the 
most  common  meaning  of  the  word  throughout  the  United  States.  It 
is  true  that  in  some  lucidities  other  words  have  this  meaning,  and  in 
some  localities  garbage  includes  far  more  than  the  above.  Thus  in 
Connecticul  and  Rhode  Island  and  to  some  extern1  in  Massachusetts 
and  other  parts  of  New  England,  and  also  in  Jacksonville  and  Tacoma, 
"swill"  is  used  with  the  same  meaning  as  garbage,  and  often  to  the 
exclusion    of    the    Latter  term,  while    in  the    middle    and    western    states 

swill,  unless  limited,  indicates  distillery  refuse.     In  Massachusetts  offal 

L8  the  term  U8Ually  applied  t<>  garbage.      Il   is  also  employed  iii  St.  Paul. 

In  southern  cities,  and  popularly,  thougl t   officially,  in  Philadelphia, 

garbage  is  called  -slops. '"  a  word  which  in  New  England  means  chamber 
refuse  or  an\  kind  of  filthy  liquid  from  the  house.  In  Atlanta,  Charles- 
ton, Galveston,  Mac Ga.,  and    in  southern   cities  generally,  garbage 

includes  not  only  kitchen  refuse  bu1  also  papers  and  rubbish  of  all 
kinds.     In  New   York  (it\  and    the  aeighboiing  cities  in  thai  state  and 


(366  REFUSE  DISPOSAL. 

New  Jersey,  garbage  includes  ashes  as  well  as  dry  refuse  and  kitchen 
refuse ;  but  since  New  York  has  attempted  to  separate  the  kitchen 
wastes  from  ashes,  etc.,  the  attempt  is  made,  at  least  officially,  to  apply 
the  term  garbage  to  putrescible  waste  only. 

When  garbage  is  treated  separately  from  ashes  and  other  refuse  it 
is  necessary  to  define  by  rule  or  ordinance  what  is  meant  by  garbage. 
It  is  difficult  to  enforce  the  separation  of  garbage  from  other  waste  ma- 
terial, and  as  the  first  step,  it  is  necessary  to  inform  the  public  what 
will  be  considered  garbage.  So  too  in  making  contracts,  it  must  clearly 
be  understood  by  both  the  city  and  the  contractor  exactly  what  is  to  be 
removed  or  destroyed.  Garbage  is  variously  defined  ;  sometimes  merely 
as  "  animal  and  vegetable  waste."  Usually  garbage  is  considered  to 
consist  of  waste  from  food  material.  In  the  District  of  Columbia  gar- 
bage is  defined  as  "  the  refuse  of  animal  or  vegetable  matter  which  has 
been  used  or  intended  for  food."  Definitions  of  garbage  from  Pitts- 
burgh1 and  Xew  Orleans2  are  given  below. 

Most  of  these  regulations  are  more  concerned  with  specifying  what 
shall  not  be  considered  garbage  and  what  must  not  be  mingled  with  it. 
than  they  are  with  making  a  positive  definition.  Very  many  of  these 
rules  specifically  mention  a  great  number  of  substances  which  must  not 
be  allowed  to  go  into  a  garbage  receptacle.  Rain  water  is  one  of  the 
things  that  must  be  kept  out,  and  often  covers  are  required  for  this 
purpose.  Liquids,  disli  water  and  slops  of  all  kinds  are  forMdden.  In 
Fort  Wayne  garbage  "must  be  drained  before  being  put  into  the  ves- 
sel." Ashes  are  the  commonest  form  of  household  refuse  and  are  there- 
fore usually  specifically  excluded.  Among  other  materials  sometimes 
mentioned  are  glass,  crockery,  sweepings,  oyster  and  clam  shells,  saw- 
dust, cork  dust,  old  boots  or  shoes,  dead  animals,  lawn  clippings,  bot- 
tles, earthen,  tin  or  iron  ware,  rubbish,  dirt,  tin  cans,  poisonous  matter, 
excrement,  urine,  coal,  and  dirt. 

What  is  excluded  from  garbage  yaries  some  in  accordance  with  its 
final  disposition.     If  it  is  to  be  used  as  a  fertilizer,  slaughter-house 


1  Pittsburgh,  Garbage  Ordinance,  >Sec.  2  (15  January,  1895): 

"  Tbe  words  '  garbage  and  offal,1  as  used  in  this  ordinance,  shall  be  held  to  include 
every  refuse,  accumulation  of  animal,  fruit  or  vegetable  matter,  liquid  or  otherwise, 
that  attends  the  preparation,  use,  cooking,  dealing  in  or  storage  of  meats,  fish, 
fowls,  fruits  or  vegetables." 

2  New  Orleans,  Ordinances  No.  I860,  Council  Series : 

"That  the  word  'garbage'  as  used  in  this  ordinance  shall  be  construed  to 
mean  house  and  kitchen  offal,  and  all  refuse  matter  not  excremental,  whether  solid 
or  liquid,  and  composed  of  animal  and  vegetable  substances,  including  dead  animals 
coming  from  public  or  private  premises  of  the  city  and  not  destined  for  consump- 
tion as  food.1' 


REFUSE  DISPOSAL.  667 

refuse  and  dead  animals  are  an  advantage,  the  more  of  them  the  better. 
In  some  cities  where  the  garbage  is  reduced,  and  in  some  even  where  it 
is  cremated,  tin  cans  are  made  to  yield  a  profit  and  are  not  objected  to. 
In  other  places  where  garbage  is  fed  to  swine,  cans  are  an  incumbrance, 
and  when  garbage  is  plowed  in,  they  are  a  positive  disadvantage. 
Toledo  and  Fitchburg  are  examples  of  cities  where  garbage  is  fed  to 
hogs  and  where  it  is  forbidden  to  place  empty  tins  in  the  garbage. 
The  difficulty  of  enforcing  such  a  rule,  is  probably  the  reason  why  it  is 
not  more  often  found.  In  Boston,  although  garbage  is  to  some  extent 
used  for  feeding,  it  is  required  that  cans  and  bottles  which  have  con- 
tained food  shall  be  put  with  the  garbage.  This  rule  came  about  from 
the  triple  separation  which  is  made  in  that  city,  the  contractors  declin- 
ing to  have  cans  with  the  dry  refuse  which  they  sort  over  for  salable 
material.  In  Fort  Wayne,  though  the  garbage  is  cremated,  it  is  forbid- 
den to  place  cans  in  it.  When  garbage  is  cremated  it  is  an  advantage 
to  have  as  much  combustible  material  as  possible  mixed  with  it.  Hence 
in  Lowell1  it  is  provided  that  "in  the  garbage  vessels  shall  be  placed  all 
kitchen  refuse,  apple  and  potato  parings,  corn  husks,  cabbage  leaves, 
shoes,  rubbers,  old  bedding,  soiled  linen  or  cotton  and  all  refuse  that 
can  be  burned."  and  similar  provisions  are  found  in  other  cities.  In 
Atlanta  and  other  southern  cities  a  similar  practice  is  in  vogue,  ami 
garbage  is  held  to  mean  kitchen  waste  plus  all  rubbish  of  a  combustible 
nature,  but  docs  not  include  ashes.  True  garbage  is  in  these  cities 
called  slops. 

In  Columbus,  ( ).,  Elizabeth,  X.  J.,  Rochester  and  St.  Louis  the 
scavengers  or  the  contractor  remove  and  dispose  of  slaughter-house 
refuse. 

In  Asbury  Park,  N.  J.,  Augusta,  Ga.,  Cleveland,  the  District  of  Col- 
umbia. Detroit,  Houston,  Tex.,  Minneapolis,  New  Orleans,  Philadelphia, 
St.  Louis,  and   St.  Paul  the  garbage  collectors  remove  dead   animals. 

The  following  is  the  weight  of  a  cubic  yard  of  garbage  as  reported  by 
various  cities : 

WEIGHT  OF   GARBAGE. 

Asbury  Park- one  cubic  yard,  weighl  1,472  pounds. 

Boston  ..." "      "  1,100 

Brockton '•  1,500 

Buffalo 1,260 

Cambridge  l-      l 1,688 

i  leveland "      ' 1,600 

District  of  Columbia. .   "      "        •■  "  1,512 

Evansville ' 1,000 

Lowell 1,241 

Lynn •■  1,500 

'  Lowell,  Rules  and  Regulations  of  Board  of  Bealth  |  L897),  p.  ::•"•.  Sec.  L. 


668  REFUSE  DISPOSAL. 

Newton one  cubit-  yard,  weight  1,500  pounds. 

Paterson "       "        "  "         1,800 

Pittsburgh "       Ll         lt  "         1,500 

Providence "       "         "  "         1,234       " 

St.  Louis ••       "         lt  ll         1,080       " 

Yonkers k"       "         "  lt         1,500       " 

Average - ....  1 ,405       LL 

The  weight  of  garbage  of  course  varies  according  to  its  character 
and  the  amount  of  other  refuse  and  the  amount  of  water  contained  in 
it,  but  the  average  weight  given  above  is  probably  not  far  from  correct. 

In  some  cities  garbage  is  collected  only  from  private  residences,  and 
not  from  hotels,  restaurants,  stores  and  markets.  Many  other  cities, 
while  ready  and  willing  to  remove  garbage  from  hotels,  do  not  do  so, 
but  permit  its  removal  by  private  parties.  Hotel  garbage  is  more  desir- 
able for  feeding  to  swine  than  is  garbage  from  private  houses,  and 
perhaps  in  the  majority  of  cities  a  considerable  part  of  the  hotel  garbage 
is  removed  by  private  parties  to  be  used  for  that  purpose.  Such  gar- 
bage usually  has  a  small  market  value.  The  farmer  may  pay  a  small 
amount  of  cash  for  it  or  in  many  instances  he  furnishes  to  the  hotel  the 
products  of  the  farm  at  a  reduced  price.  In  Providence  the  garbage 
from  the  principal  hotel  is  sold  for  about  $200.  A  few  years  ago  a 
single  hotel  in  New  York  City  received  #1200  a  year  from  the  sale  of 
its  garbage,  but  now  has  to  give  it  away.  It  is  sometimes  claimed  that 
the  city  has  no  right  to  prevent  such  a  sale  of  garbage  to  private  par- 
ties, but  the  writer  has  heard  of  no  decision  on  this  point;  but  such 
sale  sometimes  results  in  nuisance,  owing  to  the  carelessness  of  the  pri- 
vate contractor,  and  occasionally,  as  in  Lynn,  the  disposal  of  any  garbage 
to  private  parties  is  forbidden.  There  are  not  many  such  cities,  how- 
ever, as  the  municipality  is  usually  glad  to  be  rid  of  a  part  of  the  ex- 
pense of  garbage  removal. 

It  more  often  happens  that  a  city  refuses  to  remove  the  garbage  from 
hotels  and  markets.  There  is,  of  course,  no  just  reason  for  such  refusal 
and  it  is  only  refused  on  grounds  of  economy.  The  removal  of  garbage 
from  stores,  markets,  produce  commission  houses,  and  the  like  is  usually 
considerable  of  a  burden  and  some  cities  are  glad  to  escape  it.  It  is 
argued  that  the  waste  accumulated  in  such  places  is  the  result  of  busi- 
ness venture  and  the  cost  of  removal  should  be  a  burden  on  the  busi- 
ness, and  provided  for  as  any  other  business  outlay.  Such  a  reason  is 
no  reason  at  all,  for  the  paramount  argument  for  the  municipal  removal 
of  garbage  is  the  prevention  of  nuisance,  municipal  removal  being  the 
only  means  by  which  nuisance  can  be  avoided.  This  the  writer  well 
knows,  for  in  his  own  city  the   market   men   and   produce   dealers   are 


REFUSE  DISPOSAL.  669 

obliged  to  get  rid  of  the  refuse  themselves,  and  they  promptly  deposit 
decaying  fish  and  vegetables  on  the  nearest  dump,  evading  the  police 
and  other  inspectors  with  great  ingenuity.  There  is  another  reason 
than  that  of  economy  in  collection,  which  leads  cities  to  decline  the 
refuse  of  markets,  and  that  is  the  difficulty  of  disposal.  Market  refuse 
rarely  consists  of  pure  garbage,  i.  e.,  putrescible  materials,  but  is  mixed 
with  sawdust,  paper,  etc.  It  will  not  do  to  place  it  on  a  dump,  and  it 
is  not  desirable  to  put  it  in  garbage  that  is  to  be  fed  to  swine.  In 
Chicago  the  contractor  is  not  required  to  remove  garbage  from  hotels 
containing  over  twenty  persons.  In  Cincinnati,  Dayton.  Davenport,  la., 
Fort  Wayne.  Muncie,  Ind.,  Rockford,  111.,  Springfield,  Mass..  and  Min- 
neapolis, the  public  garbage  service  is  not  extended  to  hotels.  In 
Evansville,  Fort  Wayne,  Pawtucket,  Providence,  and  Wheeling  markets 
and  produce  dealers  are  obliged  to  dispose  of  refuse  at  their  own  ex- 
pense and  in  their  own  way.  In  Philadelphia  decayed  fruits  and  vege- 
tables are  not  collected  by  the  contractor,  but  must  be  disposed  of  when 
delivered  at  reduction  works.  In  Rochester  all  such  refuse  is  removed 
by  the  health  department,  but  markets  and  produce  dealers  pay  to  the 
city  a  nominal  sum  for  the  service.  In  Boston  produce  dealers  are 
required  to  remove  their  garbage  to  the  scows  at  their  own  expense 
and  are  charged  for  the  privilege  of  depositing  it.  In  1898  11,314.55 
was  recen  <•<!  from  this  source. 

It  has  usually  been  considered  best  by  municipal  authorities,  and 
indeed  !y  sanitary  officers,  to  collect  ami  dispose  of  garbage  separately 
from  other  forms  <>f  refuse.  There  are  several  reasons  tor  this.  Gar- 
bage is  the  most  offensive  form  of  a  city's  wastes  and  the  necessity  for 
its  removal  is  the  most  pressing.  It'  it  is  kept  separate'  from  ashes 
there  is  a  less  bulk  to  lie  moved,  and  the  expense  is  therefore  less.  For 
most  cities  it  is  easier  to  dispose  of  pure  than  mixed  garbage,  for  the 
former  may  be  led  to  hogs,  while  the  latter  is  usually  placed  on  a  dump 
to  the  annoyance  of  many.  Lastly,  it  is  only  when  garbage  is  kept 
separate  that    it    can    be  utilized.       Feeding    lo    hogS    has    long    been  the 

moving  cause  for  separate  garbage  collection,  and  of  late  years  the 
promise  of  the  recoverj  of  a  part  of  the  value  of  garbage  b\  reduction 

processes  induced  so  able  a  sanilai\  officer  as  the  late  (ieoige  F.  War- 
ring, Jr.,  to  advocate  separation  of  the  different    varieties  of  ;i  city's 

wastes.  The  cities  named  below1  require  the  separation  by  the  house- 
holder of  garbage  from  other  forms  of  refuse. 


1  Adrian,  Mich..  Ubany,  Allegheny,  Asbnrj  Park,  Atlanta,*  Atlantic  city, 
Augusta,  Ga.,*  Auburn,  V  ^  .,  Baltimore,  Boston,  Bridgeport,  Brockton,  Brooklyn, 
Buffalo,  Cambridge,  Camden,  Chelsea,  Cincinnati,  Cleveland,  Columbus,  O.,  Daven- 
port, la.,   Dayton,   Denver,  Detroit,  Dubuque,  Erie,  Evansville,  Everett,  Mass.,  Fall 


670  REFUSE  DISPOSAL. 

The  rules  requiring  the  separation  of  garbage  from  other  refuse  are 
enforced  by  fines,  as  are  other  similar  regulations,  and  obedience  is  also 
secured  by  relieving  the  contractor  or  city  employee  from  the  duty  of 
removing  the  garbage  when  it  has  improper  substances  in  it,  or  when  in 
any  other  manner  it  is  offered  for  collection  in  violation  of  the  rules 
prescribed.  This  is  quite  a  common  provision,  but  in  some  cities,  as 
Asbury  Park  and  Buffalo,  it  is  required  that  the  contractor  shall  at 
once  report  the  fact  to  the  health  department.  In  Asbury  Park  a 
separate  slip  is  sent  to  the  health  department  for  each  case,  on  which  is 
stated  the  reason  why  the  garbage  was  not  removed. 

Garbage  Receptacles. 

The  garbage  receptacle,  especially  when  separation  of  true  garbage 
is  made,  is  usually  one  of  the  commonest  forms  of  nuisance  to  be  found. 
Every  garbage  can,  unless  it  is  emptied  daily  and  thoroughly  washed 
after  emptying  (which  is  practically  never  done)  is  in  hot  weather  sure 
to  be  offensive.  The  annoyance  from  it  can  probably  never  be  entirely 
done  away  with,  and  it  is  only  with  great  care,  and  at  some  expense, 
that  it  can  be  reduced  to  a  minimum. 

Nearly  every  city  requires  that  the  householder  shall  provide  a  water- 
tight covered  receptacle  to  hold  garbage.  The  rule  from  New  York 
City,  shown  below,1  has  served  as  a  model  for  many  others.     In  Min- 


River,  Findlay,  O.,  Fitchburg,  Galveston,*  Hartford,  Haverhill,  Holyoke,  Indian- 
apolis, Jackson,  Mich.,  Jacksonville,*  Jersey  City,  Kansas  City,  Kingston,  N.  Y., 
Lawrence,  Lowell,  Lynn,  Macon,*  Maiden,  Manchester,  Melrose,  Mass.,  Memphis,* 
Meriden,  Milwaukee,  Minneapolis,  Montclair,  N.  J.,  Muncie,  Nashville,  New  Bed- 
ford, New  Brighton,  Newbnrgli,  New  Haven,  New  London,  Newport,  Newton,  New 
York,  Oakland,  Cal.,  Omaha,  Paterson,  Pawtucket,  Philadelphia,  Pittsburgh,  Port- 
land, Me.,  Portland,  Ore.,  Poughkeepsie,  Providence,  Pueblo,  Colo.,  Quincy,  111., 
Richmond,  Va.,*  Rochester,  St.  Louis,  St.  Paul,  Salem,  Salt  Lake  City,  San  Jose, 
Savannah,*  Sioux  City,  Somerville,  Mass.,  Springfield,  Mass.,  Springfield,  O.,  The 
District  of  Columbia,  Toledo,  Trenton,  Utica,  "Wheeling,  Wilkesbarre,  Wilmington, 
Del.,  Worcester,  Yonkers. 

*  In  most  southern  cities  combustible  refuse  and  garbage  are  collected  together, 
but  separate  from  ashes. 

JNew  York,  Sanitary  Code  (1899),  Sec.  11G: 

"That  it  shall  be  the  duty  of  every  owner,  tenant,  lessee,  and  occupant  of  any 
and  every  building,  or  place  of  business  in  the  generally  built-up  portions  of  the 
City  of  New  York,  forthwith  to  provide  or  cause  to  be  provided,  and  at  all  times 
thereafter  to  keep  and  cause  to  be  kept  and  provided  within  such  building,  or  place 
of  business,  suitable  and  sufficient  boxes,  barrels  or  tubs  for  receiving  and  holding 
without  leakage,  and  without  being  filled  to  within  four  inches  of  the  top  thereof, 
all  the  ashes,  rubbish,  garbage,  and  liquid  substances,  of  whatever  kind,  that  may 
accumulate  during  thirty-six  hours,  from  said  building  or  place  of  business,  or  the 
portion  thereof  of  which  such  person  may  be  the  owner,  tenant,  lessee,  or  occu- 
pant." 


REFUSE  DISPOSAL.  671 

neapolis  the  manager,  proprietor  and  agent  are  made   responsible.     In 

Chicago  and  Cincinnati  the  ordinance  requires  that  the  owner  shall  pro- 
vide the  receptacle  when  a  house  contains  more  than  two  tenements. 
Tn  St.  Louis  where  private  scavengers  collect  from  hotels,  they  must 
furnish  two  sets  of  receptacles  to  avoid  transferring  the  garbage  in  the 
street.  In  Grand  Rapids  where  the  garbage  is  collected  by  private 
scavengers  at  the  owner's  expense,  the  contractor  or  licensee  is  obliged 
to  furnish  the  receptacles.1  The  rule  shown  below'2  is  found  in  the  act 
establishing  a  bureau  of  health  in  Pennsylvania  cities  of  the  second 
class. 

Of  about  LOO  cities  from  which  reports  have  been  received  on  this 
subject,  the  following  have  no  regulations  in  regard  to  the  garbage  re- 
ceptacles: Galveston.  Macon,  .Maiden,  Mass.,  Manchester,  X.  II.,  Xew 
Brighton,  X.  Y..  Newburgh,  Newton,  Pawtucket,  Portland,  Ore., 
Poughkeepsie,  Springfield,  O.,  and  Toledo.  .Ml  the  others  require 
water-tight  receptacles  for  garbage,  and  nearly  all  require  that  they  shall 
l»e  kept  covered.  In  Pennsylvania  cities  of  the  second  class  garbage 
receptacles  must  -'be  perfectly  water-tight  and  so  kept"  and  be  "pro- 
vided with  a  tight  fitting  cover,  which  cover  shall  not  be  removed  ex- 
cept when  absolutely  necessary.'"  It  is  a  difficult  matter  to  enforce  the 
rule  about  covering  garbage  receptacles,  and  according  to  the  observa- 
tions of  the  writer  in  his  own  and  other  cities,  it  is  much  more  often 
violated  than  obeyed.  It  is  perhaps  for  this  reason  that  a  few  cities, 
although  requiring  tight  garbage  receptacles,  do  not  reqire  that  they 
shall  be  covered,  as  Atlantic  City,  Brooklyn,  and  Davenport,  la.  In 
Detroit  the  covers  must  be  hinged.  In  the  District  of  Columbia  the 
Cover  must  be  provided  with  a  handle.  Receptacles  must  be  provided 
with  handles  in  Asbury  Park,  Buffalo,  Chicago,  the  District  of  Col- 
umbia, Kansas  City,  Pennsylvania  cities  of  the  second  class,  and  Sail 
Lake  City,  and  usually  it  is  specified  that  there  shall  be  two  handles, 
one  at   each   side. 

The  size  of  the  receptacle  is  not   usually  regulated.     In   Brooklyn, 

New  York.  Jersey  City,  and  Memphis,  it  must  be  large  enough  to  con- 
tain the  garbage  made  during  thirty-six  hours.  In  Cleveland  it  nui-i 
be  large  enough  to  contain  forty-eight  hours'  garbage,  and  in  Yonkers  it 

Miraiid  I!;t]ii<ls.  Ordinance  of  18  July,  L898,  Sec.  5. 

'Pennsylvania,  Chapter 258  of  L895,  Sec  •-'": 
The  bureau  of  health  shall  cause  :>  printed  notice  t"  '"■  lefl  at  each  and  everj 
hotel,  tavern,  eating  house  ami  dwelling  he  use  in  tin-  city,  Btal  ing  thai  a  scavenger 
will  call  for  offal,  garbage  and  swill  at  certain  times  mentioned  in  the  notice,  and 
requiring  thai  such  offal,  garbage  and  swill  be  ready  in  prescribed  and  suitable  yes 
vi  is  for  the  scavenger  when  h<'  '-alls  for  the  same,  and  a  copj  of  tins  section  shall  be 
appended  to  such  not  ice." 


672  KEF  CSV  DISPOSAL. 

must  hold  the  garbage  for  three  days.  Most  of  the  above  cities  and 
also  some  others  provide  that  the  receptacles  shall  be  sufficient  for  hold- 
ing the  garbage  "  without  being  filled  to  within  four  inches  of  the  top." 
A  minimum  size  is  prescribed,  of  two  gallons  in  Muncie,  Inch,  three  gal- 
lons in  the  District  of  Columbia  and  St.  Louis,  four  gallons  in  Cleve- 
land, five  gallons  in  Asbury  Park  and  Kansas  City,  and  six  gallons  in 
Paterson,  and  one  bushel  in  Wilmington,  Del.,  and  a  maximum  of  ten 
gallons  in  the  District  of  Columbia,  Paterson,  and  Muncie,  fifteen  gal- 
lons in  Kansas  City  and  St.  Louis,  twenty  gallons  in  Asbury  Park  and 
Fort  Wayne,  and  one-half  barrel  in  Bridgeport,  and  two  bushels  in 
Erie,  Pittsburgh,  and  Allegheny.  In  Rockford,  111.,  garbage  receptacles 
must  be  fifteen  inches  in  diameter,  and  twenty  inches  deep.  In  the 
District  of  Columbia  not  more  than  one  receptacle  under  ten  gallons  is 
allowed.  In  Philadelphia  the  garbage  receptacle  must  be  "  easily  and 
quickly  handled  by  one  man."  Several  cities  which  do  not  prescribe 
the  size  of  garbage  receptacles  report  the  size  in  common  use  as  follows : 
Sioux  City,  thirty  gallons;  Denver,  twenty-four  to  thirty  inches  deep 
and  fifteen  to  twenty-four  inches  in  diameter;  Evansville,  from  four 
gallons  to  a  barrel ;  Indianapolis,  about  ten  gallons.  In  Rochester  the 
garbage  receptacles  must  have  a  capacity  of  one  gallon  for  each  member 
of  the  family. 

The  materials  of  which  garbage  receptacles  shall  be  made  are  some- 
times specified.  Thus  in  Cleveland  they  may  be  either  metal  or  earthen. 
In  the  District  of  Columbia,  Pueblo,  Denver.  Kansas  City,  and  Buffalo 
they  must  be  of  metal,  and  in  Rockford,  111.,  Milwaukee,  New  London, 
Newport,  R.  I.,  Holyoke,  and  Asbury  Park  they  must  be  of  galvanized 
iron.  It  is  recommended,  though  not  required,  that  they  be  of  gal- 
vanized iron  in  Allegheny,  Atlantic  City,  Erie,  Newton,  Mass.,  New 
Haven.  Nashville,  Pittsburgh,  Worcester,  and  Yonkers.  Lowell  and 
Providence  recommend  that  they  be  not  made  of  metal  as  the  garbage 
freezes  to  them  in  the  winter,  and  it  is  impossible  to  pick  it  out  with  a 
bar  without  speedily  destroying  the  can.  In  Providence,  the  advice  is 
to  use  galvanized  iron  in  summer,  but  wooden  vessels  in  the  winter. 
Printed  slips  advising  this  are  given  the  drivers  of  the  wagons  to  be  left 
at  the  houses  where  galvanized  cans  are  found  on  the  advent  of  cold 
weather. 

It  has  been  the  observation  of  the  writer  that  regulations  in  regard 
to  garbage  receptacles  are  very  pooly  enforced,  and  that  in  most  of  the 
cities  of  the  United  States  wooden  barrels,  firkins,  tubs,  pails,  and 
boxes  are  generally  used  as  suits  the  convenience  of  the  householder, 
('overs  as  a  rule  are  not  provided,  or  if  they  are,  speedily  become  lost. 
Almost  any  wooden  receptacle   is  water-tight,  as  it  is  kept  swollen  by 


REFUSE  DISPOSAL.  673 

the  moist  garbage,  but  very  serious  nuisance  results  from  the  absence  of 
covers.  The  uncovered  garbage  barrel  is  not  only  offensive,  but  eats 
and  dogs  scatter  its  contents  about  the  yard,  and  it  receives  large 
amounts  of  rain  and  snow  which  very  much  increase  the  cost  of  either 
cremation  or  reduction.  Theoretically,  wooden  receptacles  are  not  so 
good  as  metal,  but  unless  the  latter  are  emptied  daily  and  washed  out, 
conditions  never  fulfilled,  the  metallic  ones  soon  become  nearly  as  offen- 
sive as  those  made  of  wood.  A  common  form  used  in  Providence  is  a 
beer  keg.  It  is  durable,  tight,  and  will  not  be  destroyed  in  winter,  it  is 
not  readily  tipped  over  by  dogs,  and  if  it  has  an  iron  cover  is  secure 
from  all  animals.  The  scavengers,  however,  object  to  it  on  account  of 
its  weight.  Sometimes  the  garbage  pail  is  kept  in  a  small  house  or  box 
built  for  that  purpose,  but  the  experience  of  the  writer  is  that  this  also 
soon  becomes  filthy  and  offensive. 

It  is,  of  course,  clear  that  if  garbage  pails  could  be  emptied  and 
washed  daily  they  could  be  really  kept  clean.  Otherwise  to  talk  about 
a  clean  garbage  receptacle  is  absurd.  For  this  reason,  there  are  few 
regulations  as  to  how  garbage  receptacles  shall  be  kept,  but  in  Asbury 
Park  the  owners  of  garbage  receptacles  "shall  cause  the  same  to  be  kept 
(dean,"  and  in  "good  repair,*"  and  in  Minneapolis  they  shall  be  "emptied 
and  cleansed  as  often  as  may  be  necessary  to  prevent  such  receptacles 
or  the  contents  thereof  from  becoming  a  nuisance:""  but  the  same  ordi- 
nance, perhaps  because  it  was  realized  that  the  foregoing  was  impracti- 
cable, requires  that  the  receptacle  shall  be  placed  in  a  position  "  as 
remote  as  possible  from  any  surrounding  dwellings  and  not  less  than 
twenty-five  feet  from  any  adjacent  street."  In  Buffalo  it  is  required  of 
the  contractor  that  "  From  May  1st  until  October  31st,  all  garbage  recep- 
tacles, when  emptied  of  contents,  shall  be  thoroughly  disinfected  before 
they  are  returned  to  the  premises,  and  such  disinfecting  shall  be  done 
as  directed  by  and  to  the  satisfaction  of  the  commissioner  of  health.'" 
A  similar  requirement  is  found  in  Erie. 

There  is  no  use  in  providing  garbage  cans  unless  all  garbage  is  kept 
in  them  and  not  thrown  into  the  yard  or  around  the  can.  Hence  the 
I  >i>t  rid  of  <  'olunibia1  rule  requires  that 

"  occupants  of  anj  dwelling  house,  apartment  01  tenement  bouse,  and  each  pro- 
prietor of  anj  boarding  bouse,  commission  warehouse,  botel,  restaurant,  and  other 
place  where  garbage  is  accumulated,  shall  cause  all  garbage  from  bis  or  her  prem- 
ises i"  '"•  inn  in  the  receptacle  provided  for  thai  purpose,11 

and  in  Providence2  no 

u swill,  garbage  or  offal  shall  be  placed  in  any  receptacles  for  ashes  or  rnbbisb, 
or  deposited  in  anj  yard  or  \auli  other  tlian  its  proper  receptacle." 

1  District  of  Columbia,  Police  Regulations,   \rt.  \l\'..  Sec.  S. 
^Providence,  Rules  of  the  Board  of  Udermen  (1899),  Chapter  1,  Sec.  16. 

a 


674  REFUSE  DISPOSAL. 

In  that  city  whenever  improper  substances  are  put  in  the  garbage, 
a  printed  copy  of  the  rule  is  given  to  the  householder. 

Trouble  sometimes  results  from  persons  overhauling  garbage  after 
it  has  been  placed  in  the  alleys  or  other  accessible  places,  looking  for 
junk,  or  perhaps  for  the  best  of  the  garbage  itself  to  take  away  for 
their  own  use.     Hence  the  following  rule  in  the  District  of  Columbia:1 

"  No  person  other  than  the  owner  or  authorized  collector  shall  interfere  with  or 
disturb  any  garbage  after  it  shall  have  been  piit  in  a  garbage  receptacle  and  placed 
in  an  accessible  place  for  collection;  nor  shall  any  unauthorized  person  molest,  hin- 
der, delay,  or  in  any  other  manner  interfere  with  any  garbage  collector  in  the  dis- 
charge of  his  duty.'1 

A  similar  regulation  forbidding  molestation  of  the  garbage  or  upset- 
ting it  or  scattering  it  upon  the  street  is  found  in  Atlanta,  Charleston, 
Chicago,  Cincinnati,  Grand  Rapids,  Memphis,  and  Pennsylvania  cities 
of  the  second  class. 

Location  of  Garbage  Receptacles. 

The  fact  that  a  garbage  pail  ie  a  nuisance  and  that  therefore  its 
location  should  be  as  far  from  dwellings  as  possible,  has  only  been 
recognized  so  far  as  the  writer  is  aware  in  Minneapolis,  as  shown  on 
page  678 ;  but  in  Bridgeport,  Camden,  District  of  Columbia,  New 
Haven,  Providence,  Rochester,  and  Yonkers  they  must  be  placed  where 
the  board  of  health  or  its  inspectors  direct,  though  in  Rochester2  the 
position  is  not  to  be  fixed  by  the  board  of  health  if  "  they  are  kept 
within  or  upon  the  private  grounds  of  residences  and  sufficiently  removed 
from  adjoining  premises  to  prevent  any  offense  thereto."  In  those 
cities  in  which  it  is  required  that  the  garbage  pails  be  placed  outside  of 
the  premises  it  is  intended  and  often  specified  that  they  shall  be  so 
placed  only  on  the  days  for  collection,  and  in  Buffalo  they  must  be  taken 
in  from  the  curb  line  within  one-half  hour  of  the  time  they  are  emptied- 

The  most  important  practical  consideration  in  regard  to  the  location 
of  garbage  receptacles  is  whether  they  shall  be  kept  on  the  premises  or 
placed  on  the  sidewalk.  In  a  general  way  it  may  be  said  to  cost  more 
to  remove  garbage  from  the  yard  than  from  the  curb,  but  the  conditions 
may  sometimes  be  such  that  one  is  as  cheap  as  the  other.  The  length 
of  haul  may  for  instance  prevent  the  collection  of  more  than  two  loads 
in  working  hours,  even  if  the  collection  is  made  from  the  curb,  and  yet 
the  margin  of  time  may  be  sufficient  to  permit  of  the  collection  of  the 
two  loads  from  the  premises.  In  Chelsea,  Mass.,  it  costs  twenty-five 
per  cent,  more  to  collect  from  the  rear  of  the  house  than  from  the  side- 


1  District  of  Columbia,  Police  Regulations,  Art.  XIV.,  Sec.  8. 

2  Rochester,  Ordinances  of  Board  of  Health  (1895),  No.  23. 


REFUSE  DISPOSAL.  675 

walk,  but  the  citizens  insist  upon  the  former.  In  Boston  this  practice 
is  followed,  but  is  considered  too  expensive.  In  Cincinnati  on  the  other 
hand,  where  the  practice  is  to  place  them  on  the  sidewalks,  it  is  not  con- 
sidered satisfactory. 

The  cities  named  below1  provide  that  the  receptacles  for  garbage 
shall  be  placed  on  the  sidewalk   for  the  convenience  of  the  scavengers. 

In  Colorado  Springs,  Kansas  City,  Toledo,  and  Chicago,  the  garbage 
is  to  be  placed  in  the  alley  in  the  rear,  if  there  is  one.  In  Cambridge 
it  is  to  be  placed  outside  the  premises  in  the  summer  but  not  in  the 
winter.  In  Detroit,  while  outside  the  lot  line,  the  receptacles  must  not 
be  over  two  feet  from  it,  and  in  Allentown,  Pa.,  and  in  Paterson  they 
must  be  set  at  the  curl). 

In  most  cities  the  garbage  pail  must  be  kept  on  the  premises.2  In 
Boston,  Milwaukee,  New  Haven,  the  District  of  Columbia,  and  St.  Paul 
it  is  provided  that  the  receptacle  must  be  kept  in  an  accessible  loca- 
tion.    Scavengers  are  not  expected  to  go  up  stairs  or  down  cellar  for  it. 

In  Denver,  Fort  Wayne,  Omaha,  Pueblo,  and  St.  Louis  it  may  be 
placed  either  just  within  or  just  without  the  street  line  ;  but  in  Atlanta. 
Cleveland,  Erie,  New  Brighton,  and  Pennsylvania  cities  of  the  second 
class  it  must  he  kept  in  rear  of  the  house,  or,  in  the  latter  cities,  in 
areas  in-  passageways.  In  Macon  it  must  be  set  on  the  premises  near 
the  gate. 

It  is  more  economical  tor  the  scavengers  to  carry  a  pail  to  the  recep- 
tacle when  the  latter  is  on  the  premises  and  to  empty  the  receptacle 
into  the  pail  than  it  is  to  carry  the  private  receptacle  to  the  wagon  and 
return  it.  By  the  use  of  a  carrying  pail  one  trip  is  saved  at  each  house, 
and  this  is  the  more  common  method  of  collection,  hut  it  is  sometimes 
forbidden,  as  in  Asbury  Park.  In  such  cases  it  is  supposed  that  the 
Scavengers  will  return  the  receptacle  to  the  place  where  found,  and  this 
is  specified  in  sonic  of  the  rules,  as  in  the  one  given  below.3 

1  Camden,  Colorado  Springs,  Cambridge,  * "  1 1  i  < ; i  l^  •  •  -  Cincinnati,  Detroit,  Fitcbburg, 
Galveston,  Holyoke,  K;uis;in  City,  Nevi  London,  New  Fork,  Paterson,  (leading, 
Sioux  City,  Springfield,  <>..  Toledo,  and  LTtica. 

2  Allegheny,  Asbury  Park,  Atlanta,  Atlantic  City,  Auburn,  Battle  Creek,  Boston, 
Bridgeport,  Buffalo,  Chelsea,  Columbus,  Dayton,  District  of  Columbia,  Erie,  Fall 
River,  Grand  Rapids,  Hartford,  [ndianapolis,  . lacks.. n,  .Mich.,  Lowell,  Lynn,  Mil- 
waukee, Minneapolis,  New  Bedford,  Nevi  Brighton,  Newport,  Newton,  Pawtucket, 
Providence,  Philadelphia,  Pittsburgh,  Richmond,  Quincy,  111..  Rochester,  Salem, 
Savannah,  Somerville,  Springfield,  Muss..  Syracuse,  Wheeling,  Wilmington,  Del.. 
and  Worcester. 

:  Buffalo,  Contractors1  Specifications  for  Removal  "f  Ashes  and  Garbage: 
"Receptacles  containing  material  shall  be  removed  from  premises,  placed  at 
curl)  line  by  contractor,  and  contents  unloaded  into  wagons  within  a  reasonable 
length  of  time,  which  shall  no1  exceed  one  (1)  hour  after  receptacles  are  placed  at 
i-urb  in  ticni  of  premises,  and  the  receptacles  Bhall  be  returned  to  the  place  on  prem- 
ises from  which  they  were  re red  within  one-half  (i)  hour  after  they  are  emptied." 


676  REFUSE  DISPOSAL. 

frequency  of  Removal. 

The  frequency  of  removal  of  garbage  varies  in  different  cities, 
though  it  is  rarely  moved  less  often  than  once  in  a  week. 

The  only  city  in  which  garbage  is  collected  seven  times  in  a  week 
is  Washington.  In  other  parts  of  the  District  of  Columbia  it  is  col- 
lected less  often. 

It  is  collected  six  times  a  week  during  the  entire  year  in  Adrian, 
Mich.,  and  Allegheny,  Macon,  Ga.,  New  York  City,  Philadelphia,  and 
Savannah  ;  from  15  May  to  15  October  in  Brookline  ;  from  15  June 
to  15  September  in  Asbury  Park,  N.  J.  ;  from  1  April  to  20  November 
in  the  centre  of  city  in  Dubuque,  la.  ;  in  the  summer  time  in  Atlantic 
City,  Davenport,  la.,  Denver  (in  centre),  Colorado  Springs  (in  centre, 
May-October1),  Norfolk,  and  Richmond,  and  in  the  central  districts  of 
Buffalo  and  Chicago,  Columbus,  Cincinnati,  Detroit,  Manchester,  N.  H., 
Milwaukee,  New  Brighton,  Pittsburgh,  St.  Paul,  Salt  Lake  City,  and 
Quincy,  111. 

Garbage  is  collected  four  times  a  week  in  Newport,  R.  I.,  from  May 
to  September. 

The  most  common  method  is  to  collect  the  garbage  three  times  each 
week.  This  is  followed  in  Newburgh,  New  London,  Ct.,  and  in  San 
Jose,  Cal.,  all  the  year  round  and  in  all  parts  of  the"  city.  It  is  collected 
in  certain  districts  three  times  a  week  in  Detroit,  Hartford,  Chicago, 
Cincinnati,  Columbus,  Quincy,  111.,  Pittsburgh,  Manchester,  New 
Brighton,  St.  Paul,  and  Toledo.  The  garbage  is  collected  three  times 
a  week  in  the  winter  in  Atlantic  City,  Norfolk,  and  Richmond  ;  three 
times  a  week  in  the  summer  in  Brockton,  Mass.,  Cambridge,  Colorado 
Springs,  Galveston,  Holyoke,  Kansas  City,  Lynn,  Maiden,  Paterson, 
Sioux  City,  Somerville,  Mass.,  Utica,  Worcester,  and  Wilmington,  Del.  ; 
from  15  November  to  15  June  in  Asbury  Park,  N.  J.  ;  from  21  Novem- 
ber to  30  March  in  the  suburbs  of  Dubuque,  la. :  from  November  to 
April  in  Newport,  R.  I.;  from  June  to  September  in  Bridgeport;  from 
May  to  October  in  Brooklyn  and  New  Bedford;  from  16  July  to  15 
October  in  Camden  ;  from  April  to  November  in  Cleveland  and  Chel- 
sea, Mass.  ;  from  15  April  to  15  November  in  suburbs  of  the  District 
of  Columbia ;  from  May  to  September  in  Haverhill ;  from  April  to 
October  in  Providence,  Fall  River,  and  Pawtucket;  from  April  to  Sep- 
tember in  Newton,  Mass.,  and  St.  Louis  ;  from  May  to  November  in 
New  Haven;  from  April  to  November  in  Evansville. 

Garbage  is  collected  twice  a  week  all  the  year  around  in  all  parts  of 
the  city  in  Allentown,  Pa.,  Fitchburg,    Lowell,    Portland,  Ore.,  Salem, 


1In  all  these  periorls  both  months  aiv  included. 


REFUSE  DISPOSAL.  677 

Springfield,  Mass.,  .Springfield,  ().,  Tacoma,  and  Wilkesbarre.  It  is 
collected  twice  a  week  in  certain  parts  of  Chicago,  Cincinnati,  Colum- 
bus, Quincy,  111.,  Pittsburgh,  Hartford,  and  Toledo.  Garbage  is  col- 
lected twice  each  week  in  the  summer  in  Boston,  Dayton,  Erie,  Pa., 
Muncie,  Ind.,  Rochester,  CJtioa  :  New  York  City  from  May  to  October, 
in  Bridgeport,  Brockton,  Buffalo  (except  in  centre),  and  Cleveland:  in 
the  winter  in  Cambridge,  Holyoke,  Maiden,  Mass..  Paterson,  Sioux 
City,  Somerville,  Mass.,  Dtica,  Wilmington,  Worcester ;  from  November 
to  April  in  Brooklyn,  New  Bedford  :  from  :2i!  October  to  15  July  in 
Camden,  from  December  to  March  in  Chelsea;  from  16  November  to  20 
March  in  the  suburbs  of  the  District  of  Columbia;  from  October  to 
April  in  Haverhill:  from  December  to  April  in  Xew  Haven;  from 
October  to  March  in  Newton,  Mass..  and  St.  Louis;  from  November  to 
March  in  Providence,  Pawtneket,  Fall  River,  and  in  the  spring  and 
autumn  in  Kansas  City:  in  June,  July  and  August  in  LambertviUe, 
X.  .1.  :   from  December  to  March  in  Evansville. 

'•arbage  is  collected  once  a  week  at  all  seasons  and  in  all  parts  of 
Battle  Creek.  Mich.  It  is  collected  once  a  week  in  certain  parts  of 
Denver  and  Colorado  Springs,  and  from  residences  in  Salt  Lake  City 
all  the  year.  It  is  collected  once  a  week  in  the  winter  from  all  parts  of 
Boston,  Muncie.  Ind.,  Kansas  City,  Dayton.  Rochester,  and  Davenport, 
la.  It  is  collected  once  a  week  from  December  to  March  in  Auburn, 
X.  Y.:  from  November  to  March  in  Erie;  from  November  to  April  in 
Bridgeport,  Buffalo,  and  Cleveland.  It  is  collected  once  a  week  in  the 
snmmer  from  Rockford,  111.  In  Rockford,  111.,  in  winter  not  over  a 
load  is  allowed  to  accumulate.  In  Dubuque,  la.,  municipal  collection 
ceases  entirely  in  tin-  winter. 

From  the  foregoing  it  will  be  noticed  that  very  few  cities  collect 
garbage  every  day,  and  of  these  several  are  southern  cities.  A  number 
of  cities  make  a  distinction  as  to  frequency  of  collection  in  different 
sections,  collecting  \\  oftener  in  the  central  portions.  Such  are  Buffalo, 
Chicago,  Cincinnati,  Columbus,  Denver,  Detroit,  District  of  Columbia, 
Dubuque,  la..  Hartford,  Milwaukee.  New  Brighton,  Pittsburgh,  St. 
Paul,  and  Salt  Lake  City.  A  majority  of  the  cities  collect  the  garbage 
more  frequently  in  the  summer  than  in  the  winter,  and  it  is  usually 
done  three  times  a  week  in  the  slimmer  ami   twice  in  the  winter. 

Unless  garbage  is  collected  daily,  il    is  necessarj  to  divide  the  city 

into  districts,  certain  scavengers  collecting  in  certain  districts  on  certain 

days.     A  practical  difficulty  is  thereby  developed,  which  in  Providence, 

at  least,  is  the  cause  of  much  complaint.  Ii  is  evidenl  that  with  tri- 
weekly collections,  certain   houses   musl   each  week   he  neglected   from 

Friday  until   Monday.      As  this  in  the  long  inn  would  happen  to  a  given 


678  REFUSE  DISPOSAL. 

individual  not  more  than  once  in  three  weeks,  it  would  appear  not  to 
work  a  great  hardship;  but  from  the  fact  that  the  seeming  neglect  is 
apparently  sporadic,  it  causes  just  so  much  the  more  friction. 

Only  a  few  cities  make  no  distinction  in  frequency  of  collection  in 
different  seasons.1 

In  a  number  of  cities  garbage  is  collected  more  frequently  from 
hotels  and  restaurants  than  it  is  from  private  houses.  Usually  it  is  col- 
lected daily  from  all  such.2  Garbage  is  collected  daily  from  markets  in 
Auburn,  Buffalo,  Chelsea,  Somerville,  and  Tacoma. 

Hours  for  Removal. 

In  most  cities  the  garbage,  when  collected  separately,  is  collected 
during  the  day  time,  the  period  extending  over  the  whole  working  day. 
In  a  few  cities  collections  are  made  at  night.  In  Buffalo  it  is  collected 
from  the  business  district  between  (3.30  p.  m.  and  5  A.  m.  ;  Portland,  Ore., 
between  9  P.  M.,  and  8  A.  M. ;  in  St.  Paul,  between  12  p.  M.  and  (.»  A.  M. : 
in  Elmira,  during  June,  July,  August,  and  September,  between  6  p.  M. 
and  9  A.  M.  In  Spokane,  it  is  collected  from  10  P.  M.  to  10  A.  M.  from 
1  April  to  1  October,  and  from  10  p.  M.  to  11  A.  M.  during  the  rest  of 
the  year.     In  Ridgewood,  N.  J.,  garbage  is  collected  at  night. 

In  other  cities  it  is  collected  early  in  the  morning.  In  Asbury  Park 
it  is  collected  from  the  business  section  before  9  A.  M.,  also  in  Norfolk ; 
in  Salt  Lake  City,  before  8  A.  M.  In  Milwaukee  it  is  collected  between 
4  A.  M.  and  2  P.  M.  In  Asbury  Park,  Boston,  and  Buffalo  it  is  collected 
from  hotels  early  in  the  morning. 

In  New  Orleans  and  Wilmington,  Del.,  the  scavengers  must  ring  a 
bell  at  each  corner  loud  enough  to  be  heard  the  length  of  the  block, 
and  in  Erie  they  must  give  notice  of  their  approach.  In  Philadelphia 
the  contractor  is  to  frequently  call  out  "  slop."  In  Pennsylvania  cities 
of  the  second  class,  "  warning  of  their  approach  shall  be  given  by  the 
sounding  of  a  horn  at  each  street  corner  and  at  the  middle  of  each 
block."3 

Vehicles  for  Garbage  Removal. 

All  the  cities  reporting  except  Cincinnati,  Savannah,  and  Springfield, 
O.,  have  some  regulations  in  regard  to  garbage  wagons.  If  there  are 
any  regulations  at  all,  they  invariably  require  that  the  wagons  shall  be 

Adrian,  Mich.,  Allegheny,  Allentown,  Pa.,  Battle  Creek,  Fitchburg,  Lowell. 
Macon.  Newburgh,  New  London,  New  York  City,  Philadelphia,  Portland,  Ore., 
Salem,  San  Jose,  Cal.,  Savannah,  Springfield,  Mass.,  Springfield,  O.,  Tacoma,  Wilkes- 
barre,  and  Wilmington,  Del. 

2  Battle  Creek,  Boston,  Bridgeport,  Brooklyn,  Buffalo,  Chelsea,  Detroit,  Denver, 
Evansville,  Haverhill,  (if  they  have  five  guests),  Kansas  City,  (in  summer),  Lynn, 
Nashville,  Portland,  Ore.,  St.  Louis,  Somerville,  Tacoma,  and  Utica. 

3  Pittsburgh,  Garbage  Ordinance  (1895),  Sec.  4. 


REFUSE  DISPOSAL.  679 

tight  or  water-tight.  They  also  require  that  the  wagons  shall  be 
covered.  The  only  cities  where  this  is  not  the  practice  are  Lambert" 
ville,  N.  J.,  Portland,  <  )re.,  Springfield,  0.,  and  Savannah.  Usually  it 
is  specified  that  the  cover  shall  be  wood  or  metal  to  correspond  with  the 
cart,  but  canvas  covers  are  permitted  in  Atlanta,  Asbury  Park.  Bridge- 
port, Buffalo,  Cincinnati,  Richmond,  San  Francisco.  Scranton,  and 
Springfield.  Mass.  It  is  sometimes  specified  that  the  covers  must  be 
kept  on  except  during  the  actual  loading  of  the  garbage,  as  in  the  Dis- 
trict of  Columbia  and  St.  Louis. 

In  some  cities  wooden  wagons  or  carts  are  used  for  the  collection  of 
garbage.  The  only  regulation  for  their  construction  beyond  those  above 
given,  and  that  the  writer  has  seen,  is  in  Omaha  where  the  garbage 
wagons,  if  of  wood,  must  be  one  and  one-half  inch  tongued  and  grooved 
pine  stock.  Metal  carts  are  either  required  or  are  used  in  the  cities 
named  below.1  They  are  invariably  preferred  to  wooden  carts  as  it  is 
easier  to  keep  them  tight,  and  in  the  end  they  are  more  economical. 
The  only  objection  to  metal  carts  was  made  in  Lowell  where  a  certain 
style  of  cart,  the  Flanagan,  was  considered  too  heavy  and  clumsy.  In 
Atlanta  the  wooden  garbage  carts  are  made  by  the  city  at  a  cost  of  840. 
In  Providence  the  contractor  builds  his  own  wagons  which  have  metal 
bodies-     They  hold  from  two  to  three  tons  and  cost  about  $300. 

No  facts  were  obtained  to  show  whether  dump  carts  and  wagons  are 
chiefly  used,  or  these  from  which  the  contents  have  to  be  shoveled.  It 
is  the  impression  of  the  writer  that  dump  carts  and  wagons  are  preferred. 
They  render  the  handling  easier,  but  in  many  cases  this  may  not  decrease 
the  number  of  employees  or  the  cost.  The  objection  to  dumping  carts 
is  that  if  properly  constructed  they  cost  rather  more  than  those  that  do 
not  dump.  It  is  bad  to  have  any  sort  of  opening  or  movable  tail-board 
in  a  garbage  cart,  as  it  is  almost  impossible  to  keep  it  water-tight 

The  number  of   horses  used  with  a   garbage  wagon  is    usualh   either 

one  or  two,  though   sometimes,  as   in    Brooklyn   ami  Providence,  three 

horses  are  used  with  some  of  the  wagons.  As  regards  the  use  of  single 
or  double  tennis,  the  cities  are  about  evenly  divided. 

In  most  cities  either  one  or  two  men  go  with  each  wagon,  and  here 
again  the  cities  are  about  evenly  divided  as   to  practice.     In  Brooklyn 

lour  men    go  with  each  wagon,  in  Cincinnati  and    Chelsea  three,  ami    in 

Providence  sometimes   three.      The   writer  has   not    learned   that   any 

Allegheny,  Aabury  Park,  Atlantic  City,  Boston,  Buffalo,  Camden,  Cleveland, 
Columbus,    Davenport,   Denver,    Detroit,   District  <<(  Columbia,    Erie,    Evansville, 

Fall  River,  Fori   Wayne,  Lynn,  Milwaukee,  New   I- Ion,  New  Orleans,  New  i'ork, 

Norfolk,  Pawtucket,  Philadelphia,  Pittsburgh,  Providence,  Trenton,  Wilmington, 
Del.,  Xonkers. 


680 


REE  USE  DIHP  0  8 A  L. 


scavengers  are  uniformed  except  in  Asbury  Park  where  they  are  required 
to  wear  duck  suits. 

A  few  cities  make  use  of  barrels  for  the  collection  of  garbage.  In 
Lowell  they  are  used  by  private  scavengers,  and  in  St.  Louis,  Bridge- 
port, Rochester,  and  the  District  of  Columbia  they  are  employed  in 
municipal  work,  but  not  exclusively.  In  Haverhill,  New  Bedford,  New 
Haven,  Muncie,  Ind.,  and  Syracuse  they  are  used  exclusively  for  muni- 
cipal collection.  In  the  District  of  Columbia  and  Muncie,  metal  barrels 
are  used  of  thirty  gallons  capacity  in  the  District  of  Columbia,  and 
forty-three  gallons  in  Muncie.  In  the  latter  city  eight  barrels  are  used 
on  each  wagon.  In  New  Bedford  each  two-horse  wagon  carries  eight 
to  thirteen  kerosene  barrels  ;  these  are  provided  with  galvanized  iron 
covers  which  come  down  eight  inches  over  the  barrel.  The  barrels  last 
about  one  season. 


Fig  71. 
Garbage  Wagon,  New  Bedford. 


In  Syracuse  barrels  and  covers  like  those  in  New  Bedford  are  used. 
They  have  an  iron  handle  on  each  side.  Ten  of  these  are  carried  on  a 
two-horse  wagon  with  two  men.  They  hold  350  pounds  of  garbage 
each.  When  seen  by  the  writer,  they  appeared  to  be  satisfactory ;  all 
the  covers  were  on  and  very  little  garbage  was  dropped  between  them, 
but  they  are  to  be  given  up  for  metal  wagons.  In  Haverhill  and  Bridge- 
port the  wooden  barrels  have  wooden  covers  which  are  provided  Avith 
gaskets   and   fastenings,  though   plain    kerosene   barrels  costing  ninety 


TtEF  I  rSE  DISP  0  &  1  L . 


681 


Fig.  72. 
Garbage  Cart,  Richmond.    Cost,  $75.    Capacity,  one  cubic  yard. 

cents  with  covers  not  fastened  have  been  used  in  the  latter  city,  but 
box  wagons  are  preferred.  In  New  Brighton  and  Haverhill  sonic 
trouble  is  experienced  from  the  dropping  of  garbage  between  the  barrels, 
and  in  Haverhill  in  keeping  the  covers  on.  In  that  city,  in  order  to 
secure  better  results,  it  is  proposed  to  put  one  man  only  on  each 
wagon  in  order  to  fix  responsibility  for  its  condition.  Collection  in 
barrels  in  Haverhill  is  found  to  he  more  expensive  than  collection  in 
box  wagons. 

In  Lowell  many  private  scavengers  use  barrels.     Some  arc  like  those 
used  in  New  Bedford  with  deep  galvanized   iron  covers  and  others  have 

Covers    which    are    screwed    down    like    those  of  niedit   soil  tubs.      Screw 

covers  are  also  used  iii  St.  Paul.  Yonkers  lias  abandoned  this  method 
in  favor  of  metal  carts. 

The   ideal    way    to  collect    garbage   Would     he   to   remove   the   receptacle 
with  its  contents,  replacing    it   with  a  (dean  and  empty  one.      This  is.  ot 

course,  too  expensive  to  he  practical,  hut   ii    is  sometimes  required    Eor 

fish   market     or    other   especially    offensive    offal.1       A   similar    rule    is    in 

force  in  Fort  Wayne  in  regard  to  hotels. 

lAsbury  Park,  Sanitary  Code  (1897),  Sec.  84: 

■•  In  tlic  case  ef  lisli  markets,  oo  tisli  refuse  or  other  offal  shall  be  emptied  from 
the  receptacle  in  which  ii  is  stored,  bul  both  offal  and  receptacle  shall  be  removed 
from  the  premises  and  transported  together  outside  "f  the  city,  and  the  sai<l  recep- 
tacle shall  no!  !"•  broughl  bach  into  ill-'  i  Itj  until  ii  has  been  made  clean  and  odor- 
less. 


682 


A*  El '  USE  J  J  ISP  O  SA  A. 


Fig.  7;]. 
New  Style  Metal  Garbage  Wagon,  Providence.    Cost,  $300. 


Fig.  74. 
Old  Style  Wooden  Garbage  Wagon,  Providenc  e. 


REE USE  DISP  0  SAL. 


683 


There  is  nothing  to  be  gleaned  from  a  study  of  the  data  given,  to  show 
the  most  economical  number  of  men  and  animals,  or  size  of  vehicle  to 
be  used  in  collecting  garbage.  The  number  of  horses  and  also  the  num- 
ber of  men  to  a  certain  extent,  depend  upon  the  size  of  the  wagons. 
The  following  shows  the  size  of  vehicles  used  in  a  number  of  cities : 


Asbury  Park 48  cubic  feet. 

Atlantic  City 51  cubic  feet. 

Boston 57  cubic  feet. 

Brockton 32  cubic  feet. 

Buffalo 4  cubic  yards. 

Denver 3  cubic  yards. 

Detroit 52  cubic  feet. 


District  of  Columbia 37  cubic  feet. 

Li  iwell 75  cubic  feet. 

Newton 60  cubic  feet. 

Pittsburgh 54  cubic  feet. 

Providence 74  to  96  cubic  feet. 

Rochester 128  cubic  feet. 

Salem 42  cubic  feet. 


In  Buffalo  it  is  required  that  the  garbage  and  other  refuse  wagons 
be  of  a  uniform  size  and  multiples  of  one  cubic  yard. 

The  cost  of  garbage  carts  and  wagons  varies  from  ¥40  in  Atlanta  to 
$350  in  Paterson.  As  a  rule  the  cheapest  carts  are  used  in  the  south 
and  the  most  expensive  wooden  wagons  in  New  England.  Metal 
wagons  and  carts  are,  as  a  rule,  more  expensive  than  those  of  corre- 
sponding dimensions  made  of  wood. 


Fig.  75. 
Hill  Dump  Cart. 


Fi<;.   76. 
ii ill  i mi ii 1 1 •  (  .hi   upset  . 


684  REFUSE  DISPOSAL. 

A  cart  used  in  the  city  of  New  York  and  neighboring  cities  for 
separate  and  mixed  wastes  and  other  purposes  is  shown  in  Figs.  75- 
76.  It  is  made  in  various  sizes  by  Thomas  Hill,  48  Railroad  Ave- 
nue, Jersey  City.  A  cart  holding  thirty-five  cubic  feet  costs  about 
$115,  with  covers  $10  more.  A  wagon  somewhat  similar  to  this  cart 
is  quite  popular,  and  the  style  used  in  Boston  is  shown  in  Fig.  82. 

The  cart  used  in  the  District  of  Columbia,  Wilmington,  Del.,  Port- 
land, Me.,  and  other  cities  is  shown  in  Fig.  77.  It  is  made  by  the 
United  States  Sanitary  Co.,  Washington.  A  cart  holding  thirty-seven 
cubic  feet  weighs  1,300  pounds  and  costs  $175.  A  fifty-four-foot  cart 
weighs  1,500  pounds  and  is  sold  at  the  same  price. 

The  wagon  body  shown  in  Figs.  78  and  79  is  used  in  Detroit  and 
Cleveland.  In  the  former  city  they  are  made  by  the  Detroit  Safe  Com- 
pany and  cost  $50.  They  are  said  to  be  durable.  They  are  lifted  off  of 
the  wagons  and  put  in  tiers  on  freight  cars  to  be  removed  from  the  city. 

The  wooden  tip-carts  used  in  some  parts  of  the  south,  where  much 
dry  refuse  is  mixed  with  the  garbage,  may  be  seen  in  the  illustration  of 
the  interior  of  the  Jacksonville  crematory. 

The  following,  prescribing  the  care  to  be  taken  of  garbage  wagons, 
is  from  the  District  of  Columbia1  garbage  rules : 

"  No  driver,  owner,  or  superintendent  having  charge  or  control  of  any  cart  or 
other  vehicle  for  carrying  garbage  shall  allow  such  cart  or  vehicle  to  needlessly  re- 
main, nor  allow  a  needless  number  of  such  carts  or  vehicles  to  gather  before  any 
residence,  building,  or  place  of  business  within  the  city  of  Washington  or  the  more 
densely  populated  suburbs  thereof;  nor  allow  any  such  cart  or  vehicle,  or  anything 
thereto  appertaining,  to  be  in  a  condition  needlessly  filthy  or  offensive;  nor  allow 
any  such  cart  or  vehicle,  or  implement  used  in  connection  therewith,  to  be  stored  or 
kept  in  any  place  where  needless  offense  is  given  to  any  person  or  persons.  No 
driver  of  any  such  cart  or  vehicle  shall  occupy  an  unreasonable  length  of  time  in 
loading  or  unloading  such  cart  or  vehicle  or  in  passing  along  any  alley,  street,  ave- 
nue, or  public  road;  nor  allow  the  lid  or  cover  of  such  cart  or  vehicle  to  be  other- 
wise than  securely  closed  except  as  may  be  necessary  for  the  loading  or  unloading 
and  cleaning  of  such  cart  or  vehicle." 

Overloading  of  garbage  wagons  is  a  cause  of  offence  and  renders 
covers  useless,  and  is  often  forbidden.2  In  New  York3  "  no  part  of  such 
contents  or  load  shall  fall,  leak  or  spill  therefrom."  In  Yonkers  a  gar- 
bage wagon  is  not  to  be  kept  within  fifty  feet  of  a  dwelling.  In 
Asbury  Park  two  garbage  wagons  must  not  be  within  600  feet  of  each 
other  on  the  street. 


1  District  of  Columbia,  Police  Regulations,  Art.  XIV.,  Sec.  1. 

2  St.  Louis,  Ordinance  17216,  Sec.  9: 

"  Said  carts  or  wagons  shall  not  be  filled  to  overflowing,  and  the  covers  of  said 
carts  or  wagons  shall  be  kept  closed  except  when  the  garbage  is  being  placed  in 
them." 

*  Sanitary  Code  (1899),  Sec.  125. 


REFUSE  DISPOSAL. 


685 


Fig.   i  r. 
United  States  Sanitary  Company's  Cart. 


side:   view 

Fig.  Ts. 
Working  Drawing  of  Movable  Bodj  for  Garbage  Wagon,  Detroit. 


Fig.  79. 
Working  Drawing  ol  Movable  Bodj  i"i  Garbage  Wagon,  Detroit. 


686  REFUSE  DISPOSAL. 

It  is  often  one  of  the  regulations  that  the  wagons  shall  be  marked 
"garbage  cart,"  "garbage  wagon,"  "licensed  garbage,"  or  "garbage," 
and  sometimes  the  number  and  owner's  name  is  added.  The  letters  are 
usually  to  be  four  inches  high,  and  are  to  be  black  upon  a  white  ground. 
In  Cambridge  private  garbage  wagons  are  to  have  the  owners'  initials 
two  inches  high.  In  Colorado  Springs  the  words  on  the  cart  must  be 
legible  at  eighty  feet.  Often,  as  in  Brooklyn,  the  District  of  Columbia, 
and  Providence,  the  wagons  must  be  inspected  and  approved  by  the 
health  officer.  Usually  garbage  wagons  are  required  to  be  painted 
uniformly  and  of  a  distinctive  color. 

In  Asbury  Park  the  garbage  wagons  are  owned  by  the  city  and  the 
contractor  pays  a  rental  of  fifteen  per  cent,  per  annum  on  their  cost, 
and  is  obliged  to  keep  them  painted  and  in  repair.1  In  Atlantic  City 
and  Fort  Wayne  the  wagons  are  owned  by  the  city ;  the  work  is  let  out 
by  contract. 

Garbage  wagons,  in  order  to  be  kept  clean,  must  be  frequently 
washed,  and  this  is  required  to  be  done  daily  by  many  rules,  and  some- 
times, as  in  Asbury  Park,  it  is  specified  that  they  be  washed  inside  and 
out.  Mr.  Hering's  report  showed  that  in  nearly  all  cities  it  is  required 
by  rule,  or  is  the  custom  to  wash  the  garbage  wagons  daily,  and  in  some 
cases  after  each  load.  The  latter  is  the  rule  in  Boston,  Brockton,  Cam- 
bridge, Dayton,  Erie,  Fall  River,  Grand  Rapids,  Lynn,  Pawtucket, 
Pittsburgh,  Providence,  St.  Louis,  and  St.  Paul.  In  Kansas  City  and 
St.  Louis  it  is  said  that  they  are  washed  with  hot  water.  In  Detroit 
they  are  steamed. 

In  a  number  of  cities  it  is  required  that  the  garbage,  or  the  wagons, 
or  the  receptacles  be  disinfected,  but  usually  only  in  the  summer  time. 
In  Buffalo  the  dates  are  from  1  May  to  31  October.  According  to 
Mr.  Hering's  report,  in  Kansas  City  and  Salem  the  wagons  after  washing 
are  disinfected  with  carbolic  acid,  and  in  Tampa  this,  is  used  for  the 
scows.  In  Newark  " Egyptian  Powder"  and  lime  are  used,  in  Pitts- 
burgh phenyl,  and  in  Chicago  the  garbage  which  is  collected  together 
with  ashes  is  said  to  be  disinfected  twice  daily  at  the  dumps  with 
potassic  permangate  in  solution,  at  a  cost  of  thirty-three  cents  a  ton. 
In  Detroit  the  bodies  of  the  wagons  are  disinfected  with  copperas.  Lime 
is  used  for  disinfection  in  Macon,  Rochester,  Ltica,  and  Wilmington, 
Del.,  and  in  Newport,  R.  I.,  on  the  scow.  In  Buffalo  there  is  attached 
to  each  garbage  wagon  a  tank  containing  a  solution  of  "  dead  oil "  and 
compressed  air,  by  means  of  which  the  driver  sprays  the  wagon  and  the 
receptacles.2      In   Atlantic   City,   Boston,   Cleveland,   Erie,   Galveston, 

1  Asbury  Park,  Report  of  Board  of  Health  (1897),  p.  24. 

2  Municipality  and  County,  Vol.  3,  p.  159. 


REFCSE  DISPOSAL. 


68; 


Tex..  Grand  Rapids,  and  Lynn  it  was  simply  stated  that  the  garbage 
wagons  were  disinfected,  but  no  particulars  were  given. 

It  sometimes  becomes  necessary  to  transport  garbage  a  considerable 
distance  from  the  city  where  it  is  collected  in  order  to  provide  for  its 
proper  disposal.  ( Occasionally  it  is  found  most  economical  to  do  this  in 
wagons,  either  those  in  which  it  is  collected  or  in  larger  ones  to  which 
it  is  transferred.  Where  garbage  is  fed  to  swine  or  plowed  in,  and  the 
distance  is  only  a  few  miles,  this  is  the  usual  practice.  In  Providence 
farmers  find  it  profitable  to  draw  it  from  seven  to  twelve  miles.  If  the 
distance  is  great,  other  means  have  to  be  provided.  In  Providence  at 
one  time  all  the  garbage  was  taken  out  on  cars,  small  dump  cars  being 
used  for  the  purpose.  At  present  some  of  it  in  that  city  is  carried  out 
on  flat  cars.  Such  cars  are,  of  course,  uncovered,  and  the  method 
creates  considerable  nuisance.  In  Pittsburgh  the  half  dried  garbage  is 
removed  in  box  cars.  The  best  method  of  railroad  transportation  is 
that  employed  in  Cleveland  and  Detroit.  In  those  cities  the  wagon 
bodies  in  which  the  garbage  is  collected,  shown  on  page  685,  are 
hoisted  on  to  flat  cars,  twenty-four  bodies  being  placed  on  one  car. 

Sometimes  garbage  is  transported  by  water,  as  in  Baltimore,  Boston. 
Cincinnati,  the  District  of  Columbia,  Lynn.  Newport,  R.  I.,  Tacoma, 
and  Tampa.      In  Boston  and  Lynn  such  of  it  as  is  towed  to  sea  is  taken 


I'h..    SI  I. 

Cai  used  ;i  i  Cleveland  for  Transporting  Wagon  Bodies  loaded  with  Garbage 


G88 


REFUSE  DISPOSA  L. 


out  together  with  the  other  refuse  in  Barney  dumping  scows.  In  New- 
port the  scow  is  arranged  with  a  slanting  deck  so  that  the  load  may 
slide  off  into  the  water.  But  in  the  other  cities  ordinary  deck  scows 
are  used. 


Fig.  81. 
Scow  for  Transporting  Garbage  to  Sea,  Newport. 


Collection  of  Garbage. 

There  are  few  general  laws  which  authorize  municipalities  to  col- 
lect and  dispose  of  garbage.  Power  to  do  this  is  usually  conferred  by 
charters  or  general  incorporation  laws.  The  laws  of  Massachusetts.1 
Xew  York,2  and  Xew  Jersey,3  do,  however,  provide  that  cities  and 
towns  may  contract  for  the  disposal  of  garbage,  and  in  New  York  they 
may  also  collect  garbage.  In  New  Jersey4  garbage  crematories  may  not 
be  built  without  the  consent  of  the  township  in  which  they  are  to  be 
located. 
Methods  of  Collection. 

.Most   cities  provide   for  the  collection  of  garbage  at  public  expense. 
There  are  two  ways  of  doing  this,  by  contract  and  by  the  employees  of 

1  Massachusetts,  Chapter  377  of  1889. 
-  New  York,  Chapter  066  of  1894. 

3  Xew  Jersey,  Fublic  Laws  (1896),  p.  50. 

4  Xew  Jersey,  Public  Laws  (1885),  p.  822. 


REF I  rS£!  1>  isp  0  SA I . 


689 


Fig.  82. 

Method  of  Dumping  Garbage  onto  scows  in  Boston,  also  showing  Metal  Garbage  Wagons. 
From  Report  of  the  Street  Department,  1898. 


some  municipal  department.  Below  is  given  a  list  of  cities  which  pro- 
vide for  the  collection  of  garbage  by  contract  and  also  the  department 
which  has  charge  of  the  work.1 

Cities  which  provide  for  the  removal  of  garbage,  ashes,  and  rubbish 
by  contract  usually  let  the  contract  only  after  advertising  for  bids.     In 


1  Health  Department  Asbury  Park,*  Atlantic  City,*  Auburn,  N.  Y.,  Augusta, 
Ga.,  Bridgeport,  Brookline,  .Mass.,  Chelsea,  Cleveland,  Columbus,  Davenport, 
Denver,  Detroit,  District  of  Columbia,  Dubuque,  Everett,  Fall  River,  Fitchburg, 
Haverhill,  Holyoke,  Milwaukee,  Minneapolis,  Montclair,  New  Bedford,  New  Haven, 
Newport,  Newton,  Paterson,  Paw  tucket,]  Portland,  Me.,1  Providence,]  Quincy, 
Rockford,  111.,  St.  Louis.  St  Paul,  San  Antonio,  Utica,  Wheeling,  Wilkesbarre, 
;ind  Wilmington,   Del. 

The  director  of  public  safety  makes  the  contract  in  Allegheny,  Columbus,  and 
Pittsburgh. 

The  department  of  public  works  has  charge  in  Buffalo,  Evansville,  Fori  Wayne, 
Philadelphia,  and  Terre  Haute. 

The  street  department  has  charge  in  Boston  (in  certain  districts,  in  others  the 
work  is  done  by  citj  employees),  Brooklyn,  Hartford,  Indianapolis,  Manchester  and 
New  London. 

In  Newburghi  Rochester,  and  Toledo,  the  city  council  makes  the  contract 

*  The  city  ow  us  t  he  wagons. 
Sanitary  committee. 
Board  of  Aldermen,  ex  officio  Board  of  Health. 


690  REFUSE  DISPOSAL. 

order  to  secure  uniform  conditions  for  the  bids,  specifications  are  usually 
furnished  which  describe  at  some  length  the  character  of  the  work  to  be 
done.  Such  specifications  are  issued  by  all  the  larger  cities.  On  page 
4(.»  of  the  Report  of  the  State  Board  of  Health  of  New  Jersey  for  1897, 
may  be  found  model  specifications  for  the  removal  of  garbage  and  rub- 
bish. Good  specifications  may  also  be  obtained  from  Buffalo  and  Phila- 
delphia. Contractors  are,  of  course,  to  give  bonds  and  obey  the  regula- 
tions of  the  health  department.  Contractors  are  generally  required  to 
call  daily,  or  oftener  for  complaints,  and  sometimes,  as  Augusta,  Ga.,  and 
Pittsburgh,  and  doubtless  other  cities,  they  are  required  to  have  a  tele- 
phone. The  contractor  frequently  has  a  special  man  to  attend  to  these 
complaints.  In  all  cities  which  have  sanitary  inspectors  these  officers 
on  their  rounds  look  after  the  garbage  collection ;  but  some  cities,  as 
Pittsburgh,  have  a  special  inspector  for  this,  and  in  Detroit  there  are 
two  such  inspectors. 

The  list  below1  gives  the  cities  in  which  the  garbage  is  collected  by 
employees  of  the  city  and  also  the  departments  which  have  charge  of  the 
work. 

In  quite  a  number  of  cities  there  is  no  municipal  collection  of 
garbage.2 

There  appears  to  be  a  well  nigh  unanimous  demand  on  the  part  of 
health  officers  and  oftentimes  of  the  public  generally,  for  the  municipal 
collection  of  garbage.  This  may  be  inferred  from  the  small  number 
and  generally  small  size  of  the  cities  which  do  not  thus  provide  for  gar- 
bage collection,  and  also  from  the  expressed  desire  of  the  sanitary  au- 
thority of  several  of  these  cities  for  municipal  collection.  There  are 
several  stages  in  the  development  of  the  methods  of  garbage  collection 


iHealth  Department.  Atlanta,  Dallas,  Galveston,  Houston,  Joliet,  111. ,  Kansas 
City,  Mo.,  Lafayette,  Ind.,  Lawrence,  Lowell,  Lynn,  Macon,  Memphis,  Milwaukee, 
Richmond,  Salem,  Salt  Lake  City,  Sioux  City,  Somerville,  and  Tampa. 

Street  Department.     Boston  (in  part),  Camden,  and  Manchester. 

Street  Cleaning  Department.     Baltimore,  Cincinnati,  and  New  York. 

Overseers  of  Poor.     Brockton,  Cambridge,  Taunton,  and  Worcester. 

Board  of  Public  Works.  Evansville,  Louisville  (1901),  New  Orleans,  Norfolk, 
Terre  Haute,  and  Yonkers. 

Superintendent  of  Streets.     Kingston,  N.  Y. 

Scavenger  Department.     Savannah. 

Board  of  City  Affairs.     Dayton. 

Board  of  Public  Affairs.     Springfield,  O. 

City  Commissioner.     Muncie. 

-Albany,  Altoona,  Akron,  Battle  Creek,  Bay  City,  Mich.,  Binghamtnn,  Canton, 
Concord,  Council  Bluffs,  Des  Moines,  Duluth,  Erie,  Elmira,  Findlay,  Fort  Worth, 
Gloucester,  Mass.,  Grand  Rapids,  Harrisburgh,  Jackson,  Mich.,  Lancaster,  Pa., 
Meadville,  Pa.,  Oakland,  Cal.,  Omaha,  Peoria,  Plainfield,  N.  J.,  Portland,  Ore., 
Pnughkeepsie,  Pueblo,  Scranton,  Seattle,  South  Bend,  Inch,  Sacramento,  San  Fran- 
cisco,  Tacoma,  Troy,  and  Woonsocket. 


REFUSE  DISPOSAL.  691 

and  disposal.  In  small  cities,  villages,  and  in  the  country,  garbage  is 
often  fed  to  swine,  composted  or  buried  on  the  premises,  or  mixed  with 
ashes  and  other  refuse  and  carted  off  at  intervals  at  the  owner's  expense- 
The  next  step  is  for  the  neighboring  farmers  who  wish  to  use  garbage 
to  feed  to  swine  to  call  along  certain  routes  with  more  or  less  regularity 
to  remove  the  garbage  which  is  kept  separate  for  them  by  the  house- 
holder. Such  methods  are  now  rarely  if  ever  employed  in  cities  of 
25,000,  though  they  are  in  Peoria  and  Poughkeepsie,  and  very  many 
cities  much  smaller  have  better  and  more  systematic  methods.  The 
next  step  is  for  the  city,  usually  through  the  agency  of  the  board  of 
health,  to  attempt  to  control  the  collection  of  garbage  by  licensing  and 
regulating  the  scavengers.  Indeed  a  survival  of  this  method  is  found 
in  nearly  all  cities,  for  almost  every  municipality  finds  it  necessary  to 
permit  private  scavengers  to  collect  garbage  from  hotels  and  restaurants, 
and  often  from  private  houses,  and  sometimes,  as  has  been  shown,  this 
method  of  disposal  is  forced  on  the  hotels  and  markets  by  the  muni- 
cipality. In  most  of  the  cities  named  on  page  »'»!»<),  note  2,  the  garbage  is 
collected  in  this  way.  Other  cities  which  maintain  a  good  municipal  col- 
lection yet  collect  a  considerable  quantity  in  this  way.  Thus  in  Lowell 
and  Fort  Wayne  about  half  the  garbage  is  so  collected.  In  Denver 
from  thirty  to  sixty  scavengers  collect  without  charge  nearly  all  the 
garbage  except  the  poorest,  but  this  city  in  1899  was  put  to  the  ex- 
pense of  11,600  in  looking  after  their  omissions. 

Nearly  all  these  cities  forbid  the  removal  of  garbage,  except  by 
licensed  scavengers.  The  licenses  are  usually  granted  by  the  health 
department,  but  sometimes  when  the  municipal  collection  is  made  by 
another  department,  that  depart  nienl  may  also  control  the  licensing. 
This  is  the  case  in  Hartford  where  the  street  depart  incut  collects  the 
garbage  and  the  ashes.  In  Grand  Rapids,  Mich.,  and  Erie,  Pa.,  the 
License  is  issued  by  the  mayor.  The  regulations  governing  the  garbage 
wagons  usually  apply  to  both  municipal  and  private  wagons,  and  have 
been  fully  considered.     Usually  a  written   application  has  to  be  made 

stating  the  name  of  the  owner,  the  kind  and  size  of  vehicle,  the  places 
from  which  the  garbage  is  taken,  and  its  disposal.  The  form  of  appli- 
cation used  in  Philadelphia  requires  the  applicant  to  state  that  the  gar- 
bage will  be  ved  in  accordance  to  the  rules  of  the  board  of  health, 

ami    he    must    also   stale    where  the  garbage  is  to  be  taken  and  tor  what 

it  i-  to  be  used.1     In   that  city  no  licensee  are  granted  if  the  garbage  i^ 
to  l.e  fed  to  hogs,  ami  this  requiremenl   is  practically  prohibitive.     In 
Salt  Lake  City  persons  who  remove  the  garbage  from  their  own  prem- 
-  me  nol  required   t<>  take  oul  a  license. 

1  Philadelphia,  Reporl  ot  Board  ol  Health  (1895),  p.  115. 


592  REFUSE  DISPOSAL. 

Another  step  is  to  require  the  licensed  scavengers  to  collect  all  the- 
garbage  in  their  districts  or  in  the  city,  and  to  require  the  householder 
to  deliver  the  garbage  in  suitable  receptacles  to  the  licensee,  the  house- 
holder paying  for  the  collection.  This  is  the  plan  followed  in  Cleve- 
land (until  1898),  Erie,  Grand  Rapids,1  Oakland,  Cal.,  and  Portland, 
Ore. ;  in  such  cases  the  charge  to  be  made  is  usually  fixed  by  the 
ordinance. 

In  Chicago  in  1899  a  new  ordinance  was  adopted  governing  private 
collectors  of  garbage,  manure,  ashes  and  all  other  kinds  of  wastes.2  All 
wagons  must  be  inspected  monthly  by  the  health  officials,  and  on  each 
inspection  they  are  furnished  with  a  tin  sign,  the  signs  being  of  different 
colors  on  alternate  months. 


I  The  Grand  Rapids  ordinance  has  been  tested  in  the  Supreme  Court  and  its 
validity  affirmed.     Report  of  Board  of  Health  (1899-1900). 

2  Rules    and   Regulations   Governing   the   Gathering,  Removal,    and   Dis- 
posal  of  Garbage,    Manure,    and   other   Refuse    by 
Private   Scavengers. 
"  Rule  1.     (a)   The  box  or  body  of  every  wagon  or  other  conveyance  used  for  the 
private  scavenging  of  offal,  table  refuse  and  other  matter  usually  known  as  garbager 
or   swill   and  other  animal  and  vegetable  refuse  and  wastes,   including   decaying 
animal  matter  and  fish,  shall  be  absolutely  water-tight  and  provided  with  close-fit- 
ting covers,  which  shall  be  kept  closed  except  when  loading,  unloading  or  cleansing.. 
The  outside  of  the  box  or  body  is  to  be  painted  white,  and  on  each  side  shall  appear 
in  black  letters,  not  less  than  four  (4)  inches  high,  the  name  of  the  Licensee  and  the 

number  of  the  wagon,  thus : 

JOHN   SMITH 

Licensed 

No.  1. 

"If  more  than  one  wagon  is  employed  by  a  Lincesee,  his  wagons  shall  be  num- 
bered consecutively  No.  1,  No.  2,  etc. 

"  Rule  2.  (a)  Drivers  and  collectors  must  perform  their  work  expeditiously,  with- 
out loitering  or  delay,  and  shall  not  allow  any  garbage  (solid  or  liquid),  or  other 
refuse  to  fall  upon  the  sidewalk,  gutter,  street  or  other  surface  without  at  once  re- 
moving and  cleaning  up  the  same.  Under  no  circumstances  shall  they  empty  tlie 
contents  of  garbage  cans  or  other  receptacles  on  the  ground,  or  elsewhere  than  into 
the  wagon  box  direct. 

"  (b)  No  driver  shall  allow  his  wagon  to  be  so  fully  loaded,  or  to  be  in  such  bad 
condition  or  repair,  or  of  such  faulty  construction,  or  to  be  so  improperly  driven  or 
managed  that  any  portion  of  its  offensive  contents,  solid  or  liquid,  shall  fall  upon  or 
in  any  place,  street  or  premises;  and  it  shall  be  his  duty,  in  such  event,  to  replace 
at  once  on  his  wagon  and  to  remove  what  has  so  fallen. 

II  (c)  Garbage  wagons  must  be  cleansed  and  disinfected  at  the  place  of  disposal 
and  before  being  returned  to  service.  They  must  at  all  times,  when  not  in  use,  be 
kept  in  a  cleanly,  inoffensive  condition;  repainted  from  time  to  time,  and  the  owner's 
name  and  the  wagon  number  be  always  legible  and  distinct. 

"  (d)  The  boxes  or  bodies  of  wagons  for  hauling  manure  or  dry  wastes  and  refuse 
must  be  sufficiently  tight  to  prevent  any  leakage  or  filtering  of  dust,  etc.,  and  their 
loads  must  be  securely  covered  with  canvas  sheets  or  tarpaulins.  No  portion  of  the 
contents  of  such  wagons  must  be  allowed  to  escape  into  the  air  or  to  litter  the  street- 


REFUSE  DISPOSAL.  693 

Often  no  fee  is  charged  for  a  garbage  license,  and  in  other  cases  it 
is  nominal,  as  twenty-five  or  fifty  cents.  In  Spokane  it  is  $2.  But  in 
those  cities  where  the  licensee  has  an  exclusive  privilege  and  makes  an 
authorized  charge  upon  the  householder  for  collection  a  larger  fee  is 
sometimes  imposed.  'Jims  in  Elmira,  X.  Y.,  it  is  $40  annually,  in  Erie, 
Pa.,  $100;  and  in  Portland,  Ore.,  $12.  Most  licenses  are  granted  for 
one  year,  but  in  Spokane  the  time  is  three  months. 

In  cities  where  collection  is  by  private  scavengers,  it  is  made  com- 
pulsory upon  the  householder,  not  only  to  provide  a  receptacle  and  place 
the  garbage  in  it,  but  to  deliver  it  to  the  scavenger.  In  Cleveland1  the 
householder  was  (before  municipal  collection  was  adopted)  fined  $5  for 
every  day  during  which  garbage  was  allowed  to  remain  on  the  premises 
after  the  scavenger  had  called.  In  Erie  the  householder  is  fined  if  gar- 
bage remains  on  the  premises  more  than  four  days  in  the  summer  and 
one  week  in  the  winter,  but  the  scavenger  is  not  required  to  move  it  if 
the  householder  is  more  than  one  month  in  arrears  in  his  payment. 
These  regulations  have  not  as  yet  (1899)  been  thoroughly  enforced  in 
either  Erie  or  Grand  Rapids.  In  fact  one  reason  why  the  collection  is 
unsatisfactory,  when  conducted  in  this  manner,  is  that  it  almost  impos- 
sible to  overcome  the  ingenuity  and  persistence  of  the  householder  in 
avoiding  the  payment  of  the  necessary  fees.  Thus  in  Montclair,  X.  J., 
where  greal  effort  was  made  to  secure  the  thorough  removal  of  garbage 
in  this  manner,  it  was  reported  that  only  thirty-five  per  cent,  was  regu- 
larly collected.2 

The  maximum  [nice  fixed  for  the  removal  of  garbage  by  private 
scavengers  is  in  : 

Grand   Rapids:     1<»  <<-nt  >.  per  week  for  private  families  and   f]    for  hotels,  res- 
taurants, aii'l  boarding  houses. 


Tin-  name  <>f  the  Licensee  and  the  number  of  the  wagon  must  be  displayed  as  in  the 

t  garbage  wagons. 

Rule  ■'>.     As  soon  as  a  wagon  is  leaded  it  must  be  driven  at  once  to  the  specified 
place  "i  disposal  and  on  no  account   be  allowed  to  stand  in  the  vicinity  of  human 

habitations,  sele.nl  houses,  etc.      All  collections  must  he  disposed    of    within    twelve 

(12)  hours  after  being  collected. 

"Rule    1.     Collections  of  garbage,  manure  and  other  refuse  must  be  disposed  of 

onlj  at  the  place  or  places  specified  in  the  application  for  license.     This  specification 

is  a  prime  condition  of  the  approval  of  the  license,  and  disposal  elsewhere,  without 

-,  authority  of  the  Commissioner  of  Health,  will  result  in  prompl  revocation 

of  i  he  license. 

'•  Rule  •">.  All  private  scavenging  of  garbage  and  ot  her  material  defined  in  Rule  1 
must  be  done  between  seven  (7)  o'clock  p!  m.  and  seven  (7)  o'clock  \.  u.  during  the 
months  of  Slay,  June,  July,  August,  September,  and  October,  and  between  six  (6) 
o'clock  p.  m.  and  eighl  (8)  o'clock  v.  m.  during  the  remaining  months  of  the  year. 

'Cleveland,  Ordinances  (1892),  Chapter 80,  Sec.  196. 
New  Jersey,  Report  of  State  Board  of  Health  (1896),  p.  84 


694  REFUSE  DISPOSAL. 

Erie:    Hotels  or  restaurants,  daily  or  bi-weekly,  $1.50  per  month. 
Families,  3  collections  a  week,  75  cents  per  month. 
2  lt  "       50     "        "  " 

2  "  "       April-October  and  1  collection  per  week  No- 

vember-March, 25  cents  per  month. 
Elmira:    10  cents  per  cubic  foot  for  first  100  feet  and  8  cents  afterwards. 
Omaha:    Each  barrel  of  30  gallons  or  over,  20  cents. 

Receptacles  of  less  than  30  gallons,  for  each  10  gallons  10  cents. 
Oakland,  Cal. :    Private  families,  25  cents  per  month. 
Portland,  Ore. :    Private  families,  25  to  50  cents  per  week. 
Montclair,  N.  J. :    15  cents  a  can,  or  $  12  per  annum  per  house. 
Superior,  Wis. :    50  cents  per  house  per  month. 

It  can  be  readily  seen  that  if  garbage  is  removed  from  every  house 
at  the  above  prices,  and  even  at  the  lowest  price  given,  it  would  amount 
to  several  times  more  than  the  most  expensive  municipal  collection. 
Even  if  the  garbage  is  half  collected,  private  scavengers  furnish  the 
most  expensive  means  of  getting  rid  of  garbage.  It  would  seem  that 
this  alone  ought  to  compel  every  city  to  provide  for  municipal  removal ; 
but  it  must  be  remembered  that  payments  for  garbage  removal  must  be 
made  from  the  tax  levy,  and  a  councilman  who  votes  to  raise  the  tax 
rate,  meets  with  no  favor  at  the  hands  of  constituents,  even  if  by  so 
doing  he  has  diminished  their  living  expenses ;  but  outside  of  any 
pecuniary  advantage  in  municipal  collection,  its  sanitary  value  requires 
its  adoption.  Health  officers  are  agreed  that  it  is  only  by  municipal 
collection,  that  a  good  service  from  a  sanitary  standpoint  can  be  secured. 

As  regards  the  choice  between  collection  by  contract  and  by  city 
employees  the  correct  decision  is  not  so  evident.  There  are  general 
economic  and  social  considerations  in  regard  to  the  letting  out  of  muni- 
cipal work  which  it  is  not  intended  to  discuss  here,  but  which  are  of 
great  importance  and  which  should  have  perhaps  the  greatest  weight  in 
deciding  the  question.  As  a  matter  of  fact,  good  results  are  obtained 
by  both  contract  and  municipal  collection. 

Contract  work  is  sometimes  not  as  satisfactory  as  that  done  by  city 
employees,  for  many  health  officers  have  expressed  a  wish  that  their 
cities  would  employ  municipal  labor  instead  of  contract,  but  the  writer 
knows  of  no  instance  in  which  a  contrary  preference  has  been  expressed. 

The  writer  has  attempted  to  collect  data  in  regard  to  the  amount  and 
cost  of  collecting  garbage,  ashes,  and  rubbish,  but  it  has  been  found  a 
very  difficult  task.  In  most  cities  these  waste  materials  are  not  weighed 
and  the  amount  in  tons  or  cubic  yards  must  be  estimated  from  the  num- 
ber of  loads,  and  as  these  are  not  always  of  the  same  size  the  estimate 
may  not  be  a  very  close  one.  In  many  cities  no  account  is  kept  of  even 
the  number  of  loads,  so  that  in  such  cases  the  estimate  is  still  more 
unreliable.     It  is  important  to  know  the  cost  of  disposal  as  distinguished 


REFUSE  I) isp os A  L. 


695 


from  the  cost  of  collection  but  often  they  can  not  be  separated.  Again, 
the  cost  of  collecting  garbage  and  ashes  is  lumped  with  street  cleaning 
or  other  sanitary  work.  A  few  of  the  figures  in  the  tables  here  given 
are  taken  from  the  September  Bulletin  (1900)  of  the  U.  S.  Commis- 
sioner of  Labor,  but  most  of  the  data  have  been  obtained  by  corre- 
spondence or  from  official  reports. 


Table   Showing  the   Amount  of   Garbage  Collected  anh  Cost  of  Collec- 
tion in  a  Numbeb  of  American  Cities. 


City. 


Allegheny 

Asbury  Park 

Atlanta 

Augusta,  Ga ........ 

Atlantic   City 

Baltimore 

Birmingham,  Ala  . .  . 

Boston 

Bridgeport 

Brockton 

Brookline 

Borough  of  Brooklyn 

Buffalo 

Cambridge 

Camden 

( Ihelsea 

Cincinnati 

<  lleveland 

Columbus 

Dayton 

Dallas 

Denver 

Del  roit 

I  )isi  i  iii  of  <  lolumbia 

Evansville 

Kail   River 

Fitchburg ....  .. 

Port  Wayne 

( rah  eston 

Hartford 

Haverhill 

Holyoke 

Houston 

Indianapolis.  

Joliet,  111 

Kansas  City,  Mo 

Law  rence  

Lowell 

Los  \  ngeles. 
Lynn 

Macon  

Maiden,  Mass 

Manchestei       

M  ilwaukee         

M  inneapolis 


Population, 

<  ensus  of 

1900. 


129.NJMJ 
4,148s 

S'.t.STL' 

39,441 
27,8389 

r.ns.'.cT 
:;s.4ir» 

560,892 

70,990 

40,063 

19,935 

,166,582 

352,219 

91.ssr, 

75,935 

34,072 

325,902 

381,768 

UJ5,560 

85,333 

12,638 

133,859 

285,704 

278,718 

59,007 

104,863 

31,531 

15,1  !■"■ 

37,789 

79,850 

37,175 

15,712 

14,633 

169,164 

29,353 

62  559 
94,969 
L02,  IT'.' 
68,513 
23,272 

285,315 
202,718 


fear  to 
which 

da  ta 
refer. 


1900 
1900 
1899 
1899 
1900 
1! 

1899 
1899 
1899 
1899 
1899 
is;is 
1900 
1899 
1900 
1899 
1899 
1899 
1899 
1899 
1900 
1899 
lsi.s 
1899 
1899 
1900 
1899 
L898 
1899 
1899 
1899 
L899 
1899 
L899 
1899 
1899 
L899 
1899 
1899 
L899 
L899 

1899 
1899 
1899 


Amount  Collected. 


3,772  cu.  yds. 
31,200  tons10 
15,003  loads10 
1 1,463  tons 
49,000  tons 

60,000  tons 
0,000  tons 
4,500  tons 


lll-J.OIMI 

22.SS1 

6,794 
2,000 

l.S.II) 

11,752 

22,375 

7,794 

7,133 

9,000 

12,000 

14,732 

20,946 

5,000 


tons 

tons 

tons 
tons 

tons 

tons 

tons 
tons 
tons 
cu.  yd 

cu.  yils. 
tons 

tons 
t^ns 


(  ..~t  ol   Collection. 


528,000  00 
2,600  00 » 


4,500  00 
9,900  007 

65,504  44 
9,600  00 

112,641  09 


per  ton 


5,421  tons 
l  1,887  tons10 
13,500  tons 

3, tons 

27,000  tons10 

IT.  15  I  ions 
3,500  ions 

15, Ions 

1. 163  ions 
1,035  ions 

I  tons 
T.ooo  cu.  yds.1 
7,695  cu.  yds. 

28,716  o.iis 


6,958  41 » 

1,800  00i 

120,000  00' 

33,1 0' 

25,952  65* 
1,200  00 
3,800  00] 
24,583  00 
•  ■■'.MOO  00 i 
15,800  001 
16,674  00 


1,60 

50,1 00" 

57,000  00 

1. •_".!.">  00 

11.1 Ml' 

2,600  oo' 

3,349  60 

18,933  "in 

9,850  00' 

2,725  001 

1,0515  00' 
16,691 

30,000  001 

3,222  00 

17,798  00 

6,500  00* 

7,191 

12,767  001 

12,836  :>' 

5,00 

1(1  50* 

•j.:,( mi  i mi' 

01,883  21 

IT.im, 


696 


REFUSE  UISPOKA  L. 


City. 


Montelair,  N.  J 

Muncie,  Ind 

New  Bedford 

New  Haven 

Newport 

New  Orleans 

Newton 

New  York / 

Borough  of  Manhattan  ) 

Norfolk 

Paterson 

Pawtncket 

Philadelphia 

Pittsburgh 

Providence  

Portland,  Me 

Reading  

Richmond 

Richmond,  Ind 

St.  Louis 

St.  Paul 

Salem 

Salt  Lake  City 

San  Antonio 

Somerville 

Springfield,  Mass 

Syracuse 

Taunton 

Terre  Haute 

Toledo.. 

Trenton 

Utica 

Wheeling 

Wilmington 

Worcester 

Yonkers 


Year  to 

Census  of 

which 

1900. 

data 

refer. 

13,962 

1899 

20,942 

1899 

62,442 

1899 

108,027 

1899 

22,034 

1900 

287,104 

1900 

33,587 

1899 

1,850,093 

1898 

42,624 

1899 

105,171 

1899 

39,231 

1899 

1,293,697 

1899 

321,616 

1899 

175,597 

1899 

50,145 

1899 

78,961 

1899 

85,050 

1899 

18,226 

1899 

575,238 

1899 

163,632 

1899 

35,956 

1899 

53,531 

1900 

53,321 

1899 

61,643 

1899 

62,059 

1899 

108,374 

1899 

31,036 

1899 

36,673 

1899 

131,822 

1899 

73,307 

1899 

56,383 

1899 

38,878 

1899 

76,508 

1899 

118,421 

1899 

47,931 

1899 

Amount  Collected. 


1,573  cu.  yds. 
3,705  tons 


17,000  cu.  yds. 
07,500  tons10 


152,000  tons10 

5,719  tons10 
4,443  tons 

199,357  tons 
25,000  tons 
16,000  tons 

4,146  tons 
4,810  tons10 
3,935  tons 
69,634  tons 

3,651  tons 
11,546  cu.  yds10 

8,000  load's10 
11,274  tons 

4,858  tons 
8,187  loads" 

4,000  tons 
7,204  cu.  yds. 


7,450  tons 
9,390  tons 
9,360  tons 
6,260  tons 


Cost  of  Collection. 


per  tan 


$4,000  00 > 
1,754  10 

15,000  001 
5,500  00 i 
4,980  00 

97,200  00 i 
5,700  001 

0  67 


per  ton 


4,000  001 
398,000  00 1 
92,000  001 
25,200  001 
4,500  00 J 
1  35 
10,460  00 
2,340  00 
99,673  00 
15,533  00 1 
8,000  004 
8,755  75 
10,000  00 
11,456  004 
12.000  001 
20,401  75 
1,484  87 4 
2,800  00 
12,000  001 
6,000  001 
5,700  001 
5,500  00 
12,000  00 
17,109  004 


1  Cost  of  collection  and  disposal. 

2  Cost  of  collection  and  disposal  of  ashes  and  garbage,  $27,500. 

3  Cost  of  collection  of  ashes  and  garbage,  $22,500. 

4  Cost  is  lessened  by  sale  of  garbage  or  garbage  fed  pork. 

5  Only  a  part  is  collected  by  the  city.     The  rest  is  collected  by  ranchmen   at  no 
cost  to  the  city. 

6  A  load  consists  of  ten  barrels. 

7  The  city  owns  the  wagons. 

8  Resident  population.     The  summer  population  is  probably  over  30,000. 

9  Resident  population.     In  summer  the  population   is  said  to  exceed  200,000  at 
times. 

10  The  garbage  has  a  considerable  amount  of  dry  refuse  mingled  with  it. 

11  Approximately. 


REFUSE  I) isp 0 &  1 1 . 


69" 


Disposal  of  Garbage. 

The  problem  of  garbage  disposal  has  not  yet  been  solved.  Although 
the  theoretical  value  of  the  garbage  is  considerable,  in  practice  it  has 
never  been  found  possible  to  get  rid  of  it  without  some  expense  and 
usually  not  without  some  nuisance.  Probably  every  form  of  garbage 
disposal  has  been  tried  in  the  United  States,  and  has  found  its  advo- 
cates, but  the  variance  in  method  is  in  itself  a  demonstration  that  none 
of  the  methods  are  entirely  successful. 

It  is  possible  in  the  country  to  dispose  of  garbage  on  the. premises 
where  it  is  made  either  by  burying  it,  feeding  it  to  animals,  or  burning- 
it  in  a  stove.  In  cities  the  latter  is  the  only  possible  method  of  private 
disposal.  It  is  sometimes  adopted  by  neat  people  who  do  not  wish  to 
have  a  garbage  pail  about  :  but  such  people  forget  that  to  put  garbage 
on  a  kitchen  lire,  however  carefully,  usually  gives  rise  to  some  disagree- 
able odor  which  may  he  perceived  by  the  neighbors.  A  device  was 
put  upon  the  market  a  few  years  ago  which  overcomes  this  difficulty  by 
drying  the  garbage  before  it  is  put  on  the  tire.  The  following  is  a 
description  and  cut  of  this  "carbonizer"  : 


Kk;.  88. 
Qarbage  <  arlxmizei  closed   ;i~  in  use). 


Fig.  si. 
i  .:n  bage  <  larbonizer  open. 


••  Between  the  Btove,  or  range,  and  the  flue  of  the  chimney  is  placed  ;i  horizontal 

cylinder  about  one-third  larger  in  diameter  than  the  stovepipe,  and  in  length  :ii i 

twice  the  diameter  of  tin'  pipe.     One  end  of  this  cylindei  is  removable,  and  attached 

i"  ill''  ins i< !<■  "f  this  end  is  a  basket,  ors p,  n i:i< !••  with  perforated  sides  ami  a  tight 

bottom  and  somewhat  smaller  in  dia ter  than  tin'  cylinder,  giving  a  free  passage 

for  the  smoke  and  heat,  from  the  Btove,  around  ii  ami  through  the  perforations. 
When  it  is  to  be  used  the  haskct  or  scoop  is  withdrawn  bj  means  of  a  handle  on  the 
outside  of  tin-  cylinder  head,  tilled  with  garbage  and   replaced  in  the  cylinder.     The 


098  REFUSE  DISPOSAL. 

heat  from  the  fire  drives  off  the  water  and  transforms  the  residuum  into  charcoal 
and  this  is  put  into  the  Are,  burning  witli  a  clear  name,  or  after  being  left  over  night 
may  be  used  to  kindle  the  morning  fire,  since,  with  a  piece  of  paper  or  a  stick  of 
kindling  to  start  it,  this  carbonized  garbage  will  ignite  coal." 

This  apparatus  is  made  by  the  Sanitary  Construction  Company,  30 
State  Street,  New  York.  It  sells  for  $5.  It  has  given  satisfaction  in 
many  families,  as  reported  by  the  boards  of  health  of  Boston  and  Brook- 
line,  Mass.,  but  has  never  come  into  very  general  use. 

Dumping.  The  simplest  and  most  primitive  method  of  disposal  is 
to  deposit  the  garbage  on  some  dump,  using  it  to  fill  up  low  lands. 
This  is  only  slightly  better  than  allowing  it  to  remain  and  decay  in  the 
back  yard.  This  method  of  disposal  is  more  common  when  garbage  is 
collected  together  with  ashes  than  when  it  is  collected  separately,  which 
alone  is  now  under  consideration.  This  method  of  disposal  is  less 
offensive  when  the  garbage  is  mixed  than  when  it  is  separate,  but  none 
of  the  cities  which  adopt  it  are  satisfied  with  it,  and  the  writer  never 
knew  or  heard  of  such  a  dump  which  was  not  bitterly  complained  of 
by  all  who  dwelt  or  worked  in  its  vicinity.  It  is  forbidden  by  the  rules 
of  the  state  board  of  health  of  Florida. 

According  to  Mr.  Herings  report,  the  cities  named  below  collect 
their  garbage  separately  and  dispose  of  it  by  dumping  in  waste  places.1 
Sometimes  an  appreciable  expense  attaches  to  this  method,  for  an  avail- 
able dumping  ground  may  only  be  secured  after  a  very  long  haul  and 
sometimes  it  is  necessary  to  hire  land  for  the  purpose,  and  usually  it  is 
necessary  to  station  men  on  the  dumps  to  level  off  and  cover  material 
deposited.  In  Baltimore  in  1897  the  expenses  were  -$2,370.81.  It  is 
seen  that  the  cities  employing  this  method  of  disposal  are  few  in  num- 
ber and  mostly  of  small  size,  and  the  report  from  nearly  every  one  indi- 
cates that  the  method  is  far  from  satisfactory.  In  most  of  them  the  gar- 
bage is  supposed  to  be  buried  in  pits,  or  covered  with  a  thick  layer  of 
earth  or  ashes,  but  judging  from  the  complaints  made,  this  is  frequently 
neglected.  The  dump  question  will  be  further  considered  in  connection 
with  the  disposal  of  mixed  refuse. 

Plowing  In.  A  much  more  scientific  treatment  of  garbage  is  by 
plowing  it  into  the  soil  and  making  use  of  its  fertilizing  qualities  for 
the  growth   of  crops.2     Garbage  was  formerly  used  as  a  fertilizer  by 


1  Adrian,  Mich.,  Auburn.  X.  Y.,  Battle  Creek,  Mich.,  Bay  City,  Mich.,  Elmira, 
Hartford.  Muncie,  Meadville,  Pa.,  Xew  Brunswick,  X.  J.,  Xewburgh,  Oshkosh  (in 
part),  Poughkeepsie  (in  part),  Pueblo  (in  part),  Williamsport,  Pa.,  Albany  (in  part), 
Baltimore  (in  part),  Holyoke  (in  part),  Wheeling  (in  part). 

-This  is  done  in  Manchester,  X.  II.,  Baltimore  (in  part),  Minneapolis  (in  part), 
Xew  London  (in  part),  Auburn  (in  part),  Battle  Creek  (in  part),  Omaha  (in  part), 
Pawtucket   (in  part),  Providence  (in  part),  Fall  River  (in  part),   Springfield,  Mass. 


REFUSE  DISPOSAL.  609 

plowing  in  at  Asbury  Park,  New  Bedford,  Newport,  and  doubtless  many 
other  places,  but  the  plan  was  abandoned  on  account  of  the  nuisance 
produced.  In  Baltimore,  in  l!»00,  it  cost  $9,950  to  tow  the  garbage 
in  scows  to  points  where  it  could  be  used  as  a  fertilizer. 

Thumping  in  Water.  The  dumping  of  garbage  in  streams,  lakes, 
or  the  ocean  is  in  some  respects  even  worse  than  its  deposit  on  land. 
A  city  which  deposits  its  garbage  on  land  usually  annoys  its  own  citi- 
zens merely,  but  a  city  which  deposits  it  in  a  river  often  injures  other 
communities  as  well  as  itself.  It  rarely,  if  ever,  fails  to  create  some 
nuisance,  and  is  without  exception  unsatisfactory  to  others,  if  not  to  the 
city  committing  the  offence.1 

With  the  exception  of  Newport,  New  Orleans,  Boston,  and  Lynn, 
where  it  is  towed  out  to  sea,  the  cost  of  disposal  by  this  method  adds 
nothing  to  the  cost  of  collection.  In  Boston  and  Lynn  the  amount  so 
disposed  of  is  mixed  with  other  refuse.  In  Cleveland  the  garbage  was 
taken  ten  miles  out  into  Lake  Erie,  and  some  of  it  floated  back  to  shore. 
The  annual  cost  was  $1,600.  The  cost  of  towing  to  sea  in  Boston  is 
fifteen  cents  per  load.  In  Newport  the  cost  of  disposal  is  $2,534  per 
annum. 

Feeding  to  Animals.  Another  ancient  method  of  garbage  disposal 
is  b\  feeding  to  animals,  chiefly  swine.  Formerly  it  is  said  that  con- 
siderable garbage  was  fed  to  cows,  but  at  present  it  is  rarely  attempted. 
Colorado,  Massachusetts,  and  New  Jersey  have  statutes  forbidding  the 
feeding  of  garbage  to  milch  cows,  and  so  do  a  considerable  number  of 
cities,  as  the  City  of  New  York,  Rochester,  the  District  "of  Columbia, 
and  many  other  states  and  cities  practically  forbid  it  by  forbidding  the 
Bale  of  milk  from  garbage-fed  cows,  see  p.  :>7<».  That  garbage-fed  cows 
give  poor  milk,  often  offensive  to  the  taste,  and  that  they  are  poorly 
nourished  is  generally  admitted,  and  the  practice  was  condemned  in 
nearly  every  answer  to  the   committee's  inquiry;  but  in    Peoria,  Lynn, 

and   Salem  the  health  officials  reported   that  no  evil  effects  could   be  seen 

from  such   use  of  garbage.     A    former  contractor  in    Providence   was 

accustomed  to  \'n't\  garbage  to  rattle,  sheep,  and  swine,  and  claimed 
that  that  was  the  most  economical  method,  as  the  different  kinds  of 
animals   ate  different    portions  of  the  garbage  most   suitable   for  them, 

lin  part),  Toledo,  [Jtica,  St.  Paul  (in  part),  Ne\i  Haven  (in  part),  Montclair,  V  J., 
Rochester  (largely).  In  Milwaukee  ii  was  formerly  plowed  in,  l>ut  is  now  buried  in 
i  reaches  t  \n o  feel  \\  ide. 

'The  following  cities  dispose  of  ii   in  this  manner:  <  leveland   until  1898  (Lake 

Davenport  (Mississippi  River),  Dubuque,  Kansas  Citj  (Missouri  River),  Nash- 

villi-   (Cumberland    River),    New   Orleans   (Mississippi    River),    Newport    (Atlantic 

Ocean),   Quincj    (in  part),  Boston  (in  pari   into  ocean),  Lynn  (in   part    into  ocean). 

In  Dubuque  it  is  dumped  fr a  platform  into  the  Mississippi  River. 


700  REFUSE  DISPOSAL. 

and  therefore  thrived  better  and  consumed  the  garbage  more  completely  ; 
but  he  admitted  that  garbage  was  not  a  wholesome  food  for  cattle. 

In  a  few  cities,  as  Cambridge  and  Denver,  and  probably  to  a  slight 
extent  in  many  other  cities,  garbage  is  used  as  a  food  for  poultry ;  but 
it  is  for  feeding  swine  that  garbage  is  chiefly  employed.  There  can  be 
little  question  that  this  is  the  most  economical  method  of  utilizing  gar- 
bage yet  devised,  and  is  the  cheapest  way  in  which  it  can  be  disposed 
of.  The  larger  the  city  the  more  difficult  it  is  to  make  use  of  it,  but 
that  it  is  a  very  popular  method  of  disposal  is  shown  by  the  fact  that 
it  is  employed  in  the  cities  named  below.1 

It  is  generally  stated  that  the  feeding  of  swine  upon  garbage  exclu- 
sively produces  an  inferior  quality  of  pork,  but  the  managers  of  the  poor 
farm  at  Worcester  where  all  the  city  garbage  is  fed  to  swine  and  is  their 
exclusive  food,  state  that  they  receive  more  for  their  pork  than  western 
pork  brings  in  the  same  market.  It  is  also  said  that  it  induces  hog 
cholera,  but  there  does  not  seem  to  be  any  evidence  that  this  is  so. 
The  longer  the  garbage  is  kept  before  it  is  fed  the  further  it  has  under- 
gone putrefaction  and  the  worse  it  is  said  to  be  for  the  swine  ;  but  if 
the  animals  are  fed  on  garbage  which  is  reasonably  fresh,  and  especially 
if  garbage  is  not  the  sole  food,  and  corn  is  used  for  the  final  fattening, 
very  good  pork  can  be  obtained.  Another  objection  to  the  feeding  of 
garbage  to  swine  is  that  garbage-fed  swine  are  more  liable  to  trichinosis 
than  are  swine  fed  on  other  food.  According  to  the  investigations  of 
the  Massachusetts  state  board  of  health  garbage-fed  hogs  are  afflicted 
with  trichinosis  to  the  extent  of  thirteen  per  cent.,  which  is  a  very  much 
larger  percentage  than  is  found  in  western  hogs.2  This  is  not,  how- 
ever, so  serious  a  matter  as  would  at  first  appear,  for  this  disease  is 
transmitted  to  man  almost  exclusively  through  eating  raw  ham,  and  as 
a  matter  of  fact  it  is  rare  as  a  human  disease.  If  the  small  minority 
who  indulge  in  raw  pork  would  give  up  the  practice  there  would  be  no 
cases  in  the  human  subject.  By  thus  attempting  to  minimize  the  evil 
of  the  disposal  of  garbage  by  feeding  to  swine  the  writer  does  not  intend 
to  maintain  that  it  is  a  desirable  method,  but  would  simply  venture  the 
opinion  that  under  certain  conditions  it  is  not  a  very  bad  method  ;  and 
unfortunately,  no  method  as  yet  devised  is  entirely  satisfactory.     The 


1  Adrian  (in  part),  Albany,  Asbnry  Park,  Battle  Creek,  Bay  City,  Boston  (in  part), 
Brockton,  Cambridge,  Cbelsea,  Denver,  Erie  (in  part),  Fall  River,  Fitchburg,  Haver- 
hill, Holyoke  (in  part),  Jackson,  Mich.,  Lawrence,  Lowell,  Lynn,  Maiden,  Minne- 
apolis (in  part),  Newburgh  (in  part),  New  Haven,  New  London,  Newton,  Omaha, 
Pawtucket,  Portland,  Me.,  Poughkeepsie,  Providence  (mostly),  Pueblo  (in  part), 
Quincy  (in  part),  Rochester  (in  part),  Rockford,  Salem,  San  Jose,  Sioux  City,  Somer- 
ville,  Springfield,  Mass..  Springfield,  O.,  St.  Paul  (in  part),  Taunton,  and  Worcester. 

-  Massachusetts,  State  Board  of  Health  Report  (1889),  p.  113. 


REFUSE  DISPOSAL.  701 

feeding  of  garbage  to  swine  is  the  only  method  as  yet  by  which  a  city 
can  receive  some  return  for  the  outlay  for  collection  and  disposal. 
Sometimes  the  garbage  is  sold  to  farmers,  thus  bringing  a  direct  money 
return,  as  is  shown  below.1 

In  Rochester,  Taunton,  and  Worcester  the  garbage  is  not  sold,  but 
is  fed  to  swine  on  the  poor  farm.  In  Brockton  in  1899  the  collection 
of  garbage  cost  $6,779.43,  and  the  amount  received  from  the  sale  of 
swine  was  $4,258.41.  In  Worcester  in  the  same  year  the  cost  of  col- 
lection was  *17,109  and  the  amount  received  for  pork  was  $10,641.52. 
In  the  cities  just  mentioned  a  direct  income  is  received  from  the  dis- 
posal of  garbage,  but  there  are  a  number  of  other  cities  in  which  the 
cost  of  collection  and  disposal  is  materially  lessened  by  feeding  it  to 
swine.  The  contractor  is  enabled  to  name  a  low  figure  because  he 
derives  some  return  from  his  swine.  In  Boston  the  cost  of  collection  is 
$0.20  per  capita,  in  Cambridge  *<l2~,  in  Brockton  $0.17,  in  Lynn 
$0.18,  in  Lawrence  $0.10,  in  Somerville,  $0.17,  in  Worcester,  $0.14* 
In  all  of  them  the  collection  is  made  by  the  city.  In  the  following 
cities  contracts  are  let  at  lower  prices  because  the  contractor  makes 
profit  from  his  swine  :  In  Fitchburg  the  contract  is  $2,600,  or  $0.08 
per  capita.  In  Haverhill  it  is  about  $0.07,  in  Portland.  .Mi-..  $0.09,  in 
Holyoke  $0.02.  These  are  very  low  figures  for  New  England.  In 
New  Haven  the  contract  for  1899  was  $5,500,  or  $0.05  per  capita, 
while  in  Hartford,  where  most  of  the  garbage  is  worse  than  wasted  on 
dumps,  the  cost  of  collection  in  1896,  the  last  year  for  which  figures 
were  obtained,  was  about  $0.11.  In  Denver  there  are  six  contractors 
who  collect  each  in  his  own  district.  They  do  the  work  for  nothing. 
getting  their  compensation  from  the  swine  which  they  feed.  Certain 
portions  of  the  city  could  not  be  let  out  in  this  way.  and  the  cost  of 
collection  in  these  districts  was  $1,600  in   1899. 

Reduction  Processes.  The  value  of  the  materials  contained  in  gar- 
bage is  so  considerable  that  during  the  pasl  ten  years  an  Immense 
amount  of  labor  and  large  sums  of  money  have  been  spent  to  find  some 
way  to  utilize  it  other  than  by  feeding  to  swine.  The  valuable  ingre- 
dients which  can  be  obtained  from  garbage,  besides  such  extraneous  and 

Boston  received  for  the  sale  of  garbage  in  1898,  $10,982.25. 
»  ambridge  received  for  the  sale  of  garbage  in  1899,  $6,997.40. 
Lawrence  received  for  the  sale  of  garbage  in  iv,.'T.  $796.23. 
Lowell  received  tor  the  sale  "t  garbage  in  1899,  $8,547. 
Lynn  received  for  the  sale  of  garbage  in  1899,  $2,714.60. 
Maiden  received  for  the  sale  of  garbage  in  '  - 
Salem  received  for  the  sale  "i  garbage  in  1899,  $900. 
Somerville  received  for  the  sale  "i  garbage  in  L899,  $800. 
Springfield,  Mass,  received  for  tin-  sale  of  garbage  in  1900,  $1,244.05. 


7()2  REFUSE  DISPOSAL. 

accidental  materials  as  junk,  rags,  lost  articles,  etc.,  are  the  grease  and 
the  fertilizing  ingredients,  nitrogen,  phosphoric  acid  and  potash.  The 
value  of  the  garbage,  as  it  depends  upon  these  substances,  varies  in 
different  seasons,  and  in  different  cities  and  in  different  sections  of  the 
same  city.  The  poorer  the  people,  the  poorer  the  garbage,  for  the 
grease  and  nitrogenous  matters  are  more  completely  used  as  food. 
Summer  garbage  is  not  as  valuable  as  that  gathered  at  other  seasons, 
chiefly  on  account  of  the  waste  vegetable  matter  as  corn  husks  and 
melon  rinds,  and  partly  also  doubtless  because  less  meat  is  consumed 
at  that  season.  In  northern  cities  winter  garbage  is  less  valuable  than 
that  of  the  autumn  and  spring,  because  it  usually  is  mixed  with  more 
or  less  ice  and  snow.  The  variation  in  garbage  analyses,  and  also  in 
garbage  statistics,  is  due  many  times  to  the  varying  amounts  of  water 
contained  in  it.  If  water-tight  receptacles  are  insisted  on,  garbage  will 
contain  more  water  than  when  it  is  kept  in  leaky  boxes.  If  the  recepta- 
cles are  kept  covered  there  will  be  less  water  than  otherwise,  on  ac- 
count of  the  exclusion  of  rain  and  snow.  If  garbage  is  weighed  as  col- 
lected in  the  cart  it  will  contain  a  higher  proportion  of  water  than  if 
allowed  to  drain  after  dumping  on  to  a  floor  or  railway  car.  Also  the 
weight  and  value  of  garbage  will  vary  according  to  the  strictness  of 
separation  from  other  wastes.  The  average  composition  of  3,000  tons 
of  summer  garbage  from  Buffalo,  St.  Louis,  Philadelphia,  and  Brook- 
lyn, N.  Y.,  treated  under  the  direction  of  George  E.  Waring,  Jr.,1  was 
as  follows: 

Average  Composition  of  One  Ton  of  Garbage: 

Rubbish,  140  lbs 7  Per  Cent. 

Water,  1420  lbs 71 

Grease,  40  lbs 2         " 

Tankage,  400  lbs.  (Containing  Ammonia,   13  lbs.,  Phosphoric  Acid,  13 

lbs.,  Potash  3  lbs.) 20 

It  is  not  clear  from  the  report  whether  the  garbage  was  allowed  to 
drain  before  the  analysis,  but  probably  it  was.  Garbage  in  most  of  the 
New  England  cities  is  rather  more  valuable  than  that  treated  by  Mr. 
Waring.     It  also  has  rather  less  rubbish  and  more  water. 

In  Providence  the  composition  of  the  garbage  treated  by  the  Sim- 
onin   process  was : 

Tankage 20     per  cent. 

Grease 4-5  l L 

Ammonia 3.5       "■ 

Bone  phosphate 12  " 

Potash 1 

1  Report  on  the  Final  Disposition  of  the  Waste  of  New  York,  George  E.  Waring, 
Commissioner  of  Street  Cleaning,  New  York,  1890. 


REFUSE  DISPOSAL. 


703 


The  analysis  of  the  Merz  output  in  Buffalo  for  several  months  was  : 

Grease 3.59  per  cent. 

Ammonia 3.70         " 

Phosphoric  Acid :].9o        " 

An  analysis  of  the  Philadelphia  tankage  as  made  from  garhage  by 
the  Arnold  process  is  given  by  Mr.  Hering  as: 

Moisture 4.80  per  cent. 

Phosphoric  Acid 2.69         " 

Ammonia 0.06        " 

Potash GO         " 

The  analysis  in  Pittsburgh  was  : 

Ammonia 3      per  cent. 

Phosphoric  Acid 3  " 

Potasli 1.5         '• 

According  to  Waring's  estimates,  which  are  not  high,  garbage  would 
be  worth,  if  its  ingredients  could  be  utilized,  -S2.4T  a  ton. 

The  amount  of  garbage  collected  per  day  varies  very  greatly  accord- 
ing to  the  care  with  which  it  is  separated  by  the  householder  and  gath- 
ered by  the  city.  The  following  are  the  estimates  of  the  amount  of 
garbage  collected  per  capita  annually: 


City. 

Boston 

Buffalo 

Cambridge. . 

Detroit 

Indianapolis. 
Lowell 

Lynn 

Milwaukee. 


Pounds  of  Garbage 

Collected  per  capita 
per  annum. 

:>47 
137 
150 
84 
174 
100 
16G 
205 


City. 

New  York . . . 

Paterson 

Philadelphia. 

Salem 

Somerville. .  . 

St.  Louis .... 

Worcester. . . 

Average . . . 


Pounds  of  Garbage 

<  lollected  per  capita 

per  annum. 

147 
80 
321 
21  '■-' 
:'.7."> 
223 
178 
L99 


If  the  above  average  be  correct,  millions  of  tons  must  be  collected 
annually  from  our  large  cities  worth  double  that  Dumber  <>t'  millions  of 
dollars.     It  is  not  to  be  wondered  that  energetic  efforts  have  been  made 

to  save  this  waste. 
Merz  Proc<  88. 

This  was  the  first  successful  led  net  ion  process  tor  the  treatment  of 
garbage,  that  is.  it  was  the  first  that  was  applied  for  an\  length  of  time 
to  the  treatment  of  all  the  garbage  of  a  eit\  of  considerable  size.  .Manx 
attempts  at  reduction  had  previously  been  made,  sometimes  on  a  con- 
siderable scale,  as  those  of  the   Whites  at     Barren   Island  at   about    1870; 

but  none  of  these  attempts  were  entirely  successful  even  from  a  mechan- 
ical  standpoint.     The    Merz  process   was  introduced    into   Buffalo   in 


704  REFUSE  DISPOSAL. 

1888,  and  is  still  in  operation  there.  It  is  also  employed  in  St.  Louis, 
and  a  modification  of  it  in  Pittsburgh.  The  garbage,  when  received  at 
the  works,  is  dumped  into  a  large  steel  hopper  grated  below,  from  which 
the  superfluous  water  can  drain  off  into  the  sewer.  From  the  receiving 
tanks  the  garbage  is  drawn  up  as  wanted  onto  the  second  floor,  and  as 
much  of  the  foreign  matter  as  possible,  such  as  rags,  bones,  iron,  cans, 
bottles,  etc.,  is  culled  from  it.  The  materials  culled  out  are  sold.  The 
garbage  is  then  dumped  into  the  driers.  The  driers  are  jacketed  cylin- 
ders with  revolving  shafts,  with  arms  to  stir  the  garbage  during  the 
process  of  drying.  Each  drier  holds  about  three  tons  and  the  operation 
of  drying  consumes  about  six  hours.  When  the  material  leaves  the 
dryer  it  is  pretty  well  triturated,  is  of  a  dark  brown  color,  is  quite  greasy 
and  has  very  little  odor.  It  is  then  carried  to  the  extractors,  winch  are 
closed  tanks  with  false  bottoms.  Here  naphtha  is  allowed  to  percolate 
through  it  to  extract  the  grease.  The  solution  of  grease  is  drawn  off, 
the  naphtha  driven  off,  and  the  grease  barreled  for  sale.  Garbage 
grease,  however  obtained,  always  has  a  garbage  odor  and  is  not  suited 
for  soap  making.  Much  of  it  is  shipped  abroad,  and  the  market  here 
is  limited  to  a  few  customers,  as  it  can  be  put  to  little  use  unless  sub- 
jected to  destructive  distillation.  Grease  obtained  by  the  Merz  process 
is  of  a  dark  brownish  or  greenish  color,  as  is  indeed  the  grease  obtained 
by  all  the  reduction  processes.  The  dry  residue  after  the  separation  of 
the  grease  in  the  extractors  is  ground  and  sifted  and  sold  to  fertilizer 
manufacturers.  The  writer  twice  visited  the  works  in  Buffalo  and 
found  them  quite  offensive.  The  process  may,  however,  be  carried  on 
in  a  much  more  sanitary  manner,  and  is  so  in  St.  Louis.  The  following 
conditions  were  found  in  that  city  by  Dr.  William  C.  Woodward  •} 

"  Gases  arising  in  the  course  of  this  process  are  passed  through  condensers,  and 
the  non-condensible  portions  passed  through  the  furnace. 

"Throughout  the  entire  establishment,  wherever  garbage  or  its  products  are 
exposed  to  the  atmosphere,  are  large  ventilating  lines,  into  which  all  foul  gases  are 
drawn  by  means  of  fans.  These  gases  are  carried  through  the  fires  under  the  boilers 
and  are  there  decomposed.  A  separate  sewer  has  been  laid  directly  into  the  river, 
it  having  been  found  impossible  to  use  the  public  sewer  without  creating  a  nuisance. 
This,  it  is  claimed,  is  not  due  to  odors  from  the  reduction  plant,  but  to  the  hot 
water  from  that  plant  setting  free  foul  gases  from  materials  deposited  in  the  sewers 
elsewhere. 

"At  the  time  of  making  inspection  the  factory  was  engaged  in  ordinary  daily 
work.  Outside  of  the  building  no  odor  could  be  detected.  Inside,  in  places,  it  was 
quite  foul.  The  sanitary  condition,  so  far  as  the  public  is  concerned,  depends  on 
the  system  of  ventilation,  and  not  on  anything  peculiar  to  the  Merz  process.  All 
windows  and  doors,  except  a  few  on  the  side  from  which  the  wind  blows,  are  kept 
closed.11 


1  District  of  Columbia,  Report  of  Health  Officer  (1896),  p.  240. 


REE  USE  DISP  0  SAL. 


05 


^ 


Extractor. 


Discharging 
Quor. 


Sepo. 


Grease 
Pipe 


Merz     Process. 
St  LouJs.Mo. 


Vapvr/zer. 


ExfracTion  Apparatus. 


O 


rr% 


5 


\McltirPife  tyray 


Vdpcr  Pipe 


1 


Condenser 

■Wlter  Column 


'■.. 


Section  of  Dryer. 


Trap. 


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n 


\\ySltornty--  I    I 


Dryer  and  Condenser 


Km.  85. 

Diagram  Illustrating  the  construction  »f;i  Merz  Reduction  Planl .      From  the  Reporl  ol  the 
ii.  ..mi  Department  ol  Brooklyn 


706  REFUSE  DISPOSAL. 

The  plant  in  St.  Louis  is  said  to  have  cost  $280,000.  The  amount 
of  garbage  treated  there  in  the  year  ending  31  March,  1897,  was  66,341 
tons.  The  contract  price  paid  by  the  city  for  the  reduction  was  $1.80 
per  ton  up  to  100  tons  per  day  or  $65,689.48  for  that  year.  The  per 
capita  cost  of  disposal  in  St.  Louis  for  that  year  was  perhaps  $0.12.  In 
Buffalo  the  contract  price  for  disposal  is  $15,840  per  year.  In  1900 
22,881  tons  of  garbage  were  reduced,  making  the  cost  per  ton  $0.69 
a] id  per  capita  $0,045.  Works  were  at  one  time  in  operation  in  Detroit 
and  Milwaukee,  but  they  have  been  abandoned. 

In  Pittsburgh  the  garbage  is  collected  and  disposed  of  by  contract. 
The  garbage  is  carried  to  works  situated  in  the  thickly  built  portion  of 
the  city.  It  is  here  partially  dried  in  Hogel  dryers  and  it  is  then 
loaded  in  box  cars  and  carried  out  into  the  country  where  the  grease  is 
extracted  by  naphtha,  somewhat  on  the  plan  of  the  Merz  process.  The 
works  in  Pittsburgh  when  visited  by  the  writer  were  causing  a  good 
deal  of  offence,  though  the  vapors  from  the  dryers  were  burned  under 
boiler  fires  :  but  little  attention  was  paid  to  details  and  it  is  only  by 
such  attention  that  real  cleanliness  can  be  secured.  The  Pittsburgh 
contract  for  collection  and  disposal  is  for  $92,000,  or  about  $0.29  per 
capita.  The  amount  collected  could  not  be  determined,  so  that  the 
cost  per  ton  could  not  be  determined,  nor  could  the  cost  of  disposal  be 
separated  from  the  cost  of  collection. 

Simouin  Process. 

The  Simonin  process,  like  the  Merz  process,  extracts  the  grease  from 
the  garbage  by  the  use  of  naphtha.  It  has  this  advantage  over  the  Merz 
process,  in  that  the  garbage  can  be  at  once  placed  in  the  extractors 
without  previous  drying.  This  process  was  introduced  in  Providence 
in  1890  and  was  abandoned  as  it  was  not  profitable,  the  owners  receiv- 
ing no  bonus  from  the  city.  It  was  afterwards  operated  for  a  short 
time  in  New  Orleans,  but  there  was  trouble  between  the  contractors  and 
the  city  in  regard  to  the  collection  of  garbage,  so  that  after  a  short 
time  the  plant  was  abandoned.  A  plant  was  also  started  in  Cincinnati 
sih  m  after  the  one  in  Providence  and  has  been  in  operation  ever  since. 
In  1898  the  amount  paid  for  garbage  disposal  by  the  Simonin  process 
in  that  city  was  $25,000,  and  the  amount  of  garbage  about  15,000 
tons,  or  $1.62  per  ton.  The  reduction  company,  however,  claims  not  to 
have  found  the  business  very  profitable  since  the  advance  in  the  price 
of  naphtha.  The  following-  cut  and  description  of  the  process  were  pre- 
pared by  the  writer  for  a  meeting  of  the  American  Public  Health  Asso- 
ciation held  in  Mexico  in  1892.1 


1  American  Public  Health  Association,  Reports  and  Papers,  Vol.  XVIII.,  p.  259, 

189:;. 


REFUSE  DISPOSA  L. 


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708  REFUSE  DISPOSAL. 

The  garbage  is  dumped  on  the  floor  and  loaded  onto  perforated  pans 
which  are  run  into  the  extractors  on  cars.  The  extractor  is  closed  and 
filled  with  naphtha  which  is  rapidly  evaporated  by  steam  coils  in  the 
bottom.  The  hot  naphtha  vapor  carries  off  the  water  and  both  water 
and  naphtha  are  condensed  and  separated,  the  former  flowing  into  the 
river  and  the  latter  being  used  again.  The  naphtha  dissolves  the  grease, 
and  as  the  evaporation  is  stopped  before  all  the  naphtha  is  driven  off,  a 
solution  of  grease  in  naphtha  is  left  in  the  bottom  of  the  extractor  and  is 
drawn  off  for  complete  separation  in  another  still.  This  process  is 
repeated  several  times  till  all  the  water  is  removed  when  the  naphtha 
remaining  in  the  garbage  is  driven  off  by  live  steam.  The  extractor  is 
then  opened  and  the  dry  garbage  removed  and  ground  and  sifted.  The 
extractors  hold  about  eight  tons  and  the  process  takes  about  forty-eight 
hours. 

The  writer,  from  considerable  personal  experience,  believes  that  this 
process  can  be  conducted  with  very  little  nuisance  and  with  a  moderate 
degree  of  profit,  even  without  the  payment  of  a  bonus ;  but  this  can 
only  be  done  in  a  city  where  the  garbage  is  very  carefully  separated. 

Arnold  Process. 

There  are  several  processes  in  use  for  the  disposal  of  garbage  which 
consist  in  rendering  it  to  recover  the  grease  which  it  contains  and  (Irv- 
ing the  residue  to  be  used  as  a  fertilizer.  One  of  these  is  known  as 
the  Arnold  Process,  operated  by  various  local  companies  in  which  the 
same  persons  are  interested. 

This  concern  has  contracts  for  the  disposal  of  the  garbage  of  Boston, 
New  York  (Manhattan  and  Brooklyn),  and  Philadelphia.  The  works 
are  different  in  the  different  cities,  for  experiments  are  constantly  being 
tried  and  improvements  introduced.  At  the  works  in  Boston,  when 
visited  by  the  writer,  the  garbage  was  brought  from  the  dumping  dock, 
a  distance  of  about  six  miles  by  water,  on  a  large  deck  scow.  From 
this  it  was  shovelled  by  six  men  into  an  elevator  and  conveyor  which 
carried  it  to  the  upper  floor  of  the  building  and  discharged  it  into  the 
digesters.  These  are  upright  cylinders,  capable  of  holding  eight  tons. 
They  are  arranged  in  groups  of  four  over  a  press.  After  they  are  filled 
with  garbage  they  are  closed,  and  the  garbage  treated  with  live  steam. 
After  the  garbage  is  cooked  a  sufficient  length  of  time  the  contents  of 
the  digesters  are  allowed  to  fall  through  a  valve  in  the  bottom  into  the 
press.  This  press  is  of  novel  design,  and  the  pressing  is  a  continuous 
operation,  the  tankage  being  passed  between  powerful  rollers.  These 
presses  seemed  to  work  well  when  seen,  though  they  sometimes  get  out 
of  order  when  heavy  foreign  substances  get  into  them.  From  a  sanitary 
standpoint  they   are  far  better  than  screw  presses,  for  the  hot  material 


REFUSE  DISPOSAL.  70<) 

need  not  be  at  all  exposed  to  the  air.  If  they  can  be  kept  in  repair  it 
would  seem  that  they  ought  to  be  economical  as  they  do  not  require  as 
much  labor  as  ordinary  presses.  From  the  presses  which  are  arranged 
in  a  series  beneath  the  digesters  the  tankage  is  carried  by  a  common 
conveyor  to  the  dryers,  which  in  Boston  are  of  the  Anderson  type.  In 
Boston  when  the  works  were  started  the  nitrogen  was  extracted  from 
the  tankage  and  sold  in  the  form  of  ammonia,  but  at  the  time  of  the 
writer's  visit  the  works  had  suffered  from  fire  and  the  tankage  without 
being  dried  was  carried  to  sea.  It  is  said  that  in  other  works  operated 
under  this  company  the  tankage  after  drying  is  ground,  screened  and 
bagged  and  sold  to  fertilizer  manufacturers.  The  grease  and  water 
which  runs  from  the  presses  is  pumped  into  a  tank  where  the  grease 
floats  and  is  drawn  off  into  barrels,  and  the  water  allowed  to  run  into 
the  bay.  At  Boston,  and  it  is  said  in  other  cities,  little  attempt  is  made 
to  prevent  odors  arising  from  the  process.  It  would  be  possible  to  keep 
the  entire  process  enclosed  so  as  to  keep  in  and  condense  and  burn 
all  gases,  but  it  is  evidently  considered  by  the  operators  to  be  cheaper 
not  to  try  to  prevent  nuisance,  but  to  seek  a  location  where  the  nuisance 
will  affect  very  few  persons;  but  certainly  in  New  York,  Brooklyn,  and 
Boston  the\  spend  a  considerable  sum  in  transporting  the  garbage  to 
their  works.  In  Boston  they  own  six  scows  costing $3,500  each,  besides 
a  towboat. 

In  Boston  the  contract  is  for  ten  years  from  L898.  The  amount 
named  is  $47,500  per  year  and  the  contractors  are  to  take  care  of  all 
garbage  delivered  to  them.  At  present  (1899)  from  three-fourths  to 
four-fifths  of  the  total  garbage  is  disposed  of  in  this  way  and  the 
remainder  is  sold  to  farmers.  The  amount  of  garbage  collected  in  Bos- 
ton in  1899  was  about  60,000  tons,  and  of  this  about  45,000  tons  were 
treated  by  the  reduction  company.  The  cost  to  the  city  for  disposal 
must  therefore  have  been  about  $1.00  a  ton.  In  the  borough  of  Man- 
hattan a  five  year  contract  for  the  disposal  of  garbage  expires  I  August, 
L901.  The  amount  received  l>\  the  New  York  Sanitary  Utilization 
Company  under  the  contract  is  $89,990.  As  the  amount  disposed  of 
in  ls'.»'.»  was  L51,100  tons,  the  cost  per  ton  was  not  quite  $0.60.  The 
garbage  is  delivered  on  board  the  company's  scows  at  the  city  docks 
ami  the  company  tows  them  to  the  works  at  Barren  Island  iii  Jamaica 
Bay  at  its  own  expense.  The  borough  of  Brooklyn  had  a  contracl  for 
the  collection  and  disposol  ,,f  garbage  for  $120,000  per  annum.  As 
onl\  the  contractors"  estimates  are  given  for  the  amount  ot  garbage  col- 
lected, it  is  impossible  to  determine  how  much  it  costs  per  ton,  and 
likewise  it  is  impossible  to  separate  the  cost  of  collection  from  that  id 
disposal.     It  is  said  by  the  contractor  that   102,000  tons  were  collected 


710  REFUSE  DISPOSAL. 

in  1898.  The  per  capita  cost  of  collection  and  disposal  in  both  Man- 
hattan and  Brooklyn  is  not  far  from  $0.10.  In  Philadelphia  also  the 
contract  is  for  collection  and  disposal  so  that  it  is  not  possible  to 
separate  the  cost  of  the  two.  The  contract  is  for  #398,000.  Accord- 
ing- to  the  statement  of  the  director  of  the  department  of  public  works 
the  amount  collected  in  1899  was  199,357  tons.  According  to  this, 
the  cost  of  collection  and  disposal  was  about  -12.00  per  ton.  The  per 
capita  cost  of  collection  and  disposal  was  aboat  $0.30,  or  three  times 
what  it  is  in  Manhattan  and  Brooklyn,  but  not  very  much  more  than 
the  cost  for  the  same  service  in   Boston. 

Chamberlain  Process. 

The  Merz  process  was  at  one  time  operated  in  Detroit,  but  does  not 
appear  to  have  been  successful.  Some  of  the  persons  interested  in  that 
undertaking  afterwards  adopted  a  rendering  process  which  has  since 
been  employed  in  that  city  and  has  also  been  operated  at  Indianapolis 
and  Cleveland.  The  writer  has  understood  that  the  contractor  who 
collects  the  garbage  at  Columbus,  O.,  employs  this  process  for  its  dis- 
posal, but  has  never  been  able  to  obtain  definite  information  whether 
this  is  so  or  not,  though  a  recent  letter  from  the  city  clerk  states  that 
it  is  rendered  in  some  way.  Neither  has  the  writer  been  able  to  obtain 
any  description  of  the  process,  as  he  was  not  permitted  to  inspect  the 
works  which  he  visited  at  Cleveland.  It  is  said  that  the  garbage  is 
rendered  as  in  the  Arnold  process  and  the  resulting  tankage  dried  in 
rotary  driers  and  made  into  a  fertilizer,  or  sold  to  fertilizer  manufac- 
turers. At  Cleveland  apparently  little  attempt  was  made  to  prevent 
nuisance.  The  works  were  perhaps  three  miles  out  in  the  open  country 
and  the  garbage  was  carried  out  on  cars  as  explained  on  page  087.  In 
Detroit  also  the  works  are  twenty-five  miles  from  the  city,  but  in  In- 
dianapolis they  are  not  far  away,  so  that  the  garbage  is  drawn  out  in 
the  wagons  in  which  it  is  collected.  In  Indianapolis  the  disposal  is 
contracted  for  separately  from  collection  and  the  amount  paid  in  1899 
according  to  the  superintendent  of  the  street  department  was  $12,000. 
The  amount  collected  according  to  the  same  authority  was  17,454  tons, 
which  would  make  the  cost  of  disposal  about  $0.69  per  ton.  The 
amount  paid  for  collection  and  disposal  is  $42,000,  which  would  make 
the  cost  per  ton  about  *2.40  and  per  capita  $0.24.  In  Cleveland, 
Detroit  and  Columbus  the  contracts  are  for  collection  and  disposal,  so 
that  it  is  impossible  to  separate  the  cost  of  the  two.  In  Detroit, 
according  to  the  engineer  of  the  board  of  health,  14,732  tons  were  col- 
lected and  disposed  of  at  a  cost  of  $50,000  or  $3.40  per  ton.  This 
amount  of  garbage  is  small  for  a  city  the  size  of  Detroit.  The  per 
capita  cost  of  collection  and  disposal  in   1899  when   the  contract  price 


REFUSE   I'isposAL. 


'11 


712  REFUSE  DISPOSAL. 

was  $60,000  was  #0.21.  In  Cleveland  the  contract  for  collection  and 
disposal  is  for  $69,400.  It  is  stated  that  22,375  tons  were  collected  in 
1899  which  would  make  the  cost  per  ton  $3.10.  The  per  capita  cost 
of  collection  and  disposal  is  $0.18.  In  Columbus  the  contract  for  col- 
lection and  disposal  is  for  $15,800  or  nearly  $0.12  per  capita.  In 
l<s(.>!)  the  amount  collected  was  7,794  tons,  making  the  cost  $2.03  per  ton. 
Holthaus  System. 

This  system  was  first  used  for  the  treatment  of  municipal  garbage 
at  Bridgeport,  Conn.  The  works  were  well  constructed  and  from  a 
.sanitary  standpoint  the  results  were  excellent.  The  project  was  how- 
ever soon  abandoned,  apparently  because  it  was  a  financial  failure. 
The  amount  paid  in  that  city  was  $0.34  a  ton.  The  only  plant  now  in 
operation  is  at  Syracuse.  The  garbage  in  that  city  is  collected  in 
barrels  and  is  dumped  from  them  into  a  car  standing  on  an  elevator, 
which  carries  it  to  the  top  of  the  building.  The  car  is  rolled  to  the 
digester  and  its  contents  discharged  into  the  latter.  This  digester 
when  full  is  closed,  and  about  twenty  per  cent,  of  water  added,  and  the 
whole  is  digested  with  steam.  The  digesters  are  arranged  in  groups 
of  four  connecting  by  valves  with  a  press  below.  When  the  digestion 
is  complete  the  mass  is  allowed  to  fall  into  the  press  where  the  water 
and  grease  is  pressed  out  and  allowed  to  run  into  the  separating  tank 
from  which  the  grease  is  drawn  off  into  the  grease  tank  and  then  into 
barrels.  The  tankage  falls  into  a  dryer  and  from  this  it  is  carried  by  a 
conveyor  to  a  room  where  it  is  ground  and  screened.  The  whole  pro- 
cess, from  the  time  the  garbage  is  put  in  the  digesters  till  the  dry  tank- 
age and  the  grease  appear,  is  conducted  in  apparatus  which  is  securely 
closed.  Pipes  lead  from  the  different  portions  of  the  apparatus  to  a 
vacuum  pump  which  draws  all  gases  through  a  condenser  and  then 
passes  them  through  the  fire.  All  water  vapor  from  the  drying  and 
rendering  processes  is  condensed  and  all  water  is  evaporated  and  then 
condensed  so  that  all  the  liquid  wastes  from  the  works  are  free  from 
offence.  When  visited  by  the  writer  the  works  and  their  vicinity  were 
almost  entirely  free  from  odor.  There  is  no  reason  why  the  works  can- 
not be  operated  in  this  manner,  for  the  apparatus  is  intelligently 
designed  to  keep  all  gases  from  escaping.  The  contract  price  for  dis- 
posal in  Syracuse  is  $26,000  per  annum.  It  is  said  that  about  thirty- 
five  or  forty  tons  are  collected  daily.  If  the  yearly  total  is  12,000  tons, 
which  is  perhaps  not  improbable  for  a  city  of  108,000,  the  cost  for  dis- 
posal would  be  |2.16  per  ton.  The  per  capita  cost  of  disposal  alone  is 
•S<».24.  Baltimore  has  recently  contracted  to  dispose  of  its  garbage  by 
this  system  but  the  matter  has  been  taken  to  the  courts.  The  contract 
is  to  collect  and  dispose  of  garbage  and  ashes  for  ten  years  at  $148,000 
per  year,  which  is  more  than  $20,000  less  than  the  city  now  expends. 


REFUSE  DISPOSAL.  713 

American  Reduction  Company's  Process. 

This  process  does  not  differ  in  principle  from  that  of  the  Arnold 
and  Holthaus  systems  being  one  of  rendering  and  drying.  An  experi- 
mental plant  of  large  capacity  was  some  years  ago  constructed  in  Brook- 
lyn and  was  seen  in  operation  by  the  writer.  The  construction  of  this 
plant  was  far  from  satisfactory,  but  it  is  understood  that  subsequent 
plants  were  better  built.  One  was  in  operation  for  a  year  or  two  in 
Philadelphia,  and  the  following  description  is  from  a  report  by  the  board 
of  health  which  was  furnished  the  writer  by  the  company  and  is  doubt- 
less correct : 

"The  garbage  is  brought  there  daily  to  the  amount  of,  say  about  forty-five  loads. 
It  is  immediately  damped  on  a  space  adjacent  to  the  lift  consisting  of  an  endless 
chain  supplied  with  buckets.  The  garbage  is  thrown  upon  these  buckets  and  car- 
ried to  an  upper  floor  and  fed  to  the  digesters,  of  which  there  are  six.  These  diges- 
ters are  large  steel  cylinders  supplied  with  steam-pipe  and  lids  fitted  with  clamps, 
so  as  to  make  them  steam-tight.  When  filled  with  garbage  a  certain  proportion  of 
sulphuric  acid  is  added  for  the  purpose  of  disintegrating  the  mass  and  fixing  the 
volatile  constituents,  such  as  ammonia  and  the  like,  for  the  value  in  fertilizer.  Live 
steam  is  admitted  to  these  cylinders  for  about  three  hours.  There  is  about  three 
per  cent,  of  oil  secured,  and  this,  at  present,  is  skimmed  from  the  surface  and 
placed  in  i. pen  tanks  until  cooled,  when  it  is  barreled  and  shipped  abroad. 

•  At  the  completion  of  the  digesting  process  the  material  is  transferred  to  dryers, 
three  in  number,  located  on  a  lower  floor.  These  dryers  are  cylindrical,  steel- 
jacketed  tanks  in  which  there  are  revolving  arms  for  the  purpose  of  agitating  the  mass 
and  preventing  charring.  The  steam  is  admitted  into  the  jacket  and  the  process 
occupies  about  ten  hours,  when  the  contents,  deprived  largely  of  its  moisture,  is 
sifted,  ground  and  bagged  for  transportation. 

l>  This  product  is  a  dark  brown  granulated  substance,  having  t  he  so-called  caramel 
smell  or  smell  characteristic  of  roasted  vegetable  fibre,  and  is  not  putrid,  nor  foetid, 
nor  pungent,  nor  markedly  offensive. 

"From  the  digesters,  pipes  are  carried  to  condensers  into  which  they  are  admitted 
near  the  bottom,  so  that  the  vapors  and  gases  can  he  thoroughly  washed  by  innumer- 
able jfts  ,,f  water  before  the}   escape  al  the  top.     From  the  dryers  pipes  are  also 

led    to  condensers   for   the  same    purpose.      The   exhaust    pipes    from    the  condensers 

carrying  gases  which  have  escaped  condensation  to  a  large  iron  retort.  r>  x  L3,  where 
they  are  mixed  with  gases  generated  from  burning  gas  coal. 

"The  gases  from  the  condensers  are  combustible  and  when  mixed  in  the  retort 
tin-  chemical  combustion  produces  a  colorific  and  combustible  gas.  which  is  fed  to 
the  furnaces  and  t  lien-  burned,  forming  the  sole  source  of  heal  for  generating  steam 

for  t  he  works.      Tin;  live    pits  of    the  furnace-,   are  SO   arranged    thai    the   gases  must 

necessarily  impinge  upon  a  thoroughly  heated  and  somewhat  obstructing  surface  of 

brick,  thus  ensuring   a  more    complete    combustion.      What    escapes    into  the  smoke 

stacks  must  necessarily  he  deprived  of  any  deleterious  or  odorous  quality.  The 
water  of  condensation  passes  into  the  sewer.  Tins  water  upon  examination  does 
not  appear  to  be  markedly  offensive,  li  has  been  tested  in  the  laboratory  without 
producing  any  verj  significant   results. 

'•An  apparatus  has  heen  designed    and  constructed    l'.\    which  the  slumming  of  oil 

can  be  dispensed  with.  This  apparatus  is  a  centrifugal  machine,  ingenious  in  design 
and  satisfactory  in  its  results.  It  consists  of  a  bi-conical  chamber,  with  outlets  al 
the  central   plain  by  which  tl ii   is  whirled  out    into  a  covered  circular  trough. 

After  the  oil  is  extracted  ih.>  remainder  of  the  material  is  gotten  nd  of  by  the  same 


714  REFUSE  DISPOSAL. 

process,  by  simply  raising  the  dome  and  collecting  it.  as  expelled,  into  a  proper 
receptacle.  Were  this  centrifugal  apparatus  in  nse  it  would  lessen  greatly  the 
manipulation  and  exposure  of  the  material  to  the  air  during  the  process  of  manu- 
facture."1 

The  only  city  where  this  company  is  at  present  operating  works  is 
Reading.  The  contract  price  for  disposal  in  that  city  is  sixty-five  cents 
per  ton. 

In  Paterson  the  contractor  disposes  of  the  garbage  which  he  collects 
by  drying  it  in  sonic  sort  of  drying  apparatus  and  disposing  of  the  dry 
material  to  farmers,  either  giving  it  away  or  selling  it  for  a  nominal 
sum,  as  ten  cents  a  ton.  It  is  impossible  to  learn  the  cost  of  this  treat- 
ment, as  the  contract  in  Paterson  is  for  the  collection  and  disposal  of 
garbage  and  ashes,  which  are,  however,  collected  separately.  The 
amount  of  the  contract  is  $27,500,  and  in  1898  4,443  tons  were 
treated. 

hi  New  Bedford  the  contractor  delivers  the  garbage  to  a  company 
which  renders  it  for  the  grease.  The  company  receives  no  return  except 
what  it  is  able  to  obtain  from  the  garbage.  The  works  have  not  been 
long  in  operation. 

In  Ttica  the  garbage  is  collected  and  disposed  of  by  contract.  The 
contractor  is  said  to  make  a  fertilizer  of  it,  but  the  writer  has  not  been 
able  to  learn  anything  of  the  process.  He  receives  $5,700  for  collection 
and  disposal. 

( Vernation. 

(  remation  is  exclusively  employed  for  getting  rid  of  garbage  in 
England  and  on  the  continent  of  Europe,  and  is  rapidly  coming  into 
use  in  the  United  States.  The  destruction  by  fire  is  theoretically  an 
ideal  way  from  a  sanitary  standpoint  for  the  disposal  of  garbage.  The 
products  of  combustion  are  inoffensive  and  sometimes  have  a  slight 
value.  The  process  ought  to  be  so  conducted  as  to  create  no  nuisance, 
a  condition,  however,  which  cannot  be  obtained  without  great  care. 
The  chief  drawback  is  the  expense.  There  is  little  or  no  return  and 
the  outlay  for  repairs,  labor  and  fuel  is  considerable. 

Burning  in  the  Open  Air. 

This  is  the  most  primitive  method  of  cremation  and  is  almost  as 
unsanitary  in  its  operation  as  dumping,  but  better  in  its  results.  This 
method  is  employed  in  Augusta,  Galveston,  and  Macon,  ami  a  number 
of  small  cities  in  the  South1  and  to  some  extent  in  Minneapolis  and 
Youngstown,  < ). 

Augusta  ami  Macon  are  the  only  cities  which  claim  that  this  method 
is  satisfactory.     In  the  former  city  it  has  been  in  use  for  sixty  years.     In 

1  North  Carolina,  Report  of  State  Board  of  Health  (1893-4),  p.  132. 


REFUSE  DISPOSAL.  715 

both  cities  there  are  few  persons  dwelling  near  the  (lumps.  In  Augusta 
the  garbage  and  dry  refuse  are  simply  burned  where  dumped  on  the 
surface  of  the  ground.  One  man  tends  the  dumps  and  the  tires.  The 
ashes  in  Augusta  are  carted  away  to  farms  for  a  fertilizer.  In  Macon 
the  garbage  is  burned  in  open  pits  on  ordinary  grate  bars.  Cotton  waste 
and  rosin  dross  are  used  for  fuel.  Six  men  are  employed  at  $1.25  a 
day.  The  cost  of  disposal  in  Macon  is  $3,200  for  about  7,<>0()  cubic 
yards. 

Engle   Furnace. 

One  of  the  earliest  and  most  popular  furnaces  in  this  country  was 
the  Engle  :  and  it  was  brought  to  the  attention  of  the  public  by  its  use 
to  cremate  the  garbage  of  the  World's  Fair  at  Chicago.  The  following 
is  from  a  paper  by  Col.  .Morse  :] 

"  The  Engle  garbage  cremator  may  be  briefly  described  as  a  rectangular  brick 
structure,  forty  feet  long,  ten  feet  wide,  and  twelve  feet  high.  At  one  end  a  stack 
of  iron  or  a  brick  chimney  seventy-five  feet  high,  over  the  furnace  an  iron  covering 
house  with  sliding  doors,  and  at  the  sides,  a  little  above  the  top  of  the  furnace, 
wide  platforms  with  ample  driveways  and  approaches.  From  the  platforms  iron 
slopes  lead  down  to  the  feed-holes  in  the  top  of  the  furnace.  These  are  five  in  num- 
ber, one  being  large  enough  to  receive  the  carcass  of  a  horse,  the  collection  carts 
dump  their  loads  directly  upon  the  slopes,  no  further  handling  being  needed.  The 
garbage,  as  it  falls  through  the  Eeed-holes,  is  caught  by  grate  bars,  extending  across 
the  interior  half  way  from  top  to  bottom.  The  liquid  passes  through  these  bars  and 
is  retained  in  a  shallow  concave  pan  or  hearth  below  the  bars. 

'•  The  furnace  being  charged,  the  fires  are  lighted  first  at  the  front  and  afterward 
at  the  rear  end.  the  flames  from  this  tire  passing  over  and  through  the  mass  of  gar- 
bage piled  on  the  grates,  driving  the  smoke  and  gases  into  and  across  the  second  01 
front  lite,  where  they  are  consumed.  The  tlanics  front  the  second  tire  are.  by  the 
action  of  the  strong  draught,  brought  back  underneath  the  garbage  grates,  intensely 

heating  the  garbage  from  the  under  side.  When  liquids  are  to  be  destroyed,  a  part 
of  this  heat  and  flame  is  directed  under  the  hearth  or  pan,  and  all  the  contents 
quickly  evaporated  and  burned.  All  the  odors,  gases,  and  product  of  combustion 
are  passed  through  one  or  tin-  other  of  the  fires,  there  being  no  escape  except  across 

these  fire  boxes.  The  ashes,  ;is  they  fall  through  tin-  grates,  are  raked  out  of  a 
lower  range  of  doors  on  the  side,  and  from  time  to  time,  as  required,  the  garbage  is 
stirred  up  and  distributed  over  the  grates  by  bars  thrust  through  an  upper  range  ..f 
stoke  di  tors." 

This  furnace,  like  other  garbage  works.  lias  been  built  in  a  number  of 
citiefi  where  it  has  been  afterwards  abandoned,  bul  al  present  it  is  in 
operation    in    Des    Moines,    Evansville,    hid.,  Grand    Rapids,    Lowell, 

Norfolk,    Portland,   Ore.,   bid »nd,    In<L.   Richmond,    Va.,   Savannah 

and  Sail    Luke  (  ity. 

Probably  the  most  accurate  data  concerning  the  cost  of  cremation 
may  be  found  in  the  reports  of  the  board  of  health  of   Lowell.     A  ere- 

1  The  methods  of  collection  and  the  disposal  "f  garbage  by  Cremation,  read  at 
the  sanitary  convention  of  boards  of  health  at   Erie,  Pa.,  28  April.  1892,  by  W.  F. 

Moi  se. 


716  REFUSE  DISPOSAL. 

matory  Avas  built  in  that  city  in  1892  at  a  cost  of  $7,615.90;  the  next 
year  3,500  tons  of  garbage  were  consumed  at  a  cost  of  $7,670.77, 
or  82.19  per  ton.  The  second  year,  1894,  when  everything  was  in 
better  running  order,  the  amount  burned  was  3,486  tons  at  a  cost  of 
$5,742.59,  or  «$1.64  per  ton.  In  the  largest  week  of  that  year  93  tons 
were  burned  at  a  cost  of  $1.05  per  ton.  The  chief  value  of  the  Lowell 
data  is  that  they  are  given  in  such  detail  week  by  week  for  several 
years.  The  items  for  fuel,  labor,  and  repairs  are  clearly  shown.  Thus 
of  the  total  expenses  in  1894.  viz.,  85,742.59,  $3,000.15  was  for  coal; 
$1,553.90  for  labor  ;  $158.05  for  the  lease,  and  the  remainder  for  repairs. 
Coal  cost  $4.70  per  ton.  In  1895  2,750  tons  were  burned  at  a  cost  of 
$3,662.53,  or  $1.33  per  ton.  Apparently  the  reduction  in  cost  of  crema- 
tion was  due  largely  to  the  increased  disposal  to  farmers  of  a  part  of 
the  garbage  containing  the  most  water  and  the  least  combustible  material, 
and  also  to  the  fact  that  householders  were  encouraged  to  put  paper  and 
other  combustible  material  in  the  garbage.  Lowell  has  to  pa}*  more  for 
fuel  than  the  great  majority  of  cities,  and  as  the  fuel  item  is  consider- 
ably over  half  the  total  expenses,  it  can  be  seen  that  a  reduction  of  one- 
half  in  that  item,  which  many  cities  can  easily  make,  would  rnaterialhy 
diminish  the  cost.  The  lack  of  funds  to  operate  the  crematory  at  the 
rate  of  expense  above  given,  lias  resulted  in  shutting  it  down  in  the 
winter  and  selling  more  and  more  garbage  to  farmers,  till  in  1899  only 
105  tons  of  swill  (from  hospitals)  and  485  tons  of  market  refuse  and 
many  mattresses  and  some  dead  animals  were  cremated.  The  cost  that 
year  was  $1,397.86,  of  which  $177.54  was  for  coal  and  $690  for  labor. 
The  cost  of  cremation  seems  to  be  high  in  Lowell,  but  if  the  figures 
were  as  carefully  presented,  and  if  the  character  of  the  material  was  as 
well  known,  the  apparently  much  lower  cost  in  other  cities  might 
possibly  be  readily  accounted  for.  An  attempt  was  made  at  Lowell  to 
sell  the  resulting  ashes,  but  with  little  success.  An  analysis  showed 
them  to  contain  10.21  per  cent,  phosphoric  acid,  and  potassum  oxide 
6.01  per  cent.1  Portland,  Ore.,  for  some  }*ears  bad  a  crematory  twelve 
miles  down  the  river  and  towed  the  garbage  down  on  scows  ;  but 
recently  a  new  crematoiy  has  been  built,  about  thirty  minutes  drive 
from  the  centre  of  the  city,  at  a  cost  of  $16,000.  The  health  com- 
missioner states  that  in  1899  12,520  cubic  yards  were  cremated  at  a 
cost  of  $5,400,  or  $0.06  per  capita.  If  the  garbage  was  of  average 
weight  the  cost  per  ton  is  about  $0.60.  In  Grand  Rapids  a  crematory 
was  built  at  a  cost  of  $14,780.  The  health  officer  cannot  give  the  cost 
of  operating,  but  states  that  a  single  test  gave  a  cost  of  $0.21  a  ton. 
His  report    for    1899-1900,   however,   states   that  the  expense  account 

1  Lowell.  Report  of  Board  of  Health  (1897),  p.  10. 


REE  USE  I)  isp  o  SA  L . 


717 


718  REFUSE  DISPOSAL. 

for  the  year  was  $3,962.11.  In  Richmond,  hid.,1  from  1  May,  1897,  to 
1  May,  1898,  8,031  cubic  yards  of  garbage  were  burned  with  natural 
gas  as  a  fuel,  for  $1,639.05.  Such  an  amount  of  true  garbage  could 
not  be  collected  in  a  city  of  25,000  inhabitants,  and  indeed  the  report 
states  that  4,964  cubic  yards  were  "dry  garbage"  which  leaves  3,067 
yards  "  wet  "  or  true  garbage,  or  about  2,200  tons,  which  might  he  ex- 
pected in  a  city  of  that  size.  As  the  4,(.h;4  tons  of  dry  garbage  would 
help  the  fuel  account,  nothing  definite  can  be  inferred  from  these 
figures.  A  crematory  was  built  in  Salt  Lake  City  in  1897  at  a  cost  of 
#1:2,000.  In  1898  11,059  cubic  yards  of  garbage  including  many 
dead  animals  were  cremated  at  a  cost  of  $4,418.21,  or  #0.39  per  cubic 
yard.  But  it  must  be  remembered  that  much  of  this  "  garbage "  is 
combustible  material.  Three  men  are  employed  at  the  crematory  who 
work  in  shifts  of  eight  hours. 

In  Richmond.  \'a.,  about  7,500  cubic  yards  of  garbage  were  cre- 
mated in  1899  besides  many  dead  animals,  at  a  cost  of$3,960.08.  Most 
of  the  time  only  one  man  is  employed  and  $2.75  a  ton  is  paid  for  coal. 
Not  much  over  half  of  this  garbage  is  true  house  garbage,  a  very  small 
amount  for  a  city  of  105,000,  so  that  the  apparently  small  cost  of  dis- 
posal per  capita,  $0,037  is  misleading.  It  is  probable  that  the  cost  per 
ton  is  over  #0.00,  although  1,227  cubic  yards  of  waste  paper,  etc.,  were 
burned,  thus  helping  out  the  fuel  account.  Mr.  Hering's  report  states 
that  the  crematory  at  Savannah  cost  $12,000,  and  that  120  yards  are 
burned  daily  at  a  cost  of  from  $20  to  $25. 

Dixon  Furnace. 

This  furnace  is  at  present  in  use  at  Bridgeport,  Conn.,  Camden, 
Dayton,  Fort  Wayne,  Joliet,  Lafayette,  Ind.,  Louisville,  McKeesport, 
Penn.,  Memphis,  Trenton,  Wilmington,  Del.,  York,  Pa.,  and  until  1899 
was  in  use  in  Atlanta.      One  is  soon  to  be  built  in  Spokane. 

In  operating  the  Dixon  furnace  three  fires  are  required.  Two  of 
these  are  at  the  end  of  the  furnace  farthest  from  the  stack,  and  they  are 
so  arranged  that  one  of  them  sends  its  flames  over  the  garbage  and  the 
other  under  the  grate  bars  on  which  the  garbage  rests.  These  fires  are 
made  with  coal,  wood,  or  gas,  and  are  started  in  the  morning  about  one 
hour  before  the  garbage  begins  to  arrive.  Another  fire,  usually  of  coke, 
is  kept  burning  at  the  foot  of  the  stack  to  consume  the  half  burned 
gases  from  the  garbage.  The  garbage  is  dumped  directly  from  the 
carts  into  the  furnace  where  it  rests  upon  the  grate  bars.  The  ashes 
fall  through  the  grate  bars  and  are  removed  through  openings  at  the 
sides  of  the  furnace. 


1  Proceedings,  Second  Annual  Convention  of  League  of  American  Municipalities 
1 898,  p.  35. 


REFUSE    DISPOSAL. 


10 


— ^___ — __  - 


13 


720  REFUSE  DISPOSAL. 

The  Atlanta  crematory  cost  $12,190  in  1895.  About  forty-eight 
tons  per  day  were  cremated  that  year,  at  a  cost  of  $0.34  per  ton.  Accord- 
ing to  the  board  of  health  report  about  one-third  of  this  weight  was 
night  soil,  and  it  must  be  remembered  that  garbage  in  Atlanta  includes 
all  dry  refuse  which  assists  the  combustion.  In  Atlanta  it  is  said  that 
the  crematory  burning  garbage  alone  without  night  soil  requires  no  ad- 
ditional fuel.  Such  an  operation  with  garbage,  as  the  term  is  under- 
stood at  the  north,  is,  of  course,  utterly  impossible.  According  to  the 
health  department  report  of  1897,  110,204  loads  of  garbage  were  col- 
lected in  that  year,  and  such  an  amount  could  only  be  collected  by  in- 
cluding a  large  amount  of  dry  refuse.  The  furnace  in  Camden  cost 
$9,990.  It  is  only  operated  a  part  of  the  time,  and  the  expense  is  said 
to  be  about  $1  per  ton.  At  Bridgeport  a  crematory  was  erected  under 
contract  to  cremate  garbage  at  a  cost  not  to  exceed  $0.35  per  ton,  but 
at  the  present  writing  it  is  stated  by  the  city  clerk  that  it  costs  about 
$0.45  a  ton.  The  crematory  at  Dayton  cost  about  $33,000.  In  1899 
it  cost  for  operation  $8,074.06,  of  which  $4,278.66  was  for  fuel,  which 
is  natural  gas,  $1,719.75  for  labor,  and  $2,076.25  for  repairs.  According 
to  the  report  of  the  superintendent,  73,519  barrels  were  consumed  in 
1899,  of  which  6,754  were  night  soil.  As  the  superintendent  of  the 
crematory  states  in  a  letter  published  by  the  Dixon  Company  that  the 
garbage  weighs  about  250  pounds  to  the  barrel  (1,000  pounds  to  the 
cubic  yard)  the  cost  per  ton  for  cremating  must  be  $0.80.  It  is  likely  that 
there  is  considerable  combustible  material  with  the  garbage,  otherwise 
the  great  bulk  of  14,191  cubic  yards  could  hardly  be  collected  in  a  city 
of  85,000  inhabitants.  Furthermore  true  garbage  would  weigh  over 
250  pounds  to  the  barrel.  This  would  tend  to  lower  the  price,  but  the 
night  soil  would  increase  it.  In  Fort  Wayne  in  1898  5,235  tons  of 
garbage  were  cremated  at  an  expense  of  $2,686.43,  of  which  $1,409.64 
was  for  fuel.  The  cost  per  ton  for  cremation  was  about  $0.50.  Mem- 
phis has  recently  constructed  two  crematories  of  thirty  tons  capacity  for 
$7,000  each,  and  two  crematories  of  twelve  tons  capacity  for  $2,700 
each.  The  cost  of  operating  the  crematories  is  not  separated  from 
the  other  expenses  of  the  health  department  in  that  city.  Trenton 
lias  a  small  crematory  which  has  been  advertised  as  cremating  garbage 
at  *0.30  per  ton.1  When  the  writer  visited  the  crematory  in  Septem- 
ber, 1899,  it  was  not  in  use,  and  is  not  used  by  the  contractor  when  he 
can  dispose  of  garbage  in  any  other  way.  Nothing  reliable  can  be 
learned  from  that  crematory.  In  Jacksonville  a  crematory  was  built  in 
1897  at  a  cost  of  $15,000.  In  1899  3,673  tons  were  cremated  at  a 
cost  of  $4,000,  or  $1.08  per  ton.     As  may  be  inferred  from  the  wagons 

1  Proceedings,  League  of  American  Municipalities,  Detroit  (1808),  p.  30. 


REFUSE  I) ISP  0 SA  L. 


721 


2       n 


722  REFUSE  DISPOSAL. 

shown  in  the  illustration,  the  garbage  contains  considerable  combustible 
material.  When  the  writer  visited  the  Wilmington  crematory  in  Sep- 
tember, 1899  (the  visit  was  not  expected),  he  found  it  being  operated 
without  any  offence  whatever.  The  only  objectionable  feature  was  the 
draining  of  garbage  carts  before  they  entered  the  building.  This  was 
done  on  a  platform  from  which  the  water  drained  to  a  sewer.  The  in- 
terior of  the  crematory  presented  as  neat  an  appearance  as  that  of 
Jacksonville  shown  in  the  illustration.  At  Wilmington  the  ashes  are 
sold  for  from  $6  to  $8  per  ton.  The}''  are  said  to  form  from  five  per 
cent,  to  ten  per  cent,  of  the  amount  of  garbage  burned.  No  data  could 
be  obtained  from  the  city  officials  in  regard  to  the  amount  of  garbage 
consumed  or  the  cost  of  cremation.  But  at  the  time  of  the  writer's 
visit  four  men  were  employed  and  a  foreman  who  stated  that  in  August 
942  tons  of  garbage  were  cremated  and  133  tons  of  coal  at  $2  per  ton 
were  required.  This  would  probably  make  the  cost  about  $0.60  per 
ton  exclusive  of  repairs.     The  crematory  cost  $16,000  in  1897. 

In  Camden  in  1900,  2,000  tons  of  garbage  were  disposed  of  at  a 
cost  of  $1,453.50  or  $0.73  per  ton.  In  Louisville  a  50-ton  crematory 
has  been  built  at  a  cost  of  $22,000,  and  is  guaranteed  by  the  Dixon 
company  to  cremate  for  thirty  cents  per  ton,  but  it  has  not  yet  (Feb- 
ruary, 1901),  been  accepted  by  the  city,  though  it  is  said  to  give  satis- 
faction. According  to  the  statement  of  the  health  commissioner  of 
Joliet,  garbage  is  cremated  in  that  city  for  $0.20  per  ton. 

The  Dixon  company  has  recently  designed  another  style  of  furnace 
in  which  the  garbage  is  first  partially  dried  in  a  chamber  over  the  cre- 
matory proper.     See  Figs.  91  and  92. 

M.  V.  Smith  Cremator)'. 

This  crematory  is  built  by  M.  V.  Smith  of  the  American  Stoker 
Company,  Washington  Life  Building,  New  York.  Crematories  of  this 
type  have  been  built  at  Atlantic  City,  the  District  of  Columbia,  Muncie, 
Ind.,  Philadelphia,  and  Wheeling.  The  furnaces  at  the  District  of  Col- 
umbia and  Philadelphia  are  no  longer  used.  The  following  description 
is  by  William  C.  Woodward,  health  officer  of  the  District  of  Columbia  i1 

Ll  The  crematory  may  consist  of  any  number  of  furnaces  arranged  in  pairs  around 
an  apparatus  for  the  generation  of  the  gas  used  as  fuel.  Each  furnace  is  an  upright 
iron  tank,  lined  on  the  inside  with  fire  brick,  and  is  connected,  on  one  side  by  under- 
ground flues,  one  leading  from  the  gas  generator  and  the  other  to  a  chimney  com- 
mon to  both  furnaces  of  the  pair,  and  on  the  other  side  by  a  short  flue,  with  the 
other  furnace  of  the  pair.  The  opening  for  the  reception  of  garbage  is  in  the  top  of 
the  furnaces.  The  ashes  are  raked  out  from  an  opening  low  down  in  the  side. 
There  is  no  grate,  the  garbage  resting  on  the  bottom  of  the  furnace  and  burning 
only  on  top.     In  the  flue  leading  to  the  chimney  is  a  mass  of  checkerwork  of  fire 


1  District  of  Columbia,  Report  of  Health  Officer  (1896),  p.  230. 


REF USE  J) ISP  0  SA  L. 


723 


_      b  v  -  a  ft" 

-*.  -  -z  ~  —--■■-  - 

-.  -  ■  -~   i   -  —  —   ■-  z. 

~-   -    "   J  -  -  £   -  -  -   :    _  -  f& 


i-    •-    i-   y    r.    r    —    n 


724 


REFUSE  DISPOSAL. 


Fig.  93. 

Diagram  illustrating  the  Gas  Producer  of  the  Smith  Crematory  and  its  connection  with  the  Checkerwork 

Chamber. 


brick,  to  insure  the  complete  destruction  of  offensive  gas.  Valves  to  control  the  flow 
of  gas  are  set  in  the  flues. 

"  The  crematory  is  built  so  as  to  allow  the  carts  to  drive  to  the  top  and  dump 
their  contents  directly  into  the  furnace,  and  is  not  inclosed  in  a  building.  Each  pair 
of  furnaces  is  independent  of  all  others.  All  are  dependent,  however,  on  the  proper 
operation  of  the  gas  generator. 

"  The  operation  of  any  pair  of  furnaces  is  as  follows:  Carts  drive  to  the  top  of 
the  crematory,  depositing  all  garbage  into  one  furnace,  filling  it  to  the  proper  height. 
The  gas  is  then  made  to  pass  directly  from  the  generator  through  the  flue,  where  it 
is  mixed  with  air  to  support  combustion,  to  the  charged  (proximal)  furnace.  The 
flame  attacks  the  mass  of  garbage  in  it,  and  then  passes  through  the  communicating 
flue  into  the  empty  (distal)  furnace,  and  thence  to  the  flue  leading  into  the  chimney. 
The  brick  checkerwork  in  this  flue  is  so  intensely  heated  by  the  flame,  and  secures 
by  its  arrangement  such  thorough  contact  with  the  gases  from  the  garbage,  that  they 
are  completely  decomposed  and  free  from  objectionable  odor,  and  so  find  their  way 
out  of  the  chimney. 

"  While  the  contents  of  the  proximal  furnace  are  being  burned  the  garbage  is 
emptied  into  the  distal  furnace,  where  it  is  warmed  and  partially  dried  by  the  flame, 
which,  as  has  been  previously  described,  passes  through  this  furnace  during  this 
time.  As  combustion  progresses  in  the  proximal  furnace  the  ashes  are  raked  off  the 
top  of  the  mass  ^through  the  door  in  the  side.  When  the  entire  charge  has  been 
burned,  the  direction  of  the  flame  is  reversed  by  means  of  valves,  so  that  it  passes 
into  the  furnace  which  has  just  been  filled.  This  now  becomes  the  proximal  fur- 
nace, and  the  place  of  combustion.  The  other  becomes  the  distal  furnace,  into 
which  the  garbage  is  dumped,  warmed,  and  partly  dried.  The  direction  of  the 
flame  may  be  reversed  as  often  as  desired.  The  operation  of  the  furnace  is,  there- 
fore, continuous. 

''The  operation  of  the  Smith  crematory  was  witnessed  in  September,  1894,  in 
Atlantic  City,  N.  J.     The  plant  is  owned  and  operated  by  the   city,  and  has  fully 


REFUSE  DISP  0 SAL. 


725 


:    - 

3  % 


—  a 
:r  -: 


s  - 
--■ 

-  _- 

d  B 

B  E 

x  -_ 

~  3 


726  REFUSE  DISPOSAL. 

demonstrated  its  ability  to  burn  pure  garbage  in  large  quantities  and  without  nui- 
sance. The  only  objectionable  feature  at  the  time  of  inspection  was  the  leaking  of 
water  from  the  garbage  around  the  lower  doors  of  the  furnace,  even  when  closed. 
This  water  saturated  the  soil  near  by,  giving  to  the  place  a  faint  sour  smell,  charac- 
teristic of  garbage.  The  crematory  is  located  in  the  immediate  vicinity  of  a  poor 
class  of  dwellings.11 

The  crematory  at  Muncie  cost  $5,000,  and  according  to  a  letter 
received  from  the  chairman  of  the  garbage  committee,  3,705  tons  were 
cremated  in  1899  at  a  cost  of  $3,532.49,  or  $0.90  per  ton.  The  cost  of 
repairs  included  in  the  above  was  $488.39,  which  is  about,  the  annual 
average. 

The  crematory  at  Atlantic  City  cost  $65,000  and  has  eight  cells  with 
a  capacity  of  twenty-five  tons  in  twelve  hours.  In  August,  1900,  3,700 
tons  were  consumed.  The  operating  expenses  in  1900  were  $11,280, 
of  which  $6,214  was  for  coal  (steam  coal  being  $3.25  per  ton),  $4,166 
for  labor,  and  about  $900  for  repairs.  The  amount  of  garbage  cremated 
Avas  11,463  tons.  This  furnace  is  exceptionally  large  for  the  annual 
consumption  of  garbage,  for  during  a  few  weeks  of  the  summer  it  must 
receive  the  garbage  of  over  200,000  people. 

Brown  Crematory. 

This  crematory  is  built  by  McBarron  &  Co.,  39  to  45  Oliver  Street, 
Boston.  One  was  built  in  the  District  of  Columbia  but  has  now  been 
abandoned.  Another  is  used  by  the  contractor  in  Troy  to  cremate 
such  of  the  garbage  and  refuse  as  he  cannot  use  for  rilling.  The 
crematory  in  Troy  cost  $10,000.  In  the  Brown  furnace  the  flames  are 
driven  over  the  top  of  the  garbage  to  the  end  of  the  furnace  and  then 
back  again  underneath.  The  furnace  is  surrounded  by  a  water  jacket. 
Dr.  Woodward  stated  that  its  operation  in  the  District  of  Columbia 
was  satisfactory  from  a  sanitary  standpoint.  No  figures  could  be 
obtained  of  the  cost  of  operating. 

Rider   Crematory. 

The  builder  of  this  furnace  is  W.  W.  Patrick  of  Pittsburgh.  The 
only  furnace  in  operation  is  at  Allegheny,  and  no  data  could  be  obtained 
by  the  writer,  but  according  to  Hering's  report  the  crematory  cost 
$5,300  and  the  cost  of  cremating  was  about  $0.25  per  ton. 

Brownlee  Crematory. 

Crematories  of  this  type  have  been  built  at  New  Brighton,  Staten 
Island,  Sail  Antonio,  Gainesville,  Tex.,  and  Terre  Haute.  The  cost  of 
the  crematory  in  the  latter  city  was  $7,000.  During  the  last  six 
months  of  1899  2,000  tons  of  garbage  were  cremated  at  a  cost  of 
$1,035.35,  or  about  $0.50  per  ton. 


REFUSE  DISPOSAL.  707 

Vivartos  Crematory. 

This  is  said  to  be  in  use  at  Scranton. 

Ideal  Cremator)-. 

A  crematory  known  as  the  Ideal  is  in  use  at  Findlay,  O.  About 
200  cubic  yards  per  month  are  burned  by  contract  at  a  cost  of  $117. 

McKay  Crematory. 

One  of  these  was  built  at  honkers  at  a  cost  of  $5,000.  Hering 
states  that  from  twenty  to  twenty-five  tons  per  day  in  summer  and  ten 
to  fifteen  in  winter  are  cremated,  at  a  cost  of  about  $3,000  per  annum. 
According  to  a  letter  from  the- eommissioner  of  public  works  the  cost 
of  operation  in  1900  was  $3,526.  The  United  States  commissioner  of 
labor  states  that  <>,200  tons  were  cremated  which  is  a  large  amount  for 
a  city  of  that  size.     These  figures  would   make  the  cost  per  ton  80.56. 

Lester  Furnace. 

The  only  furnace  of  this  kind  is  at  Atlanta.  It  was  built  in  1899 
by  the  Dennis  Cremation  Co.,  of  Atlanta.  The  city  does  not  own  t lie 
crematory  but  contracts  for  the  cremation  of  garbage  at  vl  2,000  per 
annum,  or  about  $0.12  per  capita. 

Risley   Furnace. 

There  is  a  furnace  of  this  type  at  Houston.  Tex.,  built  at  a  cost  of 
$8,000.  In  1900  there  were  consumed  19,348  cubic  yards  at  a  cost  of 
$3,362.62.  Of  course  a  large  pari  of  this  was  combustible  refuse  as  is 
common  in  southern  cities. 

Dry  Refuse. 

While  almost  all  cities  are  convinced  of  the  importance  of  the 
municipal  collection  of  garbage,  they  arc  by  no  means  all  convinced  of 
the  advantage  of  the  systematic  removal  of  other  forms  of  waste,  par- 
ticularly ;ishcs  and  general  rubbish.  When  such  material  is  collected 
by  the  city  and  separately  from  garbage  it  is  usually  called  dry  refuse, 
but  in  the  south  it  is  more  commonly  known  as  trash.  Sometimes  this 
material  is  -till  further  separated  into  ashes  and  dry  refuse  or  rubbish, 

the  latter  term  including  all  kinds  of  rubbish  except    ashes. 

[f  all  decomposable  refuse  was  ad  ually  put  into  the  garbage  pail  there 

would  not  be  so  much  need  of  the  municipal  collection  of  dry  refuse; 
but  such  is  never  the  case  even  in  those  cities  where  separation  is 
carried  <>ut  in  the  best  manner.     Some  offensive  matter  is  sure  to  gel 

into    tlie    ash    bill    or    ash     pile    and    create    more    or   less  of   a  nuisance. 

Moreover,  the  very  existence  of  an  ash  pile  is  a  temptation  to  throw  all 
kinds  of  refuse,  slops  or  garbage  upon  it.  Unless  there  is  municipal 
collection,  the  landlord  or  householder  is  prettj  certain   to  remove  the 


728  REFUSE  DISPOSAL. 

dry  refuse  only  once  or  twice  a  year  except  in  the  better  class  of 
houses.  There  thus  remains  almost  all  the  time  in  each  yard  or  cellar, 
a  pile  or  bin  of  ashes  and  rubbish  which  hi  three  cases  out  of  four  is 
more  or  less  offensive.  If  municipal  collection  cost  more  than  private 
collection,  there  would  be  some  reason  for  hesitancy  in  adopting  it,  but 
it  is  really  cheaper.  The  refuse  has  to  be  carted  away  in  any  event  and 
the  systematic  removal  at  short  intervals  is  not  only  far  more  satisfac- 
tory, but  appears  to  be  more  economical  than  the  slovenly  method  of 
private  removal. 

Dry  refuse  in  many  cities  includes  ashes  and  all  the  rubbish  which 
accumulates  in  private  houses  and  also  in  stores,  markets,  and  the  like. 
It  does  not  include  the  wastes  from  building  operations  which  are  of  ten 
expressly  excluded  from  the  collection  by  ordinance.  Usually  the  ashes 
from  steam  boilers  used  for  power  are  removed  by  the  producers  at 
their  own  expense,  but  in  Boston  the}'  are  collected  by  the  city,  but  the 
cost  of  collection  is  charged  to  the  owner.  In  Chicago  ashes  are  not 
removed  from  boilers  used  for  heating  purposes.  In  Salt  Lake  City  on 
the  contrary,  ashes  are  removed  from  the  business  section,  and  in 
Elizabeth,  N..  J.,  they  are  removed  from  factories.  Manufacturing 
wastes  of  all  kinds  are  usually  not  removed  by  municipal  collection. 
Garden  rakings,  primings  of  trees  and  shrubs  are  not  generally  collected, 
though  they  are  in  some  southern  cities.  In  Charleston  and  Florence, 
S.  C,  they  are  collected  if  put  on  the  street  after  6  o'clock  P.  M.  in 
the  summer,  and  5  p.  m.  in  the  winter.  Cut  grass  and  sweepings  are 
removed  in  Philadelphia.  In  Lynn  all  kinds  of  rubbish  are  removed  if 
placed  in  receptacles.     In  Buffalo1  the  contractor  removes 

"everything  in  the  nature  of  dirt,  refuse,  ashes,  garbage,  grass,  manure  from 
lawns,  leaves  from  trees,  branches  of  trees,  etc.,  which  maybe  found  upon  premises, 
as  provided  in  city  ordinances,  or  piled  on  street  under  permit  from  the  superintend- 
ent ofstreets.1' 

The  general  spring  house  cleaning  gives  rise  to  much  extra  domestic 
refuse,  and  this  may  in  Boston  be  put  on  the  street  outside  of  recep- 
tacles on  certain  days  as  shown  in  the  circular  given  below.2  A  similar 
collection  is  made  twice  each  year  in  Fitchburg. 

1  Buffalo,  Specifications  for  Contractor,  Sec  7. 

2  City  of  Boston. 
Notice  in  Housekeepers  urnl  Tenants. 
"  Housekeepers  and  other  occupants  of  dwellings  are  requested  to  place  their 
bouse  and  cellar  dirt  and  sweepings  in  the  streets  opposite  their  premises  between 
the  hours  of  sunrise  and  two  o'clock  p.  m.  of  the  following  days:  Monday,  May  3; 
Tuesday,  May  4;  Wednesday,  May  5;  Thursday,  May  6;  Friday,  May  7,  when  they 
will  be  removed  by  the  city  carts.     After  which  times  no  person  will  be  allowed  to 


REFUSE  DISPOSAL.  799 

In  Asbury  Park,  Boston,  Brockton,  Brookline,  Lawrence,  Lowell, 
New  York,  Richmond,  Utica,  Yonkers,  and  perhaps  some  other  cities, 
dry  refuse  at  least  in  certain  sections  of  the  city  is  collected  separately 
from  ashes.  In  Augusta,  Ga.,  in  1809,  an  ordinance  was  passed  to  re- 
quire persons  who  had  much  of  this  refuse  to  tie  it  in  bundles  or  park 
it  in  hags.  But  it  was  found  to  be  entirely  impracticable  to  enforce  it.1 
In  Ism;  Mr.  Waring  in  Xew'York  instituted  a  change  in  the  collection 
by  which  the  wastes  of  the  city  were  to  be  collected  in  three  separate 
divisions,  garbage,  ashes,  and  dry  refuse  or  general  refuse.  The  sep- 
aration of  other  dry  refuse  from  ashes  is  not  complete  as  yet,  but  never- 
theless large  quantities  are  collected  in  that  manner,  and  at  least  two 
furnaces  have  been  built  for  its  disposal.  In  Boston  in  *1S!>7  the 
separation  of  dry  refuse  from  ashes  was  begun.  The  rules  of  the  street 
elcamug  department  in  regard  to  such  separation  are  given  below.2 

The  card  shown  in  Appendix  115  is  also  very  generally  distributed 
about  the  city,  especially  among  school  children. 

In  Asbury  Park  only  the  dry  refuse  exclusive  of  ashes  is  removed 
by  the  city. 

The  average  weight  of  a  cubic  yard  of  dry  refuse  including  ashes 
is  given  as  1,000  pounds  in  Cincinnati,  800  pounds  in  Evansville,  750 
pounds  in  Boston,  and  in  Buffalo  500  pounds. 


place  any  dirt,  ashes,  filth  or  rubbish  of  any  kind  whatever  in  any  of  tbe  ways, 
streets  or  places  of  the  city,  without  a  permil  from  the  superintendent  <>f  streets. 

"Dirt  of  any  kind  not  to  be  placed  in  the  streets  mi  Saturday.11 

in  n.i amis  W.    Wells, 

City   Ham..    Boston,   1897.  Superintendent  of  Streets. 

Note,  This  circular,  printed  in  English,  Hebrew  and  Italian,  was  posted  in  prominent  places 
bj  tbe  regular  lull  posting  companies,  and  for  a  week  was  also  carried  on  the  Bides  of  nil  the  wagons 
and  cai  1-  owned  by  this  division. 

1  Augusta,  Report  of  Board  of  Health  (1899),  p.  59. 

'"On  and  after  Monday,  October  11,  1897,  nothing  but  garbage,  f I  cans,  and 

fddd  bottles  must  be  put  into  the  garbage  receptacles,  and  nothing  but  dust  and 
ashes  must  !><■  put  into  the  receptacles  for  ashes. 

■•All  papers,  light  waste,  and  other  general  refuse  must  be  placed  in  a  third 
receptacle,  or,  if  too  bulky,  must  be  tied  in  bundles  to  prevent  their  being  scattered 
in  handling,  and  must  be  protected  fr the  weather  until  collected  by  the  proper 

BUthorit  ies. 

"Revised  Ordinances  of  1892,  Chapteb  18,  Sectios  it.  No  person  shall 
place  or  keep  in  or  near  any  building,  ashes  or  cinders  in  such  a  manner  ;is  to  be 
liable  t"  cause  lire,  nor  mix  them  with  other  substances,  nor  place  or  keep  them  ex- 
cept in  metallic  vessels,  so  placed  :is  to  be  < ■ :  1  -s i  1  >  removed, 

"The  superintendent  <>f  streets,  therefore,  calls  attention  to  the  necessity  of 
keeping  ashes  and  other  refuse  matter  as  required  by  law,  and  gives  notice  that  no 
refuse  will  be  removed  unless  protected  from  the  weather,  and  placed  so  as  to  ho 
easily  removed,  and  kept  as  follows:  — 

\shis  must  he  kepi  free  from  all  other  refuse  matter  and  in  metallic  vessels." 


730  REFUSE  DISPOSAL. 

The  weight  of  dry  refuse  exclusive  of  ashes  is  165  pounds  per  cubic 
yard  in  Lowell,  300  pounds  in  Asbury  Park,  and  205  pounds  in  Boston. 

Receptacles. 

There  are  comparatively  few  regulations  in  regard  to  the  receptacles 
to  be  used  for  dry  refuse.  Galvanized  iron  cans  are  very  generally 
recommended  and  are  in  common  use.  For  this  use  they  are  not  open 
to  the  same  objections  which  attaches  to  their  employment  for  garbage 
cans  and  they  are  reasonably  durable.  All  sorts  of  barrels  and  boxes 
are  used  to  some  extent  in  almost  all  cities  ;  but  as  a  large  part  of  dry 
refuse  is  combustible,  and  as  hot  ashes  are  liable  to  be  placed  in  the 
receptacles,  or  ashes  accidentally  dropped  into  them,  it  is  much  safer  to 
have  them  of  metal  or  otherwise  made  fire  proof,  and  this  is  required 
in  Boston,  Brooklyn,  Buffalo,  Chelsea,  Chicago,  Denver,  Jackson, 
Jersey  City,  and  New  York.      The  Boston  rule  is  shown  on  page  729. 

The  New  York  City  ordinance  and  those  copied  after  it  require  the 
receptacles  to  "  be  made  or  lined  with  some  suitable  metal."  In 
Chicago  they  are  only  required  to  be  of  iron  in  the  central  districts  of 
the  city,  and  they  are  also  required  to  have  iron  covers.  In  Denver 
brick  bins  are  permitted  for  ashes,  otherwise  they  must  be  kept  in  metal 
receptacles.  Brick  bins  shaped  like  a  bee-hive  and  holding  about  a 
load  are  found  in  nearly  every  yard  in  that  city,  but  there  is  no  muni- 
cipal collection.  Doubtless  similar  rules  are  found  among  the  fire  regu- 
lations of  other  cities.  It  is  not  usually  required  that  refuse  receptacles 
shall  be  covered. 

The  size  of  the  receptacle  is  not  generally  specified,  but  in  Phila- 
delphia it  must  not  weigh  over  one  hundred  pounds.  In  Chicago  if  of 
a  greater  capacity  than  two  bushels,  it  must  be  provided  with  handles 
at  the  sides  midway  between  the  top  and  the  bottom. 

Local 'm  a. 

Receptacles  for  dry  refuse  are  less  objectionable  on  the  sidewalk 
than  are  garbage  receptacles.  Little  mention  was  made  of  their  loca- 
tion in  the  reports  made  to  Mr.  Hering's  committee,  and  it  was  not 
thought  worth  while  to  make  a  special  enquiry.  Probably  those  cities 
which  require  that  garbage  receptacles  be  placed  outside  the  premises 
require  that  refuse  receptacles  shall  be  placed  there  also.  Besides  these 
the  following,  which  require  that  garbage  shall  be  kept  on  the  premises, 
direct  that  ashes  shall  be  kept  on  the  sidewalk :  Cambridge,  Lowell, 
Philadelphia,  Somerville,  Syracuse,  and  Salem.  The  Cambridge  rule  is 
given  below.1 

1  Cambridge,  Ordinances,  Chapter  24: 

"  Sec.  28.  Whoever  desires  the  removal  of  ashes  accumulated  from  the  burning 
of  materials  for  heating  or  domestic  purposes  only,  and  other  house  dirt,  not  includ- 


REFUSE  DISPOSAL.  731 

In  Syracuse  it  is  required  that  the  empty  barrels  shall  not  remain  on 
the  sidewalk  over  an  hour.  The  barrels  must  also  never  be  more  than 
half  rilled.  In  Springfield,  Mass.,  the  ash  receptacles  are  kept  in  the 
cellar,  from  which  they  are  removed  by  the  contractor. 

Frequency  of  Removal. 

Dry  refuse  is  not  usually  collected  as   frequently   as  garbage.     The 

data  obtained  were  not  as  complete  as  for  garbage,  but  for  the  cities 
reporting  they  were  as  follows :  Refuse  is  collected  at  irregular  inter- 
vals in  Allegheny,  Columbus,  Nashville,  and  Omaha  ;  "  when  necessary  "' 
in  Davenport:  when  "set  out"  in  Milwaukee.  It  is  collected  six  times 
a  week  in  Brooklyn.  Holyoke,  Mass.,  and  New  York,  and  in  the  central 
district  of  Buffalo:  from  the  hotels,  stores,  and  tenements  of  Boston 
Haverhill,  and  Macon:  and  in  summer  time  in  Adrian,  Mich.  It  is 
collected  four  times  a  week  in  the  business  parts  of  Boston.  It  is  col- 
lected three  times  a  week  in  Newburgh,  Norfolk,  San  Jose,  and  certain 
parts  of  Manchester,  and  in  New  Brighton.  It  is  collected  twice  each 
week  in  Richmond,  the  greater  part  of  Buffalo,  Boston,  Brockton, 
Adrian  in  the  winter,  and  Paterson  in  the  summer.  The  most  common 
interval  between  refuse  collections  is  one  week.  Weekly  collections  are 
the  rule  in  Boston,  Cambridge,  Haverhill,  Macon.  New  London,  Newport, 
Newton,  Philadelphia,  Rochester,  Sioux  City,  Somerville,  Springfield, 
O.,  Utica,  Wilmington,  Buffalo,  and  Paterson  in  the  winter. 

Hours  for  Removal. 

The  hours  for  the  removal  of  ashes  are  usually  the  working  hours 
of  the  day, but  often  it  is  the  custom  to  colled  ashes  in  the  early  morn- 
inn-  hours,  especially  in  the  business  districts  of  the  great  cities. 

Vehicles  for  Dry  Refuse. 

In  almost  all  cities  dump  carts  are  used  for  collecting  the  dry  refuse, 
especially  when  it  includes  ashes.  Usually  these  carts  are  made  of 
wood,  though  in  Wilmington,  Del.,  Flanagan  metal  carts  are  employed, 

ing  offal,  shall  cause  the  same  i"  be  pul  in  suitable  boxes  or  barrels,  and  sel  upon 
the  sidewalk  adjoining  his  premises,  and  the  superintendent  of  streets  shall  cause 
such  removal  to  be  made  at  least  once  In  each  week,  on  -^i a i ••<!  days  for  different 
portions  <>f  the  city;  but  such  l><>\i-s  or  barrels  shall  ool  be  placed  upon  anj  side- 
walk so  as  unnecessarily  to  prevent  the  convenient  use  thereof  bj  travellers.  Wher- 
ever there  is  a  convenient  driveway  into  a  yard  connected  with  any  dwelling-house, 
the  superintendent  "f  stivHs  may.  at  Ms  convenience  and  upon  reasonable  notice, 
cause  ili"  city  teams  t"  be  driven  into  such  yard,  ami  t.>  remove  therefrom  the  ashes 
ami  rubbish  before  mentioned  thai  may  be  accumulated  therein,  at  the  times  herein- 
specified. 
•\n\  person  having  or  leaving  after  dark  any  ashes,  rubbish,  or  other  refuse  on 
:m\  street  shall  causes  lighted  lantern  to  !><■  kept  thereon  during  the  night 

■  I  n  <  iommon  <  louncil,  A  pril  i v.  1 899." 


732  REFUSE  DISPOSAL. 

and  occasionally  metal  carts  like  those  shown  on  page  683,  are  used. 
It  is  probable  that  in  a  large  proportion  of  cities,  perhaps  a  majority, 
covers  are  required  for  refuse  wagons,  though  it  was  not  definitely 
stated  in  Mr.  Hering's  report.  The  following  cities  at  least  require 
covers,  and  in  all  of  them  canvas  covers  are  permitted  and  used  :  Asbuiy 
Park,  Boston,  Brockton,  Buffalo,  Lowell,  Lynn,  New  Brighton,  Newport, 
Newton,  Paterson,  Philadelphia,  Richmond,  and  Somerville. 

In  the  following  covers  are  not  required :  Chelsea,  Dayton,  Fitch- 
burg,  Manchester,  Nashville,  and  Utica. 

In  most  cities  one  Horse  and  one  man  go  with  each  cart,  but  when 
larger  wagons  are  used  there  may  be  two  horses  and  two  men.  In  a 
few  cities,  as  Boston,  Cambridge,  and  Chelsea,  when  single  carts  are 
employed  with  one  driver,  other  helpers  accompany  the  cart  along  the 
street. 

In  Omaha  it  is  reported  that  the  refuse  wagons  carry  five  cubic 
yards ;  in  Philadelphia,  three  cubic  yards.  In  Boston  the  refuse  carts 
have  a  capacity  of  54  cubic  feet;  in  Lynn,  50  cubic  feet;  in  Cambridge, 
48  cubic  feet;  in  Paterson,  40  cubic  feet;  in  Richmond,  27  cubic  feet. 

In  Asbury  Park  where  ashes  are  excluded  from  dry  refuse,  iron 
carts  are  used  which  are  described  below.1  They  are  made  by  Thomas 
II ill  of  Jersey  City.  Similar  carts  are  used  in  Boston  and  New  York. 
In  Boston  wooden  paper  wagons  are  used,  made  by  the  street  depart- 
ment, which  cost  about  -1140. 


1  Asbury  Park,  Report  of  Board  of  Health  (1898),  p.  23: 

"  The  vehicles  which  have  been  especially  designed  for  use  in  the  collection  and 
removal  of  rubbish  in  Asbury  Park,  have  two  wheels  and  large  bodies  set  near  to  the 
ground  by  means  of  bent  axles. 

"  They  have  54-inch  wheels  with  4-inch  tread  and  the  top  of  the  body  stands  61 
inches  from  the  ground,  while  the  rear  of  the  bottom  of  the  body  is  15  inches  from 
the  ground. 

"Rubbish  is  thrown  into  the  carts  over  the  top  of  the  sides  of  the  body,  and 
when  loaded  a  canvas  cover  is  spread  over  the  load  and  snugly  tied  down  to  prevent 
the  light  material  from  blowing  off. 

"The  cart  is  provided  at  the  rear  with  two  hinged  doors  which,  when  open,  per- 
mit the  quick  discharge  of  the  load  from  the  rear. 

"These  carts  weigh  960  pounds,  40  pounds  of  the  weight  being  supported  from 
the  saddle  on  the  horse's  back.  Frequent  trials,  have  shown  that,  when  judgment  is 
used  by  the  driver  of  the  cart  in  loading,  the  cart  is  so  evenly  balanced  that  when 
loaded  not  more  than  four  or  five  pounds  of  the  gross  weight  rests  on  the  horse's 
back. 

"  The  additional  weight  which  is  placed  on  the  back  of  the  horse  by  a  driver 
weighing  128  pounds  occupying  the  seat  at  front  of  the  cart  is  found  to  be  30  pounds. 

"  The  inside  dimensions  of  the  body  are  as  follows:  Length,  91|  inches;  width, 
50|  inches;  depth,  40  inches;  giving  a  capacity  of  107.78  cubic  feet,  or  3.99  cubic 
yards." 


RE1  'USE  DISP  0 SA L . 


733 


Fig.  95. 

Paper  Cart,  As  bury  ['ark,  X.  J.     From  plate  loaned  by  the  maker  of  the  cart,  Thomas  Hill.  Jersey  City. 


Below1  is  a  list  of  the  cities  in  which  there  is  a  municipal  collection 
of  dry  refuse,  and  it  is  also  shown  whether  the  work  is  done  by  con- 
tract, and  what  department  lias  it  in  charge. 

Disposal  of  Dry  Refus< . 

When  dry  refuse  is  collected  separately  from  garbage  the  must  of  it. 
except  from  markets,  produce  dealers,  etc.,  where  a  perfect  separationis 
almost  impossible,  is  comparatively  (dean  and  may  very  properly  be 
um-(\  for  filling  low  land,  and  some  of  it  even  utilized  in  laying  side- 
walks and  cellar  floors.      Ashes  are  also  employed  in    the  floors  and  par- 


health  Department  A.sbury  i';u-k. •  Atlanta.1  Chelsea,1*  Florence,  S.  C.,1  Gal- 
restonj  Lawrence,  Lowell,1  Lynn,1  Macon,  Ga.,1  Maiden,  1  Newport,*  Newton,* 
Paterson,*  Richmond,!  Salem, 1  SaH  Lake  City,  1  Somerville,1  Syracuse.1 

Street   Department      Boston,  1    Brockton,  1    Brookline,1    Buffalo,4    Cambri< 
Camden,  1  Cincinnati, 1    Dayton, 1  Fall  River,  1    Fitchburg,     Hartford,11    Manchester,  1 
New  London,*  Qtica,*  Wilmington,  Del.* 

Street  Cleaning  Department:     Baltimore,  1  \<\\  Fork.1 

Department  of  Public  Works :  Davenport,4  Detroit,*  Milwaukee,    Ne^  Bedford, 
Norfolk  :  Philadelphia.* 

Fire  Department     Battle  Creek,  Mich.t 

Poor  Depart ment     Haverhill. t 

Execul  i\  •■  Board.     Rochestei , 

Ash  Committee  of  the  Council    Springfield,  Ma 

*  By  contract 

t  By  city  employees. 


734 


REFUSE  DISPOSAL. 


titions  of  fire-proof  buildings.1  The  ultimate  disposal  of  most  dry  refuse 
collected  by  municipalities  consists  in  dumping  on  low  land.  Usually 
such  land  is  conveniently  situated  in  the  city  or  its  immediate  suburbs, 
so  that  a  long  haul  is  not  required.  Usually  the  owners  of  such  land 
are  only  too  glad  to  have  it  brought  to  grade  in  this  way  and  readily 
donate  it  for  this  purpose.  Sometimes,  however,  the  city  is  required  to 
pay  something  for  the  privilege.  This  is  true  of  Fitchburg,  and  in 
Portland,  Ore.,  the  city  has  to  pay  •$  15  per  month  for  a  dump,  and  in 
Utica  $60  per  month. 

It  is  often  necessary  to  keep  a  man  stationed  upon  a  public  dump  to 
prevent  illegal  dumping  of  filth,  to  keep  the  dump  level,  to  burn  the 
paper  and  prevent  the  intrusion  of  scavengers.  This  usually  consti- 
tutes the  only  cost  of  this  method  of  disposal. 

As  might  be  expected,  it  is  sometimes  possible  for  a  city  to  sell  some 
of  its  ashes.  The  following  are  the  prices  asked  and  the  amount 
realized  in  certain  cities : 


City. 


Year. 


Price  Per  Load. 


Amount  Received. 


Brockton 1896 10c . 

Cambridge 1896 15c . 

Chelsea 1896 12c . 

Lynn 1895 

Somerville 1896 


.$  802  25 


1,278  81 
49  10 


Table  Showing  the  Amount  of   Dry    Refuse  Collected   and   the    Cost  of 
Collection  in  a  Number  of  American  Cities. 


City. 

Population, 

Census  of 

1900. 

Year  to 
which 
data 
refer 

Amount  Collected. 

Cost  of  Collection. 

Asbury  Park 

4,1482 

560,892 

508.'.  t57 

40,063 

19,935 

1,166,582 

352,219 

91,886 

325,902 

85,333 

285,704 

104,863 

79,850 

37,175 

45,712 

62,559 

1899 
1899 
1900 
1899 
1900 
1898 
1900 
1898 
1899 
1899 
1898 
1899 
1900 
1899 
1899 
1899 

7,402  cu.  yds. 
329,096  loads3 
218,507  cu.  yds. 

9,568  loads 
29,561  cu.  yds. 
1,488,600  cu.  yds 
307,341  cu.  yds. 
39,045  loads 
258,648  tons 
17,528  tons 
80,000  loads 

4,532  tons 
54,000  cu.  yds. 

$1,800  00 

208,350  47 

98,256  67 

Huston 

Baltimore 

Brookline 

11,202  60 

237,000  00 

50,000  00 

21,198  55 

Brooklyn 

Buffalo 

Cambridge 

Dayton 

10,162  00 

Detroit 

Fall  River 

Hartford 

Haverhill 

15,000  00 

4,500  00 

19,000  00 

14,300  00 

Holyoke 

9,600  tons 
12,000  tons 

1  Report   on  the  Final    Disposition   of     the    Wastes  of    New  York,    George  E. 
Waring,  Jr.,  1800,  p.  132. 

2  Resident  population.     The  summer  population  is  probably  over  30,000. 

3  A  load  equals  about  54  cu.  ft. 


REFUSE  DISP  OS  A  L. 


,.,.» 


City. 


Population, 

Census  of 

1900. 


Lowell 

Lynn 

Maiden 

Manchester,  X.  II 

Newton / 

Newport 

New  York  (Manhattan) 

Paterson 

Philadelphia 

Rochester 

Salem.   Mass 

Somerville  

Springfield,  Mass 

Syracuse 

Utica 

Wilmington,  Del 

York.    I'enn 


Year  to 

which 

data 

refer. 


94,969 
68,513 
33,664 
56,981 

33,587 

22,034 

1,850,093 

105,171 
1,293,575 

162,435 
35,956 
61,643 
62,050 

10S.:;74 
56,383 
76,508 
33, 70S 


1899 

1890 
1900 
1899 
1899 
1900 
1.898 
L899 
1899 
1899 
1S99 
L899 
1900 
1899 
1899 
1899 
1899 


Amount  Collected. 


26,572  loads 
:j:;.207  loads 
13,961  loads1 
18,000  cu.  yds. 

20,000  cu.  yds. 
876,400  tons 

625,459  cu.  yds. 
206,272  cu.  yds. 

10,582  cu.  yds. 

29,093  loads 

24,353  loads3 


5,726 


Cost  "f  Collection. 

110,903  30 

12,476  85 

4..Y77   7."i 

17,500  00 

4,900  00 

2,988  00 

592,500  00 

67,285  71 

2, HI  2   00 

7,840  83 

11,000  00 

18,508  25 

4. M 10  00 

7,500  00 

1,880  39 

Ashes  contain  a  considerable  amount  of  unconsumed  coal.  Experi- 
ments in  New  York  City  have  shown  that  the  average  ash  in  that  city 
contains  twenty  per  cent,  of  unburned  coal,  but  probably  much  of  this 
is  very  finely  divided.  Little  soft  coal  is  burned  in  that  city.  The 
attempt  is  made  to  utilize  this  coal  in  the  ashes  in  those  crematories 
where  mixed  wastes  are  burned  as  in  the  Thackery  crematory.  Other- 
wise ii"  attempt  has  been  made  to  save  this  waste. 

In  a  few  instances  dry  refuse  is  dumped  into  the  ocean  or  a  large 
river.  In  Sioux  City  it  was  reported  in  1896  that  it  was  dumped  into 
tin-  .Missouri  river,  but  the  method  was  not  approved  of.  In  Boston 
and  in  Lynn  where  the  best  of  the  garbage  is  sold  to  farmers  and  where 
the  best  of  the  dry  refuse  is  used  tor  filling,  the  rest  of  the  garbage  and 
dry  refuse  is  deposited  together  on  scows  and  towed  to  sea.  In  Boston 
in  1898  112,528  loads  of  refuse  or  twenty-eight  per  cent  of  the  whole 
39  1,937  Loads  collected,  was  towed  to  sea.  Sometimes  the  federal  gov- 
ernment steps  iii  and  forbids  the  dumping  of  refuse  into  navigable 
waters  as  has  been  done  in  New  York  i>\  the  supervisor  of  the  har- 
bor under  acts  of  Congress  of  28   June,  1888,   and    L8  August,  1894. 

Dumping  in  the  Ohio  and   .Mississippi    ri\ers,  lias    it   is    stated,  been   for- 
bidden, but    the    writer    has    not   been  able  to  find  the  acts.      The  details 

of  this  method  of  disposal  will  be  further  considered   in   the  discussion 

of  the  disposal  of  mixed  refuse. 


\  load  equals  27  barrels. 
-  i  ,,>i  ,,t  colled  ion  and  disposal  "f  msIi.'n  and  garbage,  127,500. 
a  load  equals  '■'•  cu.  yds. 


736 


REFUSE  DISPOSAL. 


Fig.  96. 
Barney  Dumping  Boat,  loaded. 


Fig.  97.    . 

Barney  Dumping  Boat,  loaded, 
sectional  view. 


Fig.  98. 
Barney  Dumping  Boat,  after  discharge  at  sea. 


Refuse  may  be  carried  to  sea  in  various  ways.  The  simplest  is  to 
use  ordinary  deck  scows  which  are  towed  to  the  dumping  ground  by  a 
tow  boat.  Such  scows  must  be  unloaded  by  hand  labor  which  often 
makes  their  use  expensive.  If  the  deposit  is  made  in  the  open  ocean 
the  danger  is  greatly  increased  from  the  number  of  men  carried,  the  un- 
seaworthy  character  of  the  vessels  and  the  time  taken  to  unload.  The 
City  of  New  York  owns  two  self  propelling  steam  dumping  1  touts,  but 
they  have  not  proved  entirely  satisfactory.  Probably  the  best  and 
cheapest  method  of  getting  refuse  to  sea  is  in  the  Barney  scows  made 
by  the  Barney  Dumping  Boat  Co.  of  New  York.  In  that  city  the 
street  cleaning  department  charters  thirteen  of  these  scows  at  $35  per 
day.  The  city  also  pays  $46  for  towing  two  scows  to  sea  and  back 
making  the  total  cost  of  disposal  #0.12  per  cubic  yard.  These  scows 
are  also  used  in  Boston  where  two  are  owned  by  the  city.  In  Boston 
in  1898,  373  trips  were  made  at  a  cost  of  #71.02  per  trip  or  15  cents 
per  cart  load  of  refuse  carried  to  sea. 

A  considerable  amount  of  dry  refuse  is  combustible  and  burning  is 
the  most  effectual  way  to  get  rid  of  it.  When  refuse  is  used  for  filling 
low  land  a  man  is  often  stationed  on  the   dump  to  burn  paper  brought 


REFUSE  DISPOSAL.  737 

there  in  order  to  prevent  its  blowing  away,  and  also  to  improve  the 
character  of  the  filling.  In  Asbury  Park  all  dry  refuse  which  is  col- 
lected separate  from  ashes  and  garbage  is  burned  in  this  way  in  the 
open  air  on  the  ground.  In  Evansville,  Lowell,  Muncie,  Yonkers,  and 
many  southern  cities,  the  combustible  part  of  the  dry  refuse  is  burned 
in  the  garbage  crematory  together  with  the  garbage,  thus  lessening  the 
cost  for  fuel.  In  Pittsburgh  some  of  the  combustible  dry  refuse  is 
burned  in  the  old  garbage  furnace. 

The  valuable  junk  material  found  in  dry  refuse  is  usually  re- 
covered to  a  considerable  extent  by  rag  pickers  who  swarm  over  the 
dumps  and  who  usually  make  themselves  a  nuisance  by  interfering  with 
the  leveling  of  the  dumping,  and  by  setting  fire  to  rubbish.  In  Troy 
the  contractor  sorts  out  the  junk  from  the  refuse.  Chicago  and  the  city 
of  New  York  are  the  only  cities  reporting  which  receive  an}T  income  from 
this  source.  Chicago  received  in  1896  the  sum  of  $100  a  month  for 
the  privilege  of  picking  over  the  dumps.      In  New  York  in  1H98, 

Lt  the  money  paid  by  the  contractor  for  the  privilege  of  picking  over  the  rubbish 
dumped  with  the  ashes  and  street  sweepings  at  the  various  dumps,  after  furnishing 
the  department  with  sufficient  labor  for  trimming  all  the  scows  and  dumpers  tarry- 
ing ashes,  street  sweepings  and  rubbish,  for  operating  the  chute  dump  at  Seven- 
teenth street.  East  river,  and  for  unloading,  at  night,  the  temporary  storage  bin  for 
garbage  received  during  the  day  at  Lincoln  avenue,  amounts  t<>  $53,691.62.  This 
gives  for  90,000  tons  an  average  payment  of  $0.56  per  ton." 

In  Boston  and  New  York  alone  is  the  attempt  made  to  utilize  the 
junk  found  in  dry  refuse.  In  both  these  cities  the  utilization  is  joined 
with  cremation  as  a  method  of  ultimate  disposal  of  the  lighter  portions 
of  dry  refuse  (excluding  ashes),  particularly  that  collected  from  busi- 
ness sections.  In  Boston  the  contract  went  into  effect  in  January, 
1899,  and  is  for  ten  years,  but  the  city  has  the  privilege  of  buying  on 
appraisal  at  the  end  of  live  years.  The  land  was  given  rent  free  by  the 
city,  but  the  buildings  and  machinery  were  erected  by  the  contractors. 
The  plant  is  situated  in  the  business  portion  of  the  city  near  one  of  the 
refuse  wharves. 

The  com  raetor  receh  es  $5,500  per  annum  for  destroy  ing  or  dispos- 
ing of  all  dry  or  combustible  refuse  which  is  delivered  b\  the  city 
wagons.  Recently  the  same  parties  have  made  a  contract  with  the  ad- 
joining town  of  Brookline  t<»  dispose  of  the  combustible  refuse  oi  that 
town  for  $1,875  per  annum,  the  town  agreeing  to  deliver  twenty-five 
loads  -  day.  It  is  proposed  t<>  build  a  new  destructor  in  Brighton  (a 
pari  of  Boston),  to  receive  the  wastes  of  Brookline  and  that  pari  of 
Boston.  The  plant  consists  of  a  Large  room  into  which  the  wagons  drive 
and  deposit  their  Loads.  A  Long  travelling  apron  runs  from  the  Eronl  of 
this  room  back   through  it   into  the  furnace  room  where  it   discharges 

47 


738  REFUSE  DISPOSAL. 

into  the  furnace.  This  apron  is  about  four  feet  wide.  The  power  for 
moving  the  apron,  for  baling,  and  for  furnishing  light  is  obtained  from 
the  furnace,  and  it  appeared  to  the  writer  that  a  large  amount  of  heat  was 
going  to  waste.  It  was  said  that  a  sixty-horse  power  boiler  was  kept 
continually  at  eighty  pounds  pressure.  Cheap  labor  is  employed  to 
stand  along  the  moving  apron  to  cull  out  paper,  rags,  rubber,  metal, 
glass,  etc.,  and  sort  it  and  prepare  it  for  sale.  There  appeared  at  the 
time  the  works  were  visited  to  be  no  nuisance  arising  from  them  out- 
side the  building.  The  dust  in  the  building  is  quite  annoying.  The 
city  employs  twenty-two  wagons  or  carts  to  collect  this  refuse  and  the 
amount,  which  was  about  seventy -five  loads  a  day,  has  greatly  increased 
since  that  time.  It  is  said  that  about  eighty  per  cent,  of  the  refuse  is 
marketable  and  that  the  value  of  the  daily  collection  is  not  far  from  $6.0. 
In  New  York  (Manhattan)  in  1898  there  were  collected  94,000 
tons  of  rubbish  at  a  cost  of  -$63,500.  It  is  disposed  of  in  a  manner 
similar  to  that  of  Boston. 

Mixed  Refuse. 

It  is  difficult,  if  not  impossible,  to  determine  why  some  cities  have 
elected  to  collect  and  dispose  of  all  their  house  refuse  together,  and  why 
others  separate  their  garbage  from  dry  refuse.  It  is  a  fact,  however, 
that  for  a  long  time  even  before  municipal  sanitation  received  much  at- 
tention, both  methods  have  been  in  vogue.  The  largest  city  in  the 
country  for  many  years  pursued  this  method  and  it  has  also  been 
adopted  by  many  quite  small  cities. 

When  mixed  refuse  is  collected,  garbage,  ashes,  and  dry  refuse  of 
all  kinds  are  mixed  together  in  the  receptacles.  Some  restrictions  are, 
however,  made,  and  probably  in  most  cities  builders'  wastes  and  garden 
waste  are  not  removed  together  with  the  garbage. 

The  weight  of  mixed  garbage  cannot  vary  much  from  ordinary  dry 
refuse,  although  in  the  long  run  it  must  be  somewhat  heavier.  The 
only  weights  given  in  Mr.  Hering's  report  were  in  Jacksonville,  where 
one  cubic  yard  is  500  pounds ;  in  Seattle  it  is  1,222  pounds  in  winter, 
and  781  in  summer;  in  New  Brighton  and  San  Francisco,  666  pounds; 
in  Salt  Lake  City,  650  pounds. 

"Receptacles  for  Mixed  Refuse. 

In  Petersburgh,  Seattle,  Tampa,  Trenton,  and  probably  in  several 
other  places  there  are  no  regulations  in  regard  to  receptacles.  In 
Chicago,  Jersey  City,  and  Memphis  the  regulations  are  modeled  after 
those  of  New  York  before  separation  of  garbage  and  other  wastes  was 
made  in  that  city.  The  receptacles  are  to  be  of  sufficient  size  to  con- 
tain the  refuse  without  being  filled,  to  have  covers  and  to  be  of  metal 


REFUSE  DISPOSAL.  739 

or  metal  lined,  but  in  Memphis  it  is  stated  that  the  rule  is  not  enforced, 
and  in  Chicago  ordinary  wooden  boxes  are  in  common  use.  In  Eliza- 
beth, Meriden,  and  Tacoma  galvanized  iron  cans  are  reccommended,  but 
they  are  not  in  general  use.  In  fact  the  regulations  and  the  reports  of 
the  different  cities  would  indicate  that  little  is  accomplished  in  the  way 
of  controlling  the  receptacles  for  mixed  refuse,  and  that  ordinary  bar- 
rels and  boxes  are  generally  used  for  this  purpose. 

Location  of  Receptacle. 

The  receptacle  must  be  placed  on  the  sidewalk  in  almost  all  cities, 
usually  on  the  curb  line.  It  must  be  set  out  in  time  for  the  collection. 
In  Chicago  it  must  be  promptly  returned  to  the  premises  when  emptied. 
Tin'  only  cities  in  which  the  receptacle  is  required  to  be  kept  on  the 
premises  for  the  collection  are  Chicago,  Jacksonville,  and  Memphis,  and 
in  the  two  latter  cities  the  rule  is  more  often  violated  than  observed. 

Hours  for  Collection. 

Usually  collection  of  mixed  garbage  takes  place  during  the  day,  but 
in  Mobile  it  is  between  .">  and  8  a.  .m.,  and  in  the  central  portion  of  Chicago 
before  7  a.  m.  ;  and  in  the  central  portions  of  Meriden,  Conn.,  before 
9  a.  M.  :  in  Charleston  before  10  A.  m.  in  summer  and  A'2  >r.  in  winter; 
in  Louisville  before  10  A.  m. 

I'r,  quency  of  <  Collection. 

.Mixed  garbage  is  collected  daily  in  Charleston,  Long  Island  City, 
Mobile,  and  formerly  in  New  York,  and  in  the  central  portions  of 
Chicago,  Raleigh,  Elizabeth,  Newark.  Meriden.  Sacramento,  Seattle; 
and  in  tiie  summer  time  in  Petersburg!}.  It  is  collected  three  times  a 
week  in  certain  parts  of  Chicago,  Jersey  City,  Louisville,  Newark,  and 
Orange,  h  is  collected  twice  a  week  in  certain  parts  of  Chicago,  in  the 
side  streets  <>l'  Elizabeth,  Raleigh,  and  Meriden.  in  Memphis  in  the  sum- 
mer, and  in  Petersburg!]  in  the  winter.  It  is  collected  once  a  week  in 
Troy,  from  the  residences  of  Seattle  and  in  the  winter  in   Memphis. 

Vehicles  for  Mixed  Refuse. 

The  regulations  in  regard  t<>  the  vehicles  required  for  mixed  refuse 
are  doI  much  more  strict  than  for  dry  refuse  wagons.  In  eight  cities 
covers  are  required,  canvas  in  all  cases  excepl  in  Troy  where  wooden 
covers  are  used.  In  Newark,  Jersey  City,  Meriden,  Tacoma,  Troy, 
San  Francisco,  and  formerly  in  New  York  Cityii  was  stated  thai  covers 
were  not  required. 

I  9ually  dump  carts  are  employed  with  one  horse  and  one  man.  In 
Jersey  <it\  and  New  York  the  Mill  cart  shown  on  page  683  is  used. 


740 


REFUSE  DISPOSAL. 


•Below1  are  given  a  number  of  cities  in  which  garbage  and  ashes  are 
collected  together,  and  also  the  department  which  has  charge  of  the 
work. 


Table    Showing   the    Amount    of    Mixed    Refuse    Collected    and    Cost 
Collection  in  a  Number  of  American   Cities. 


of 


City. 


Population, 
Census  of 

1900. 


Charleston 55,807 

Chicago 1,698,575 

Elizabeth 52,130 

Hoboken 59,364 

Jersey  City 206,433 


Knoxville. 

Louisville 

Newark 

Orange 

Passaic 

Perth  Amboy . 
Troy 


32,637 

204,731 

246,070 

24,141 

27,777 
17,699 


Year  to 
which 
data 
refer. 


1898 
1899 
1899 
1900 
1900 
1900 
1899 
1898 
1899 
1899 
1899 
1899 


Amount  Collected. 


17,428 

.,189,970 

25,000 


tons 
en.  yds. 
en.  yds. 


17,000 

86,380 

325,000 

3,000 

18,750 


en.  yds. 
tons 
en.  yds. 
tons 
cu.  yds. 


32,850  tons 


Cost  of  Collection. 


$5,152  00 

399,637  91 

6,000  00 

4,090  00 

20,000  00 
4,000  00 

40,086  00 

61,000  00 
3,500  00 
3,400  00 
2,300  00 

28,000  00 


Disposal  of  Mixed  Refuse. 

Dumping.  By  far  the  commonest  method  of  disposing  of  mixed 
wastes  is  by  dumping  on  low  lands.  That  such  a  method  of  disposal 
creates  a  nuisance  goes  without  saying.  It  usually  gives  rise  to  many 
complaints  and  is  rarely  satisfactory,  but  is  merely  tolerated  because  of 
its  economy.  If  land  which  needs  filling  is  to  be  found  within  easy 
hauling  distance  it  is  by  far  the  cheapest  method  of  disposal.  The  cost 
of  hauling  is  the  only  cost,  and  this  would  not  usually  be  greater  than 
for  some  other  method.  Generally  nothing  is  paid  for  the  privilege  and 
no  income  is  derived  from  it  though  occasionally,  especially  in  some  of  the 
larger  cities,  some  of  the  cleanest  ashes  are  sold  for  filling.  Sometimes 
one  or  more  men  are  kept  on  the  dump  to  superintend  it.  The  follow- 
ing cities  dispose  of  their  mixed  refuse  in  this  way :  Augusta,  Ga., 
Bayonne,  X.    J.,   Charleston,   Chicago,  Duluth,  Elizabeth,  Jersey  City, 


1  Charleston.     Street  Department,  city  employees. 
Chicago.     Street  Cleaning  Department,  city  employees. 
Elizabeth.     Health  Department,  contract. 
Hoboken.     City  Council,  contract. 
Jersey  City.     Street  Commissioners,  contract. 

Louisville  (previous  to  1901).     Department  of  Public  Works,  city  employees. 
Newark.     Department  of  Public  Works,  contract. 
Passaic  City.     Health  Department,  contract. 
Perth  Amboy.     Health  Department,  contract. 
Troy.     Contracting  Board,  contract. 


REFUSE   DISPOSAL.  741 

Long  Island  City,  Louisville,  Meriden,  Conn.,  Mobile.  Newark,  Passaic 
City,  X.  J.,  Perth  Amboy,  X.  J.,  Orange.  N.  J.,  Raleigh,  Tacoma  (in 
part),  Williamsport,  Pa.,  and  Wilmington,  X.  C. 

In  Providence  a  large  public  dump  is  cared  fur  and  kept  level  by  ;i 
contractor,  who  as  compensation  has  the  refuse  he  can  recover  from  it- 

Dumping  in  Water.  In  Memphis  until  1898  the  mixed  garbage 
was  dumped  in  the  Mississippi  river  about  one  mile  below  the  city.  In 
Xew  Orleans  it  was  formerly  dumped  into  the  Mississippi  and  caused 
no  trouble  or  offence,  but  it  was  forbidden  by  the  Federal  government 
as  it  was  considered  likely  to  injure  navigation.  In  Tampa  the  mixed 
garbage  is  dumped  into  the  bay  about  two  miles  from  land  and  the 
method  was  reported  satisfactory  in  1896.  In  Tacoma  a  part  of  the 
refuse-  is  deposited  in  Puget  Sound  and  in  Xew  York,  Boston  and  Lynn 
a   part  is  towed  out  and  dumped  into  the  ocean. 

Cremation.  In  Augusta,  (in.,  Oalveston  and  Macon,  parts  of  the 
garbage  and  dry  refuse  are  separated  from  the  ashes  on  the  dumps  and 
are  burned  together  in  the  open  air.  In  the  first  two  cities  the  method 
is  said  to  lie  satisfactory,  but  in  Galveston  not. 

In  Troy  a  part  of  the  mixed  wastes,  the  most  offensive  part,  i> 
cremated  ill  a  Brown  crematory.  In  this  city  the  contractor  uso  ;i^ 
much  of  the  refuse  as  be  can  for  filling  an  island  in  the  river,  and  the 
most  offensive  he  dumps  into  the  crematory  and  burns  it  twice  each 
week. 

In  S;m  Francisco  all  the  mixed  refuse  is  treated  in  a  Thackery 
crematory.  This  crematory  was  built  by  a  private  corporation  which 
has  a  fifty  years'  franchise.  In  San  Francisco  the  refuse  is  collected  by 
private  scavengers  who  are  obliged  to  deliver  it  to  the  crematory  and 
pay  twenty  cents  per  ton  for  its  destruction.  They  in  turn  collect  tins 
from  the  householder.  The  manager  of  the  works  states  that  aboul 
'.to. oihi  loads  of  one  ton  or  three  cubic  yards  each  are  collected  annually. 

The  crematory  consists  of  a  series  of  cells  or  furnaces  just  alike, 
into  which  the  refuse  is  discharged  through  a  hopper.  All  these  cells 
communicate  with  a  very  high  chimney.  After  the  lire  is  once  started 
no  fuel  ia  used  as  there  is  enough  combustible  material  in  the  refuse  to 
consume  the  garbage.  The  only  expense  is  labor  and  repairs.  A  large 
amount   ol  ash    results,  from   eighty-five   to  ninety    per  cent.,  and    the 

works  mUBl  be  located  where  that  Can  be  easih  disposed  of  for  filling. 
The  works  in  San  Francisco  arc  said  to  have  C08<  $200,000,  and  on  ;i 
six  day8'  test     the  cost     is  said    to    have    been     L5|  cents    per    ton.      The 

crematory  was  built  by  the  Thackery  Incinerating  and  Fertilizing  Corn- 
pan}  of  San  Francisco. 


742  REFUSE  DISPOSAL. 


Night  Soil. 


Night  soil  is  usually  understood  to  mean  the  human  excrement  con- 
tained in  privy  vaults  and  also  the  liquid  house  wastes  received  in  cess- 
pools, whether  such  wastes  come  from  water-closets  or  kitchen  sinks. 
Sometimes,  however,  the  contents  of  cesspools  is  spoken  of  as  "  cess- 
pool matter  "  or  "  cesspool  water."  It  is  not  nearly  so  offensive  as  true 
night  soil  from  privy  vaults,  and  its  value  as  a  fertilizer  is  far  less. 

The  only  true  solution  of  the  night-soil  problem  is  to  do  away  with 
vaults  and  cesspools,  by  utilizing  city  sewers  to  carry  off  all  such  wastes  ; 
but  in  all  cities  there  will  be  unsewered  areas  in  the  suburbs  where 
vaults  or  at  least  cesspools  are  a  necessity,  and  many  cities  are  as  }"et 
imperfectly  sewered,  even  in  their  thickly  settled  portions,  and  others 
still,  while  endeavoring  to  abolish  vaults  have  made  only  little  progress, 
so  that  the  question  of  how  best  to  remove  and  dispose,  of  night  soil  is 
still  an  important  one. 

Licenses. 

The  persons  who  engage  in  the  business  of  collecting  refuse  of  all 
kinds  are  called  scavengers,  though  this  name  is  perhaps  most  closely 
associated  with  the  business  of  removing  night  soil.  The  work  of 
scavengers  is  regulated  in  most  cities  by  ordinances,  and  the  first  step 
in  such  regulations  is  the  licensing  of  the  persons  who  engage  in  the 
business.  The  power  to  license  scavengers  and  otherwise  to  regulate 
the  cleaning  of  vaults  is  undoubtedly  contained  in  any  broad  grant  of 
sanitary  power  as  was  shown  by  a  decision  in  Maryland,1  and  it  is  usually 
exercised  by  virtue  of  such.  Nevertheless,  special  legislation  is  some- 
times found  on  this,  as  on  almost  all  other  sanitary  subjects.  Thus  in 
New  Jersey2  the  board  of  health  in  incorporated  municipalities  is 
empowered  to  make  rules  "  for  the  purpose  of  regulating  the  business 
of  emptying  privy  vaults,  sinks,  and  cesspools  in  any  municipality." 
Similar  provisions  are  found  in  Colorado,3  Ohio,4  and  Rhode  Island.5 

There  are  very  few  cities  which  do  not  require  a  license  for  a  person 
to  engage  in  the  business  of  removing  night  soil,  and  they  of  course, 
usually  forbid  the  cleansing  of  any  vault  or  cesspool  except  by  a  licensed 
scavenger.6     As  shown  in  this  rule,  the  owners  of  property  may  be  per- 

1  Boehm  vs.  Baltimore,  61  Md.,  259. 

2  New  Jersey,  Chapter  102  of  1898,  Sec.  1. 

3  Colorado,  Act  of  13  April,  1893,  Sec.  7. 

4  Ohio,  Annotated  Statutes  (1900),  Sec.  2G16. 

5  Rhode  Island,  General  Laws  (1896),  Chapter  92,  Sec  21. 

6  Providence,  Rules  of  Board  of  Aldermen  (1899),  Chapter  1,  Sec.  45: 

'  No  person  shall  engage  in  the  business  of  removing  the  contents  of  privy 
vaults  and  cesspools,  or  shall  remove  the  contents  of  privy  vaults  or  cesspools,  with- 


REFUSE  DISPOSAL.  743 

mitted  to  remove  the  contents  of  the  vaults  and  cesspools  owned  by 
them.  In  some  cities,  as  in  Hartford,  the  owner  of  a  vault  is  never 
allowed  to  empty  it. 

In  a  number  of  cities,  as  Denver,  Jersey  City,  Rochester,  Pennsyl- 
vania cities  of  the  first  and  second  class,  the  person  who  desires  a 
license  must  make  a  written  application.  See  Appendix  llti.  In 
Rochester  the  licensee  must  be  a  resident  of  the  county.  In  Philadel 
phia  he  must  be  of  good  character  and  must  not  only  have  suitable 
apparatus,  bur  must  keep  it  under  cover  and  out  of  view  when  not  in 
use.  The  license  must  be  duly  recorded,  and  as  is  the  case  with  all 
other  licenses  and  permits,  it  is  best  recorded  on  a  stub. 

In  most  cities  the  license  is  issued  by  the  board  of  health,  though 
sometimes  by  the  clerk  or  health  officer,  but  in  Chicago  and  Denver  it 
is  issued  by  the  mayor.  Sometimes  no  charge  is  made  for  a  license,  as 
in  Detroit.  Usually  there  is  a  fee  for  the  license,  in  many  cases,  how- 
ever, a  nominal  one,  as* fifty  cents  in  Meadville,  Pa.,  or  $1  in  Providence. 
In  Charleston,  Baltimore,  and  Hartford  it  is  $2;  in  Chicago,  $5  :  in 
.Milwaukee,  Mobile,  and  Xew  Haven,  $10;  in  Paterson,  $15  for  each 
wagon;  in  Jersey  City,  $20;  in  Minneapolis,  Reading,  and  Scranton, 
$25;  in  Buffalo,  Denver,  Philadelphia,  and  Ottumwa,  la.,  $50  for  each 
wagon. 

The  licensee  is  often  required  to  give  bond  for  faithful  compliance 
with  the  rules.  In  Mobile  it  is  $100,  in  Chicago  and  Denver  $500. 
In  almost  every  city  the  license  must  be  renewed  annually,  but  in  Boston 
and  Haverhill  it  is  given  for  three  years.  Often  the  privilege  of  revok- 
ing the  license  for  cause  is  reserved  by  the  licensing  power,  and  this  us 
especially  authorized  by  the  act  establishing  the  bureau  of  health  in 
Pennsylvania  cities  of  the  second  class.1  In  Denver  the  scavengers  are 
required  to  wear  badges  which  are  furnished  by  the  health  commissioner 
and  paid  for  by  the  scavenger  and  the  money  refunded  when  the  badge 
is  returned. 

Apparatus. 

'riic  mosl  primitive  method  of  removing  ami  disposing  of  aighl  soil, 
is  for  the  owner  of  the  vault  or  the  occupant  of   the  premises  to  dip  out 

ontents  and  spade  il  into  the  soil  of  the  yard  or  garden.  This  is 
not  ;i  bad  method  in  the  country  or  for  the  more  isolated  dwellings  "i 
villages,  or  tin- suburbs  of  cities,  and   is  occasionally  and   under  proper 

out  first  obtaining  a  license  of  the  board  01  alder n;  but  nothing  in  this  section 

shall  be  construed  as  forbidding  any  person  the  owner  of  a  privj  vault  or  of  a  cess- 
pool from  removing  the  contents  therefrom,  provided  ;t  permit  be  flrsl  obtained  from 
t  be  su  perintendenl  of  lieall  b.'1 

1  Pennsylvania,  Chapter  268  of  1896. 


744 


REF USE  DI8P  OSA  L. 


restrictions  permitted  even  in  cities  of  a  considerable  size.  In  most 
cases  such  a  simple  procedure  is  not  desirable,  and  as  has  been  stated 
in  most  cities,  there  are  persons  who  make  a  business  of  removing  night 
soil,  and  such  persons  are  licensed  and  their  method  of  doing  the  work 
regulated. 

Almost  without  exception  the  regulations  prescribe  that  the  receptacle 
to  be  used  for  conveying  night  soil  shall  be  tight  or  air-tight,  usually 
the  latter.  This  was  in  former  times  about  the  only  regulation,  and 
under  it  it  was  permissible  to  use  large  box  wagons  for  this  business. 
The  night  soil  was  baled  out  of  the  vault  in  a  long-handled  dipper,  and 
the  more  solid  portions  shoveled  out  and  carried  in  a  large  tub  and 
poured  into  an  opening  in  the  top  of  the  box  which  remained  standing 
in  the  wagon  in  the  street.  The  use  of  boxes  is  considered  very  un- 
satisfactory and  is  now  permitted  in  only  a  very  few  cities,  as  Bridge- 
port, Chicago,  Minneapolis,  New  Haven,  ( Htumwa,  la.,  Salem,  and 
St.  Paul. 

The  next  improvement  was  the  introduction  of  tubs  or  barrels  which 
could  be  carried  or  rolled  to  the  vault  or  cesspool  and  into  which  the 
night  soil  could  be  directly  dipped  with  a  bucket.  Such  are  used  ex- 
clusively in  Atlanta,  Cleveland,  Hartford,  New  Bedford,  Newport,  R.  I., 
Portland,  Providence,  and  Syracuse,  and  in  almost  all  cities  there  are 
some  vaults  in  which  the  contents  are  too  solid  to  be  pumped,  and  in 
such  cases  barrels  or  tubs  must  necessarily  be  used. 


Fig.  99. 

Night-soil  Tub  used  in  Providence.      Costs  $3.50,  and  holds  3J  cubic  feet. 


REFUSE  It isp  os.  |  L. 


74-1 


Fig.  100. 
Night-soil  Barrel  made  by  Odorless  Excavating  Co.,  <H  Federal  Street,  Boston 


Fio.    101. 

*i 1 1 1 1 1 >  and  Tank  Wagon  made  hj  the  Odorless  Excavating  <  ■  >  .  G4  Federal  Street,  Boston  ["his 
apparatus  is  used  In  Boston,  Cambridge,  Brookline,  Newton,  Somerville,  QHlncy,  and  other 
Massachusetts  cities  and  towns. 


746  REFUSE  DISPOSAL. 

In  Atlanta  two  sets  of  barrels  are  used.  The  full  set  is  left  at  the 
dump  and  a  clean  set  put  on  the  wagon.  In  Syracuse  the  barrels  must 
be  carried  in  a  covered  box  wagon. 

Nearly  all  cities  now  require  the  use  of  the  so-called  odorless  or 
pneumatic  apparatus,  though  sometimes,  as  in  Camden,  it  is  only 
required  during  the  summer.  The  odorless  method  consists  in  the  use 
of  a  pump  and  a  hose  and  tank  wagon.  The  suction  from  the  pump  is 
placed  in  the  vault  or  cesspool  and  the  outlet  is  attached  to  the  tank  and 
and  the  night  soil  is  pumped  into  the  tank  without  being  exposed  to  the 
air.  As  the  night  soil  is  forced  into  the  tank,  the  air  of  the  tank  which 
is  of  course  offensive,  is  forced  out,  and  sometimes  is  made  to  pass 
through  a  small  charcoal  fire  or  through  some  deodorizer. 

Sometimes  instead  of  the  tank  wagon  barrels  are  used  to  which  the 
hose  can  be  screwed.  Their  use  is  very  common  in  the  District  of 
Columbia,  Fall  River,  Baltimore,  Asbury  Park,  and  Camden. 

With  cesspools  of  course  the  contents  can  be  readily  and  completely 
removed  by  means  of  the  pump,  but  in  the  case  of  vaults  there  is  almost 
always  some  solid  refuse  or  some  extraneous  substances,  as  tin  cans  and 
the  like,  which  cannot  be  pumped.  As  has  been  shown  in  a  previous 
chapter,  it  is  often  made  an  offence  to  put  such  substances  in  a  privy 
vault,  and  in  Fall  River  the  following  effectual  method  is  taken  to 
secure  the  enforcement  of  the  law  :] 

"  When  a  vault,  privy  or  cesspool,  shall  be  found  to  contain  an  excessive  amount 
of  tins,  crockery  or  other  rubbish,  the  health  agent  or  inspector  shall  report  the 
same  to  the  board,  and  a  tine  of  two  dollars  may  thereupon  be  imposed  at  the  dis- 
cretion  of  the  board  upon  the  owner  of  said  property,  and  the  proceeds  thereof  shall 
be  equally  divided  between  the  board  and  the  scavenger  cleaning  said  receptacle.11 

Even  when  all  such  matter  is  excluded  from  vaults,  a  considerable 
part  of  the  contents  and  perhaps  the  whole  contents  may  be  solid  unless 
the  vault  is  absolutely  water-tight.  Many  vaults  intended  to  be  water- 
tight are  not  so,  and  very  many  are  built  so  as  to  permit  the  fluid  con- 
tents to  leach  away,  so  that  it  is  often  impossible  to  remove  the 
entire  contents  with  a  pump.  Sometimes,  as  in  Woonsocket,  R.  I., 
water  is  pumped  into  the  "  dry  vaults  "  beforehand  to  facilitate  the 
pumping  the  next  da}- ;  but  in  any  event  it  happens  that  something  is 
left  behind  by  the  pump  which  has  to  be  removed  with  a  shovel.  To 
render  such  removal  as  inoffensive  as  possible,  the  pitting  outfit  was 
devised. 

This  consists  of  a  sort  of  tent  set  up  over  the  opening  into  the  vault 
and  provided  with  a  ventilator  leading  to  a  deodorizer.  The  use  of  this 
is  required  by  rule  in  Baltimore,  Newark,  New  Orleans,  Haverhill,  and 

1  Fall  River,  Regulation  of  Board  of  Health  (1804),  Sec.  58. 


REFUSE  DISPOSAL.  747 

Philadelphia,  but  as  a  matter  of  fact  it  is  seldom  used  in  any  of  these 

cities. 

In  Portland,  Me.,  night  soil  is  removed  by  the  old  fashioned  dipping 
process  and  screens  are  required  around  the  vault. 

Among  the  most  complete  rules  for  apparatus  for  removing  night  soil 
are  those  found  in  Philadelphia.  See  Appendix  117.  It  is  almost  always 
required  that  the  apparatus  shall  be  kept  well  painted,  sometimes  of  a 
distinctive  color,  and  shall  have  upon  it  the  name  of  the  licensee  and 
the  number  of  the  license,  and  the  height  of  the  letters  or  figures  is 
often  specified,  and  varies  from  two  to  six  inches.  In  Providence  -  all 
apparatus  must  have  the  name  of  the  licensee  upon  it  in  plain  letters."*  ' 
which  is  interpreted  as  requiring  the  name  upon  every  tub,  barrel,  and 
wagon.  The  capacity  of  the  wagon  in  cubic  feet  must  also  be  marked 
upon  it  in  many  cities.  In  a  number  of  cities  where  night  soil  is  re- 
moved at  night,  as  Chicago,  Jersey  City,  Milwaukee,  Mobile,  and 
Rochester,  it  is  required  that  the  scavenger's  wagon  shall  In-  provided 
with  lamps.     The  Chicago  rule  is  given  below.2 

Wagons  "ml  Apparatus  Must  be  Krj>t  Clean. 

'•The  entire  apparatus  and  appliances  shall  at  all  times  present  a  clean  appear- 
ance, be  free  from  obnoxious  odors,  and  always  in  good  and  efficient  working  order. 
Tin  workmen  shall  be  well  instructed  in  their  duties,  and  orderly  while  in  the  per- 
formance of  their  work."3 

In  Jersey  City,  Minneapolis,  Cincinnati,  and  some  other  cities  it 
is  required  that  the  wagons  must  be  washed.  In  Cincinnati  "all  carts, 
tanks,  and  vessels  used  lor  the  purpose  must  be  water-tight  and  the 
same  must  be  thoroughly  washed  and  disinfected  immediately  after 
being  emptied."4 

The  rule  given  below,  originally  enacted  in  the  sanitary  nu\i-  of 
New   York,  has  been   quite  generally  copied    by  other  cities.'     In  Wil- 

1  Providence,  Rules  of  Hoard  of  Aldermen  (1890),  Chapter  l.  See.  48. 
I  uicago,  <  >rdinances  (1881 1,  Sec.  1870: 

•  Scavengers  \\  ho  engage  in  the  business  of  remoi  ing  the  contents  of  privy  vaults 
at  night,  shall  cause  to  be  painted  upon  the  wagon  box  of  their  wagons,  in  letters 
and  figures,  their  names  and  the  number  of  their  licenses,  together  with  a  lighted 
la  m  [i  with  plain  glass  fronts  and  sides,  with  the  number  of  the  license  of  such  wagon 
painted  with  black  paint  on  the  sides  and  front  of  each  of  said  lamps,  in  distinct  and 
legible  figures  at  least  two  inches  in  size,  and  so  placed  that  said  lamps  maj  be  dis- 
tinctly seen,  and  said  Dumber  easily  re;id." 

•  Philadelphia,  bales  of  Health  Department  (1895),  see.  224. 
1  Cincinnati,  Manual  of  Health  Departmeni  (1898),  p.  LI. 

New  Fork  City,  Sanitary  (•■d--  (1899),  Sec.  124: 
••  That  do  carl  or  other  vehicle  for  carrying  anj  offal,  swill,  garbage,  or  rubbish, 
or  the  contents  of  any  privy,  vault,  cess] I,  or  sink,  or  having  upon  it  or  in  any- 
thing "ii  such  cart,  an]  manure,  oi   other  nauseous  or  offensive  substance,  shall, 


748 


REFUSE  DISPOSAL. 


mington,  Del.,  the  carts  "  when  not  in  use  must  be  kept  under  cover 
and  from  public  view."  In  Milwaukee  scavengers'  wagons  must  be 
kept  outside  the  city  unless  they  are  "  rendered  inodorous  by  the  use  of 
carbolic  acid  or  some  other  equally  efficient  deodorizer,  and  kept  in  a 
tight  barn  or  building."  In  Lowell  scavengers  must  "  avoid  as  far  as 
possible  travelling  in  the  principal  streets  when  crowded." 

In  very  many  cities  it  is  required  that  the  apparatus  be  inspected 
by  the  proper  officers  before  the  license  is  granted.  Besides  the  prelim- 
inary inspection  and  approval,  it  is  necessary  for  the  apparatus  to  be 
inspected  every  three  months  in  New  Bedford,  and  every  month  in 
Cincinnati,  Jersey  City,  Minneapolis,  and  Wilmington,  Del. 

Methods  of  Removal. 

In  most  cities  the  removal  of  night  soil  is  left  to  private  enterprise. 
All  the  city  attempts  to  do  is  to  control  the  work  by  license  and  in- 
spection, and  perhaps  by  fixing  a  maximum  price  for  which  the  work 
shall  be  done.  The  following  are  some  of  the  prices  fixed  by  ordinance 
or  board  of  health  regulations  : 


If  over  75  cubic  feet  the  charge  is  $4. 
Fixed  by  agreement  of  scavengers. 
$3  for  subsequent  loads. 


Price  per 

Cubic  Yard. 

$5.40 

Newburgh. 

4.00 

Milwaukee. 

Minneapolis. 

Denver. 

District  of  Columbia. 

3.24 

New  York  City. 

Yonkers. 

Philadelphia. 

Spokane. 

8.00 

Buffalo. 

Chicago. 

Mobile. 

2.70 

Elmira,  X.  Y. 

Fitchburg. 

<  Htumwa,  la. 

St.  Paul. 

Wilmington,  Del. 

2.4:; 

AVarren,  (). 

If  over  100  cubic  feet,  $2.16;  over  150  cubic 

feet,  $1.35. 
If  less  than  20  cubic  feet  the  minimum  is  $2. 
If  work  is  done  by  day,  $2.16. 
The  minimum  is  $2. 


without  necessity  therefor,  stand  or  remain,  nor  shall  a  needless  number  gather 
before  or  near  any  building,  place  of  business,  or  other  premises  where  any  person 
may  be;  nor  shall  any  such  cart  or  vehicle  occupy  an  unreasonable  length  of  time  in 
loading  or  unloading,  or  in  passing  along  any  street  or  through  any  inhabited  place 
or  ground;  nor  shall  any  such  cart  or  vehicle,  or  the  driver  thereof,  or  anything 
thereto  appertaining  be  (or  by  any  person  having  a  right  to  control  the  same,  be 
allowed  to  be),  in  a  condition  needlessly  filthy  or  offensive;  and  when  not  in  use,  all 
such  carts,  vehicles,  and  all  implements  used  in  connection  therewith,  shall  be  stored 
and  kept  in  some  place  where  no  needless  offense  shall  be  given  to  any  of  the  people 
of  said  city.1' 


l'rice  per 
Cubic  Yard. 

»2.00 

Boston. 

Holyoke. 

1.90 

Cleveland. 

1.65 

Grand  Kapids. 

1.45 

Manchester. 

1.35 

Lowell. 

Providence. 

Somerville. 

REFUSE  DISPOSAL.  749 


Over  240  cubic  feet,  $1.55. 

If   over  80  cubic  feet,   SI. 65;    over  120  cubic 
feet,  §1.50. 


Barrels  with  solid  matter  are  20  cents  each,  and 
the  minimum  charge  for  all  work  is  83. 


Iii  New  Bedford  the  price  is  $2  for  a  load  of  twelve  tubs,  and  in 
Hartford  #2  for  ten  tubs ;  in  Newton,  Mass.,  $3  per  load,  but  the  size 
of  the  tubs  and  loads  is  not  given;  in  Manchester  $3.50  per  load  of 
twelve  barrels.  In  Florence,  N.  C,  fifteen  cents  per  month  is  charged 
for  every  privy  and  the  work  is  done  by  the  city. 

It  is  possible  to  exercise  a  better  control  over  the  business  if  a  license 
is  issued  to  only  one  party,  and  that  is  the  method  pursued  in  Boston, 
Cleveland,  District  of  Columbia,  Hartford,  Haverhill,  Newton,  Mass., 
Portland,  Me.,  Richmond,  Ya.,  Somerville,  Mass.,  Springfield,  Mass., 
and  Warren,  O.  In  Pittsburgh  there  are  two  licensees.  This  license, 
or  contract  as  it  is  often  called,  is  usually  for  one  }*ear,  but  in  some  of 
the  Massachusetts  cities  it  is  for  three  years.  The  form  of  the  hist 
contract  in  Boston  may  be  found  on  page  93  of  the  report  of  the  board 
of  health  for  1898. 

Whether  or  not  there  is  one  licensee  or  many,  the  city  often  assists 
and  controls  the  work  through  its  own  employees.  Thus  orders  for 
work  are  frequently  received  by  the  city  at  police  stations,  as  in  Cam- 
bridge; or  at  the  board  of  health,  as  in  Boston  and  Cincinnati,  and 
either  sent  to  the  contractor  or  called  for  by  him.  This  is  to  facilitate 
work  and  assist  the  citizens  rather  than  the  licensee.  A  different  plan 
is  pursued  in  Warren,  ( >.  i1 

"The  owner  of  a  closet  desiring  the  same  cleaned,  applies  to  the  sanitary  office, 
where,  in  a  book  for  that  purpose,  is  kepi  a  record  "f  the  drawers  and  dimensions 
of  all  vaults  in  the  city.  The  sanitary  policeman  gives  the  owner  a  check  "r  slip 
from  a  stuiehrmk  of  hkinks.  wIico-mm   is  stated   the  name,  street  and   number,  the 

amount  in  vault  or  drawer,  as  the  rase  may  be,  and  the  amount  of  money  to  l>e  paid. 

The  holder  takes  this  check  or  slip  to  the  hank,  pays  the  amounl  required,  the  hank 
stamps  the  slip  ••  paid,"  and  drops  it  in  a  hoard  of  health  metallic  safety-box,  with 
Vai<-  loch  similar  to  government  Letter-box,  onlj  smaller  fastened  in  the  bank 
or  some  convenient  place.  The  contractor,  who  has  a  kej  to  this  box,  goes  to  it 
and  gets  the  slip.     This  slip  indicates  to  him  bis  order  for  work,  and   place  where, 

and  also  the  important  fact  that  the  cost  of  said  work  is  deposited  in  the  bank.  \i 
the  end  ol  « - : i .  h  month  the  president  of  the  hoard  of  health  ^i\es  the  contractor,  in 
exchange  for  the  month's  slips,  a  check  on  said  hank  for  the  amount." 

Paper  read  bj  William  T.  Fee  of  Warren  at  a  meeting  of  Local  Hoards  of  Health 
of  ohio.  Columbus,  1895. 


750  REFUSE  DISPOSAL. 

In  Cleveland  the  owner  calls  at  the  health  department  and  makes 
his  payment  in  advance,  which  can  well  be  done,  for  all  vaults  in  that 
city  are  of  standard  size,  and  the  health  officer  sends  the  contractor  to 
do  the  work,  and  an  inspector  to  see  that  it  is  done.  One  clerk  is 
detailed  to  look  after  this  part  of  the  office  work. 

The  nature  of  this  business  is  such  that  employers  do  not  care  to 
give  the  work  much  attention,  and  hence  are  liable  to  be  imposed  on  in 
some  instances,  and  in  others  to  imagine  that  they  are  imposed  upon. 
The  city  occasionally  steps  in  to  help  settle  the  dispute.     In  Cambridge  : 1 

"For  the  purpose  of  allowing  the  property  owners  an  opportunity  of  ascertain- 
ing the  quantity  taken  from  any  privy  vault  or  cesspool  any  police  officer  is  author- 
ized to  detain  for  not  more  than  thirty  minutes  any  wagon  or  tank  used  for  removing 
the  contents  of  privy  vaults  or  cesspools.11 

In  Yonkers,  N.  Y.,  "  No  scavenger  shall  be  entitled  to  receive  com- 
pensation for  such  services  until  his  verified  account  therefor  has  been 
approved  and  certified  to  by  the  health  officer."2  See  Appendix  118. 
In  Boston : 

"Said  board  of  health  on  complaint  of  a  person  charged  for  such  work,  may 
cause  the  work  to  be  measured,  and  if  it  measures  less  than  reported  by  said  com- 
pany, said  company  shall  pay  the  cost  of  measurement,  and  the  charge  shall  be 
abated  accordingly.113 

In  Philadelphia  where  a  large  number  of  orders  (2,095  in  1896), 
are  issued  by  the  board  of  health  to  remove  the  contents  of  privy  vaults 
the  rules  sriven  below  are  in  force.4 


Cambridge,  Rules  of  Board  of  Health  (1897),  Sec.  27. 

2  Yonkers,  Sanitary  Code  (1897),  Sec.  30. 

3  Contract  with  Odorless  Excavating  Company,  Boston,  Board  of  Health  Report 
(1896),  p.  94. 

4  Philadelphia,  Rules  of  Board  of  Health  (1895),  Sec.  137: 

"  The  measurers  shall,  under  the  direction  of  the  health  officer,  measure  all  wells 
cleaned  by  order  of  the  board,  and  shall  furnish  said  officer  with  a  duplicate  copy  of 
an  account  of  the  measurement.  If  the  cost  of  cleaning  said  wells  exceeds  the  sum 
of  twenty  dollars,  they  shall  receive  as  compensation  therefor  a  sum  equal  to  six 
per  cent,  of  the  amount  of  the  bills.  In  all  other  cases  the  sum  of  one  dollar  only 
shall  be  paid  equally  by  the  cleaners  and  the  owners  of  the  property  froin  whence 
the  nuisances  are  removed.  They  shall  not  grant  a  certificate  of  measurement  until 
the  rule  of  the  board  "  requiring  the  entire  contents  of  the  well  to  be  removed,11 
has  been  complied  with,  unless  otherwise  ordered  by  the  board. 

"They  shall  refuse  a  certificate  of  measurement,  unless  furnished  with  the 
original  order  and  permit  to  £lean  said  well. 

"They  shall  present  the  health  officer  with  the  certificate  of  measurement, 
accompanied  by  the  original  order  and  permit  for  cleaning  said  well,  within  forty- 
eight  hours  after  the  receipt  of  the  order  from  the  cleaner.11 


UK FVsK  DISPOSAL.  751 

Two  measurers  are  appointed  by  the  board  of  health  for  this  pur- 
pose. They  are  also  obliged  to  report  all  violations  of  rules.  Of  2.207 
inspections  in  1895  they  reported  only  three  violations.  In  Denver  the 
scavenger  is  required  to  give  a  receipt  to  the  owner  of  the  vault. 

A  few  cities  proceed  one  step  further  and  provide  for  the  municipal 
removal  of  night  soil,  though  this  has  never  been  as  popular  as  the 
municipal  collection  of  garbage  and  dry  refuse.  It  is  the  plan  pursued 
in  Atlanta,  Brockton,  Florence,  X.  C,  Lawrence,  Lynn,  Macon,  Mans- 
field, O.,  Rochester,  Salem,  Mass.,  and  Youngstown,  ( ).] 

Frequency  of  ('/cm In;/. 

(  Mi  page  186  were  given  regulations  in  regard  to  the  minimum  distance 
from  the  top  of  the  privy  vault  which  the  contents  might  be  permitted 
to  reach.  As  regards  the  time  limit,  quite  a  number  of  cities  require 
that  privy  vaults  shall  be  cleaned  annually.  In  Asbury  Park,  which  is 
chiefly  a  summer  city,  they  must  be  cleaned  between  1  November  and 
1  -lime.  In  Florence,  N.  C,  where  dry  closets  are  in  use  they  are 
cleaned  by  the  city  each  month.  In  Atlanta  the  health  department 
cleans  the  privy  vaults  once  each  week. 

There  arc  very  few  regulations  as  to  the  frequency  of  cesspool 
cleaning. 

Hours  for  Cleaning  Vaults  and  Cesspools. 

As  its  name  implies,  night  soil  was  at  one  time  usually  removed  at 
night  because  it  was  thought  that  if  the  owner  of  the  premises  was 
asleep  the  offensive  odors  created  by  the  crude  apparatus  formerly 
employed  would  not  be  noticed.  As  a  matter  of  fact  the  owner  was 
usually  awakened  by  the  noise  if  not  by  the  odor,  and  the  nuisance  was 
then  felt  to  be  more  intolerable  than  in  the  day  time.  Moreover,  it  is 
not  as  easy  to  do  the  work  well  at  night,  or  as  economical,  nor  is  it  as 
easy  to  supervise  it.  So  the  work  of  removing  night  soil  has  in  many 
cities  gradually  been  transferred  to  the  day  time.  Nevertheless,  the 
regulations  in  a  considerable    number  of  cities  still   require   that    night 


1  List  of  cities  showing  amount  of  night  snil  removed  by  municipal  collection: 

Amount. 

9,949  loads  or  7,986  tons  of  nighl  soil. 
2,699  loads  of  nighl  soil. 
4,7:;"  loads  <a  cesspool  matter. 
615  loads  of  night  soil. 

i . 7 _m  loads  "f  cess] I  mat  ter. 

i  ,8  16  loads  of  aighl  soil. 
966  loads  <>f  night  soil. 
*In  Lynn  the  health  department  also  cleanses  catch  basins  with  its  nighl  Boil 
apparatus  and  charges  it  t<i  the  commissioners  of  drains. 


\  « -: 1 1  . 

City. 

At  lanta, 

Brockton, 

1899. 

Law  rence, 

l,\  mi,* 

Sal<- in. 

Bangor,  Me 

. .  10    P.     m.     to    4    A.    M. 

Biddeford,  Me.. 

. .  10    P.     m.     to   4    A.     M. 

Chicago 

.  .  10     P.     M.     tO     6     A.     M. 

Cincinnati 

.  .10    P.   M.    to    5    A.    M.1 

Cleveland 

.  .  10     P.     M.     to    5     A.     M. 

Denver 

.  .10     P.     M.     to     5     A.     M. 

Hartford 

.  .11     P.     M.     tO     5    A.     M. 

Jersey  City  

.  .  11     P.     M.     to     4     A.     M. 

June  to  September, 

10    P.   m.    to    6    A.    M. 

<  >etober  to  May. 

752  REFUSE  DISPOSAL. 

soil  shall  be  removed  at  night.     The   following  are  some  of  the  cities 
and  the  hours  specified : 

Asbury  Park 11  p.  m.  to  4  a.  m.  May      Kingston,  N.  Y. .  .  .10   p.    m.    to   6  a.   m. 

to  October  only.  Melrose 9   p.  m.  to  6  a.   m.1 

Augusta,  Ga 9    p.    m.    to   6    a.    m.      Milwaukee 6  p.  m.  to  4  a.m.1 

Newburgh 10   p.    m.    to  5   a.   m. 

Niles,   <  > After  midnight. 

Omaha 10   p.   m.    to   5   a.   m. 

Ottumwa,  la 10   p.    m.    to   5    a.   m. 

Rochester,  N.  II..  10  p.  m.  to  6  a.  m. 
1  May  to  1  Novem- 
ber. 

Spokane 10   p.    m.   to   4   a.   m. 

St.  Louis 9    p.    m.    to   4    a.    m. 

Westbrook,   Me  .  .  .Sunset  to  sunrise. 


In  Buffalo,  Providence  and  Philadelphia  night  soil  must  be  removed 
between  sunrise  and  sunset,  though  permits  are  given  to  open  grease 
traps  in  the  business  district  after  sunset.  In  Fall  River  the  time  is 
from  sunrise  to  6  P.  M.,  in  Manchester  6  to  11  A.  m.  and  1.30  to  6  p.  M., 
in  Lowell  from  7  A.  M.  to  10  A.  M.  and  1.30  p.  m.  to  6  p.  M.  In  San 
Francisco  and  New  Orleans  the  work  must  be  done  in  the  day  time. 

Permits  for  Emptying  Vaults. 

A  large  number  of  cities  in  order  to  control  and  inspect  the  work  of 
scavengers  require  not  only  that  the  scavenger  shall  be  licensed  but 
that  a  permit  shall  be  required  for  the  emptying  of  every  vault  or  cess- 
pool.2 Some  of  the  forms  of  permits  in  use  are  shown  in  Appendices 
119-120.  In  Baltimore  the  permit  is  stamped  by  the  keeper  of  the 
dock  where  the  night  soil  has  to  be  delivered,  and  is  then  returned  to 
the  health  department  and  kept  on  file  under  the  scavenger's  name. 

In  most  cities  the  scavengers  are  required  to  take  out  these  permits 
and  are  liable  to  be  fined  if  they  do  not  do  so ;  but  sometimes,  as  in 
Albany  and  Syracuse,  the  owner  of  the  property  is  made  responsible  for 
the  permit.  In  Milwaukee  the  owner  applies  to  the  health  department 
and  then  the  health  department  "  orders  "  the  scavenger  named  in  the 
application,  to  clean  the  vault.  In  San  Francisco  the  driver  of  the 
night  soil  wagon  is  required  to  have  a  copy  of  the  permit.  In  many 
cities  no  charge  is  made  for  such  permits.     In  Scranton,  Philadelphia 


1  Unless  odorless  apparatus  is  used. 

2  Among  some  of  the  important  cities  which  have  this  requirement  are  Boston, 
Baltimore,  Buffalo,  Chicago,  Jersey  City,  Newark,  New  Orleans,  Pennsylvania 
cities  of  second  class,  Philadelphia,  Reading.  Rochester,  San  Francisco,  Milwaukee, 
Minneapolis,  and  St.  Paul. 


REFUSE  DISPOSAL.  753 

and  Reading  the  fee  is  fifty  cents,  but  in  the  latter  city  it  is  one  dollar 
when  the  vault  has  been  ordered  cleaned  by  the  board  of  health.  In 
New  Orleans  the  fee  is  twenty-five  cents,  in  Newark  and  Paterson, 
ten  cents. 

Disinfection  of  Night  Soil. 

A  very  considerable  number  of  cities  require  that  the  contents  of 
privy  vaults  and  cesspools  shall  be  disinfected  before  or  at  the  time  of 
removal.  The  writer  has  often  seen  such  disinfection  attempted,  but  it 
has  never  seemed  that  the  deodorants  every  really  accomplished  the 
desired  purpose  of  destroying  to  any  marked  degree  the  objectionable 
odors.  As  for  real  disinfection  of  the  contents  of  a  privy  vault,  that  is 
probably  never  in  actual  practice  accomplished.  The  Lowell  rule 
given  below  is  a  typical  one.1  In  Xew  Orleans  and  Shreveport,  La., 
the  disinfection  must  be  done  twenty-four  hours  before  the  removal  of 
the  contents  of  the  vault ;  and  carbolic  acid  or  copperas  must  be  used 
i'oi  that  purpose.  After  the  vault  is  emptied,  it  is  to  be  disinfected 
with  lime.  In  Newburgh  the  disinfection  is  to  be  six  hours  before  re- 
moval and  with  carbolic  acid  or  copperas. 

Thoroughness  and  Promptness  of  Work. 

It  is  often  prescribed  in  the  permits  to  empty  vaults  that  the  work 
must  be  done  within  a  given  time,  usually  forty-eight  hours.2  Another 
rule  given  below  is  found  in  a  number  of  cities.3 

1  Lowell,  Rules  and  Regulations  of  Board  of  Health  (1894),  p.  31,  Rule  6: 

"In  no  case  shall  the  contents  of  any  privy  vault  be  removed  unless  the  same  is 
properly  disinfected  before  the  work  is  commenced,  and  also  during  the  progress  of 
the  cleaning  and  after  the  completion  of  the  cleaning,  by  such  disinfectants  as  shall 
be  approved  by  the  board  of  health." 

8 Philadelphia,  Rules  of  Board  of  Health  (1895),  Sec.  216: 

l'A  permit  for  emptying  or  cleaning  a  privy  well,  vault,  sink,  or  cesspool  shall 
he  issued  in  the  name  of  the  licensed  party  applying  for  the  same,  stating  therein 
the  location  of  the  premises  and  the  name  of  the  owner,  agent,  or  occupant  thereof 
go  employing  him.  It  must  be  obtained  before  said  cleaning,  and  shall  specify  the 
ila\  for  the  removing  of  the  contents,  bul  maybe  extended  for  two  days  longer,  if, 
in  the  jndgmenl  of  the  clerk,  the  work  waa  deferred  or  postponed  in  consequence  of 
some  unavoidable  circumstances.  Permits  -.hull  only  be  good  ^f  or  forty-eight  (48) 
hours  from  date  of  issue  (nol  including  Sunday  or  any  legal  holiday  thai  maj  in- 
tervene), and  parties  cleaning  a  well  <>n  a  permit  upon  which  the  time  or  extension 
herein  specified  has  expired,  will  be  considered  as  cleaning  said  well  witl t  a  per- 
mit,   and    wil    BUbjed     thelusehes    tO    the    penalty    of    $25,  :is  provided    hy  the  A  <  t   Of 

Assembly,  forever]  violation  thereof." 
(  hicago,  I  Irdinances  1 1881  I,  Sec.  1867: 
"  The  cleaning,  emptying  and  removing  of  the  contents  of  privy  vaults,  shall  be 
done  in  an  inoffensive  manner,  and  anj  scavenger  having  begun  any  such  scavenger 
work,  shall,  withoul  any  interruption  or  delay,  Finish  the  same,  and  shall  in  everj 
instance  leave  the  privj  in  as  good  condition  upon  the  \ault  as  when  the  work  was 
undertaken.11 

18 


754  REFUSE  DISPOSAL. 

Many  cities  also  require  that  the  vault  in  all  cases  shall  be  cleaned 
to  the  bottom,  but  in  Cincinnati,  Fall  River,  Jersey  City,  and  Omaha 
this  only  applies  to  vaults  that  have  been  ordered  cleaned  by  the 
health  department. 

Returns. 

In  a  number  of  cities  scavengers  are  obliged  to  make  return  to  the 

health  department  of  all  work  done  by  them  : 

"  Each  scavenger  shall  make  return  to  the  commissioner  of  health  of  every  per- 
mit issued  to  him,  within  five  days  after  the  work  shall  have  been  performed,  certi- 
fying to  the  number  of  yards  or  loads  removed  from  the  vault  or  vaults  therein 
described,  and  the  place  where  the  same  was  deposited,  under  the  penalty  of  not 
less  than  ten  dollars  for  each  offense.1'1 

Similar  rules  are  found  in  other  cities.  In  Cleveland  and  Spokane 
the  returns  must  be  made  in  five  days  as  in  Chicago.  In  Cincinnati, 
Omaha,  Newbiirgh,  and  Yonkers  they  are  to  be  made  daily,  in  Milwaukee 
within  two  days,  in  Denver  weekly,  in  Warren,  O.,  monthly,  in  Fall 
River,  annually.  The  form  of  return  used  in  Milwaukee  is  shown  in 
Appendix  121. 

Disposal  of  Ni<jlit  S>>iJ. 

The  oldest  and  principal  method  for  the  disposal  of  night  soil  is  to 
deposit  it  on  land  and  use  it  as  a  fertilizer.  Such  a  method,  unless 
regulated,  is  liable  to  cause  nuisance.  There  is,  too,  a  temptation  for 
scavengers  to  deposit  the  contents  of  their  wagons  in  the  most  conveni- 
ent spot,  whether  on  the  surface  of  the  land,  into  a  convenient  sewer 
opening,  or  on  the  bank  of  some  stream  or  lake.  Hence  cities  have  gen- 
erally made  it  a  rule  that  night  soil  shall  not  be  deposited  anywhere 
within  the  city  limits  without  a  permit,  or  except  in  some  place  desig- 
nated by  the  health  department.2  In  Omaha  night  soil  must  not  be 
deposited  within  three  miles  of  the  city  and  in  Wilmington,  Del.,  within 
one  mile.  Other  cities  as  Lowell,  and  Mobile  simply  require  its  removal 
beyond  the  city  limits.  When  it  is  permitted  to  deposit  night  soil  within 
the  limits  of  a  city,  it  is  invariably  required,  if  it  is  deposited  on  land, 
that  it  shall  be  immediately  buried  or  covered  with  earth.  Sometimes 
more  explicit  directions  are  given,  as  in  Rochester.3 

1  Chicago,  Ordinances  (1881),  Sec.  1867. 

2  Denver,  Ordinance  No.  44  of  1893,  Sec.  51: 

"  The  health  commissioner  shall  designate  the  dumping  grounds  upon  which  may 
be  dumped  the  contents  of  vaults,  privies  and  cesspools,  and  all  garbage  and  refuse 
of  any  kind  whatsoever,  and  it  shall  be  unlawful  for  any  person  engaged  in  cleaning 
vaults,  privies,  or  cesspools,  or  in  hauling  garbage  or  other  refuse  of  any  kind,  to 
dump  such  material  on  any  other  place  or  places  in  the  city  of  Denver.'1 

3  Rochester,  Ordinances  of  Board  of  Health,  No.  29,  Sec.  10: 

"Until  further  directions  of  this  board,  the  contents  of  privy  vaults  shall  be  re- 
moved in  the  manner  aforesaid,  to  a  place  or  places  designated  by  this  board,  and 


REFUSE  DISPOSAL.  755 

In  Atlanta  a  part  of  the  night  soil  is  cremated,  but  the  rest  is 
deposited  in  pits  8  by  10  feet  by  5  feet  deep.  It  is.  then  thoroughly 
mixed  with  dry  ashes  from  the  crematory  and  afterwards  covered  with 
earth  and  sown  over  either  with  grain  or  grass  as  rapidly  as  practicable.1 
In  Salt  Lake  City  it  is  disposed  of  in  much  the  same  way  but  causes 
complaint  from  those  who  live  near  by.  In  Woonsocket  it  is  deposited 
in  similar  pits. 

In  the  District  of  Columbia  the  night  soil  is  collected  in  barrels  and 
tli*-  barrels  are  carried  down  the  river  in  scows.  It  is  supposed  to  be 
landed  on  the  shores  and  used  as  a  fertilizer  but  is  said  to  be  sometimes 
dumped  in  the  river.  In  Indianapolis  it  is  composted  with  marl  and 
sawdust  and  after  some  months  is  used  as  a  fertilizer. 

Night  soil  contains  a  considerable  amount  of  nitrogen  in  forms 
readily  available  for  use  in  fertilizer.  The  amount  of  course  varies  very 
gnarly,  depending  upon  whether  the  material  is  true  night  soil,  or  the 
contents  of  cesspools,  whether  the  vaults  which  contained  it  were  tight 
or  leaching  vaults,  and  whether  much  or  little  extraneous  matter  as 
rain-water,  ashes,  garbage,  rubbish  and  the  like  are  mingled  with  it. 

In  order  to  make  use  of  night  soil  in  commercial  fertilizers,  it  is 
necessary  to  get  rid  of  the  large  amount  of  water  by  evaporation,  and  this 
is  rendered  difficult  by  the  offensive  character  of  the  material,  and  also 
by  its  chemical  and  physical  properties.  Attempts  have  been  made  to 
use  night  soil  in  this  way  and  processes  are  at  present  in  operation  in  a 
few  cities. 

In  Baltimore  the  city  has  what  is  practically  a  perpetual  contract 
with  a  firm  to  remove  the  night  soil  from  the  city.  The  concern  owns 
four  scows  and  one  towboat.  They  have  a  dock  not  far  from  the 
centre  of  the  city,  but  in  an  isolated  position,  and  it  is  required  that  all 
the  night  soil  be  deposited  at  this  dock  on  the  scows.  The  contractors 
(for  the  disposal)  pay  nothing  for  the  franchise  and  receive  nothing 
Erom  the  city,  but  the  scavengers  pay  the  contractor  twenty-five  cents 
for  each  _<")  gallons  of  night  soil.  The  contractor  is  secured  by  the 
fact  thai  tbe  scavenger  has  to  present  his  permit  at  the  dock,  where  it 
is  after  payment    of  the   U-v,  endorsed  by   the  contractor's  agent   and 

shall  be  deposited  <>n  land  in  one  of  two  ways.  vi/..  ;    In  trenches  aol   less  than  three 
feel  in  depth,  in  which  the  contents  of  the  privy  vaults  shall  not  exceed  three  inches 

in  depth.    Said  contents  shall  !><■  covered  with  dry  earth  in  a  manner  so  thai  aoi ( 

tin-  saiil   contents  shall   be  (risible  or  in   anj    manner  offensive;  or  thej    maj  be 
deposited  into  pits  made  for  thai  purpose,  according  to  the  directions  "i  this  board, 
and  after  each  and  everj  <!••[>' >^ i t  said  contents  shall  be  covered  with  a  layer  of  dry 
earth,  which  shall  be  al  hast  (oar  inches  in  thickness  or  bj  one  fool  in  thickn* 
drj   manure." 

1  Atlanta,  Report  of  Board  of  Bealtfa  1 L805),  p.  1. 


756 


REE  USE  I) ISP  O  SA  L. 


returned  to  the  health  department.     The  method  of  loading  is  shown  in 
the  accompanying  cut. 


Fig.  102. 
Method  of  loading  Night  Soil  on  Scows  in  Baltimore. 


The  scow  is  towed  to  an  isolated  spot  seven  miles  down  the  river 
and  the  night  soil  is  pumped  out,  steam  from  the  towboat  being  used 
for  the  purpose.  Two  large  depressions  in  the  ground  are  used  to 
receive  the  night  soil,  one  being  left  to  dry,  while  the  other  is  being 
filled.  When  dry  enough  to  handle,  it  is  shoveled  out  onto  a  protected 
platform  where  it  is  further  dried  and  finally  sifted  and  sold  as  a  fertil- 
izer at  about  twenty  dollars  per  ton. 

Besides  the  making  of  night  soil  into  a  fertilizer,  and  its  deposit  on 
land  where  it  mostly  ultimately  becomes  plant-food,  night  soil  is  some- 
times gotten  rid  of  without  any  attempt  at  utilization.  This  is  the  case 
when  night  soil  is  deposited  in  rivers,  lakes,  or  the  ocean.  The  deposit 
of  night  soil  in  lakes  or  rivers  which  are  used  as  a  source  of  municipal 
supply  is  a  most  dangerous  practice,  and  even  if  the  waters  are  not  put 
to  such  use,  nuisance  and  offence  are  likely  to  be  created.  Among  the 
cities  which  dispose  of  night  soil  in  this  way  are  Brooklyn,  Cincinnati, 
Cleveland,  Davenport,  Dubuque,  Lynn,  Minneapolis,  New  Orleans, 
Pittsburgh,  and   St.  Paul. 

In  Cleveland  a  large  scow  is  kept  moored  at  the  lake  front.  It  is 
built  somewhat  like  a  catamaran  with  a  space  for  the  night  soil  between 


REFUSE  DISPOSAL.  757 

the  two  hulls.  This  is  from  time  to  time  towed  out  into  the  lake  and 
there  deposited.  It  is  supposed  to  be  taken  ten  miles  from  the  city  but 
in  had  weather  in  winter  may  not  be  towed  so  far.  The  city  pays  forty 
dollars  per  week  for  this  disposal. 

In  Minneapolis  and  St.  Paul  the  night  soil  wagons  drive  down  to 
the  bank  of  the  Mississippi  and  discharge  their  contents  into  the  river. 
In  St.  Paul  it  is  discharged  on  to  a  shute  which  is  kept  clean  with 
water  from  an  eight-inch  flowing  well.  In  Cincinnati  it  was  formerly 
deposited  on  a  scow  which  was  towed  out  into  the  river  and  there  dis- 
charged its  contents:  but  the  federal  government  ordered  this  discon- 
tinued, so  that  it  is  now  emptied  into  a  sewer  on  the  bank  just  before 
the  sewer  empties  into  the  river.  At  Pittsburgh  one  of  the  scavengers 
has  a  float  on  the  river  onto  which  the  teams  can  be  driven  and  the 
contents  of  the  wagons  be  dumped  in  the  water.  The  owner  of  the 
float  charges  the  others  a  small  fee.  Another  scavenger  has  a  tank 
scow  which  is  towed  down  the  river  a  short  distance  and  there  dis- 
charged. 

Night  soil  contains  so  much  water  that  it  is  rarely  disposed  of  by 
cremation,  though  in  several  cities  a  portion  at  least  is  carried  to  the 
crematory.  This  is  true  of  Atlanta,  Camden,  Dayton,  Evansville,  Find- 
lay.  <)..  Jacksonville,  McKeesport,  Pa.,  Muncie,  and  New  Brighton. 
In  Atlanta  in  1898  there  were  cremated  '2,'-\t\'2  loads  of  night  soil. 
In  Dayton  during  thirty  days  there  were  cremated  1,900  barrels  con- 
taining 300  pounds  to  the  barrel.  During  the  year  1899  there  were 
cremated  in  that  city  ''>.7o4  barrels  of  night  soil  for  which  service  the 
scavengers  paid  the  city  $1,350.80. 

Grease,   Bones,  etc. 

Waste  grease  "I   domestic   production,  commonly   known   as  soap 

grease,  is  usually  an  offensive  material  as  it  accumulates   slowly    and    is 

allowed  to  remain  on  the  premises  some  time  before  sold  to  the  " soap 
grease  man.'"  This  soap  grease  is  usuallj  collected  by  itinerant  dealers, 
who  trade  for  it,  using  snap  in  exchange,  or  else  pay  cash,  and  who 
make  their  collections  in  hand  carts  or  modesl  wagons.  This  business 
tends  to  give  considerable  offence  from  the  slow  transportation  of  the 
decomposing  grease  through  the  streets.  Many  cities  attempl  to  regu- 
late it  by  specific  rules,  ami  others  control  it  through  general  rules,  such 
as  are  referred  t"  on  page  1 5  I. 

These  regulations  require  thai   the  collector  shall  be  Licensed  and 
that    the   material  shall  hi'  removed  in   tighl  covered  receptacles.     In 

man\    cities  it   is  Bpecified    that   the  wagons  shall    not  stand  on  the  street 


758  REFUSE  DISPOSAL. 

in  one  place  any  longer  than  necessary.1  In  Pennsylvania  cities  of  the 
second  class  such  wagons  are  allowed  to  stand  in  one  place  not  longer 
than  fifteen  minutes,  and  in  Cincinnati  the  time  is  five  minutes.  In  the 
latter  city  closed  vessels  are  required  between  1  October  and  1  May. 
In  Denver  grease  can  be  collected  only  after  sunset.  In  St.  Louis  soap 
grease  may  be  stored  only  beyond  one  mile  from  the  city. 

Besides  domestic  grease,  there  is  in  all  cities  a  large  amount  of  mar- 
ket refuse  consisting  of  tallow  and  bones,  the  latter  having  adherent  a 
large  amount  of  fat  and  some  flesh.  These  materials  are  usually  col- 
lected by  parties  who  render  them,  and  a  considerable  sum  is  paid  the 
market  men  for  them.  They  are  often  quite  offensive,  particularly  if 
they  are  not  collected  daily  in  the  summer  time.  Among  the  most  ex- 
plicit regulations  of  this  business  whieh  the  writer  has  seen  are  those  of 
Lynn2  and  Camden.3  In  Lynn  the  wagons  must  be  brought  to  the 
health  department  on  the  first  of  each  month  for  inspection.  The 
license  fee  is  one  dollar  per  month.  In  Camden  the  fee  is  $75  per  year 
for  each  wagon. 

A  firm  engaged  in  this  business  in  several  cities  makes  use  of  the 
form  of  wagon  shown  in  the  accompanying  illustration  and  in  the  city 
of  the  writer  it  gave  excellent  satisfaction.  This  firm  believes  that  it 
is  for  their  interest  to  collect  market  refuse  daily  as  it  is  then  in  better 
condition  and  the  products  obtained  from  it  bring  a  better  price. 

!Fall  River,  Regulations  of  the  Board  of  Health  (1894),  Sec.  13: 
"  No  person  shall  allow  any  vehicle  under  his  control,  containing  fat,  bones,  soap 
grease  or  any  bad  smelling  substance  to  stand  in  any  street,  alley,  lane  or  on  any 
public  grounds  of  the   city,  longer  than  is  absolutely  necessary  for  the  purposes  of 
loading  and  unloading." 

2  Lynn,  Rules  of  the  Board  of  Health: 

"  First.  A  license  fee  of  one  dollar  per  month  for  each  and  every  wagon  licensed 
shall  be  paid. 

Lk  Second.  Vehicles  and  vessels  used  exclusively  for  the  transportation  of  bones 
and  tallow  shall  have  a  covering  of  canvas  which  shall  completely  cover  the  con- 
tents of  the  vehicles  and  vessels  so  used. 

tl  Third.  Vehicles  used  for  the  transportation  of  grease  and  other  refuse  matter 
shall  have  a  covered  top  to  the  same,  with  nap  on  front  and  rear,  which  shall  be 
kept  down  and  fastened  except  when  in  actual  use. 

lt  Fourth.  All  vehicles  and  vessels  used  in  the  transportation  of  either  bones,  tal- 
low, grease,  or  refuse  matter,  shall  be  kept  in  such  condition  as  will  prevent  the 
escape  of  any  of  their  contents,  or  the  odor  thereof,  and  entirely  conceal  the  same 
from  view. 

'•  Fifth.  Every  vehicle  so  used  shall  have  the  name  of  the  owner  and  number  of 
the  wagon  in  letters  and  figures  of  two  inches  in  size  painted  thereon  in  some  con- 
spicuous position. 

-'■sixth.  When  the  holder  of  this  license  discontinues  the  business  for  which  it 
is  granted  lie  shall  return  it  to  this  office. 

"  Seventh.  Any  violation  of  the  above  rules  will  cause  a  revocation  of  this  license 
and  subject  the  offender  to  prosecution.11 

:i  Camden,  Ordinances,  28  July,  1890,  and  26  June,  1893. 


REFUSE  Ulsp  0  s.  1 L. 


759 


Fig  103. 
Fat  Wagon  used  liy  Schwarzschild  &  Sulzberger, of  New  Sqrk. 


Old  Junk,  Rags,  and  Bones. 

Among  the  various  kinds  of  refuse  or  junk  that  are  collected  by 
peddlers,  those  most  liable  to  cause  offence  are  hours  and  rags.  Junk 
bones  differ  from  market  bones,  as  the  former  are  of  domestic  origin 
and  have  usually  been  cooked  and  freed  from  most  of  the  adherent  fat 
and  meat.  Midi  rags  and  bono  arc  not  usually  offensive  enough  to 
lied  covering  during  transportation  through  the  streets,  and  though  the 
collectors  are  usually  licensed,  it  is  by  the  police  rather  than  by  the 
sanitary  department.  The  storage  of  this  form  of  junk  may,  however, 
give  rise  to  nuisance,  and  regulations  in  regard  to  it  are  Found  in  many 
cities.  Sometimes  a  permit  for  storage  is  required.  It  is  sometimes 
forbidden  to  store  such  jnnk  in  dwelling  houses.  ;is  in  Cambridge, 
Lowell,  and    Lynn,     [n  Jersey  City  rags  and  bones  must   not   he   kept 

within  twenty  feci    of   ;i  dwelling.      A   more    stringenl    rule    is  found    in 
• ;  i    I  district  of  ( lolumbia.1 


iict  of  ( !olumbia,  Webb's  Di| 
iiSki  e  II'.     It  shall  be  unlawful  for  any  person  to  store,  put,  or  place 

bones  which  shall  have  been  purchased  <>v  bartered   in  anj  bouse,  storeroom,  stable, 

bnilding,  or  place,  within  two  I dred  feet  "t  anj  dwelling  bouse,  other  than  the 

dwelling  house  of  the  person  storing  Buch  bones,  under  a  penalty  of  t  i  x . -  dollars  for 
each  and  every  day  thai  the  same  shall  he  stored,  put,  "i  placed  as  aforesaid;  and  it 
shall  be  unlawful  for  any  person  or  persons  to  Btore  old  rags  which  shall  have  been 


760  REFUSE  DISPOSAL. 

Dead  Animals. 

Dead  animals  are  of  two  classes,  the  smaller  animals,  as  dogs,  cats, 
rats,  hens,  etc.,  which  are  altogether  worthless,  and  the  larger  animals, 
as  horses,  cattle,  and  swine,  which  are  of  value  for  their  grease,  hides, 
and  for  fertilizer. 

In  regard  to  the  smaller  animals  there  is  oftentimes  no  very  efficient 
means  of  getting  rid  of  them,  and  it  is  no  uncommon  thing  in  many 
cities  to  see  them  lying  for  days  in  yards  and  vacant  lots,  in  ponds  and 
streams,  and  in  the  streets.  In  some  cities,  as  Atlanta,  Buffalo,  Cleve- 
land, Detroit,  Houston,  Tex.,  Lawrence,  St.  Louis,  and  St.  Paul,  the 
garbage  men  are  required  to  remove  small  dead  animals  if  placed  with 
the  garbage.  In  cities  like  Omaha,  where  the  licensed  garbage  collector 
receives  his  pay  from  the  householder,  the  price  for  such  removal  is 
fixed  by  ordinance.  In  Omaha  it  is  seventy-five  cents  for  each  dog,  and 
twenty-five  cents  for  each  cat.  If  small  animals  are  found  on  the  street 
it  is  usually  the  duty  of  the  street  cleaning  department  to  remove  them, 
but  in  Philadelphia  the  garbage  contractor  performs  this  duty,  and  in 
the  City  of  New  York  the  health  department.  In  Denver  a  special 
contractor  collects  and  disposes  of  all  dead  animals  for  $1,500  per 
annum.  In  Nashville  they  are  collected  by  the  board  of  public  works. 
In  Mobile  there  is  a  special  contractor  who  is  paid  by  the  city,  but  the 
owner  of  the  animal  must  pay  if  he  can  be  found.  In  Richmond  also 
there  is  a  special  contractor.  In  a  number  of  cities  it  is  customary  for 
citizens  to  report  dead  animals  to  the  police,  and  for  the  scavenger  to 
call  at  the  station  for  orders. 

If  such  dead  animals  are  on  private  property  the  health  department 
may  properly  order  the  owner  to  dispose  of  them.  In  Providence  this 
is  usually  done  if  the  private  property  is  enclosed  like  a  yard  or  area ; 
but  in  the  case  of  open  lots,  private  alleys,  and  streams  and  ponds  the 
carcass  is  removed  at  the  expense  of  the  city.  A  considerable  nuisance 
is  thus  promptly  abated  at  a  small  expense. 

The  larger  animals  usually  have  a  considerable  value.  In  most 
cities  one  or  more  parties  are  found  who  remove  such  when  notified  by 
citizens,  police,  or  sanitary  officers.  Usually  this  is  done  without  cost, 
but  sometimes  a  small  charge  is  made,  and  in  other  cases  a  small  sum, 

purchased  or  bartered  in  any  house,  storeroom,  stable,  building,  or  place,  within 
fifty  feet  of  any  dwelling  house,  other  than  the  dwelling  house  of  the  person  storing 
such  rags,  and  the  entire  stock  of  old  rags,  so  collected  and  stored,  shall  be  removed 
from  the  premises  or  shipped  at  least  once  in  every  fifteen  days;  and  any  person  or 
persons  storing  old  rags,  or  refusing  or  neglecting  to  remove  the  same  in  accordance 
with  these  provisions,  shall  be  liable  to  a  line  of  five  dollars  for  every  day  that  they 
shall  so  offend." 


REFUSE  DISPOSAL.  761 

as  one  or  two  dollars,  is  paid.  In  St.  Louis  they  must  be  delivered  to 
the  garbage  contractor. 

Lest  dead  animals  should  be  allowed  to  remain  in  the  streets,  it  is 
sometimes  required  that  the  fact  of  the  body  so  lying  shall  be  at  once 
reported  to  the  city  officer.1  In  Cleveland  the  report  must  be  made 
within  eight  hours. 

While  provision  is  thus  made  by  private  or  public  effort  for  the 
proper  disposition  of  dead  animals,  the  improper  disposition  is  usually 
forbidden.  The  disposal  of  dead  animals  by  throwing  into  public  waters 
is  most  objectionable,  and  this  is  often  prohibited  by  laws  designed  to 
prevent  the  pollution  of  rivers  or  to  protect  public  water  supplies. 
Most  of  the  legislation  specifically  relating  to  the  disposal  of  dead  ani- 
mals is  local,  but  some  of  it  is  statutory,  as  in  Georgia,  Maine,2  Mis- 
souri, and  Vermont.  The  Georgia  Law3  applies  only  to  counties  con- 
taining cities  of  60,000  inhabitants,  and  requires  that  dead  animals  shall 
be  buried  or  made  into  a  fertilizer  within  three  hours. 

Most  of  the  local  regulations  forbid  the  improper  disposition  of  dead 
animals,  and  many  of  them  follow  the  type  of  that  of  the  City  of  New 
York.4  The  rules  also  go  further  and  prescribe  what  shall  be  done 
with  the  carcass.5 


I  New  York,  Sanitary  Code  (1899),  Sec.  140: 

II  That  it  shall  be  the  duty  of  tin-  owner,  and  of  the  person  that  last  had  or  then 
having  charge  of  any  animal,  so  dead  or  injured  oi  diseased,  and  being  in  any  street 
or  public  place,  to  at  once  give  notice  thereof,  and  of  the  nearest  street  and  avenue 
where  it  may  be,  to  sonic  inspector  or  officer  of  this  department,  or  of  the  sanitary 
bureau,  unless  such  animal  is  at  once  removed  by  some  proper  person." 

Maine,  Chapter  39  of  1899: 

"  Whoever  personally  or  through   the  agency  of  another  leaves  or  deposits  the 

carcass  of  a  dead  horse,  row,  sheep,  hog  or  any  other  of  t he  larger  domestic  animals 

in  any  place   where   it    may  cause  a   nuisance  shall,  upon    receiving  a  notice  to  that 

effect  from  the  local  board  of  health,  promptly  remove,  bury,  or  otherwise  dispose 

of  the  remains,  and  if  lie  fails  to  do  so  within  such  time  as  may  be  prescribed  by  the 

local  hoard  of  health,  and  in  such  manner  as  may  be  satisfactory  to  such  hoard  of 

health,  shall  he  guiltj  of  a  misdemeanor,  and  shall  be  punished  by  a  tine  of  not  less 
than  live  nor  more  than  twenty-live  dollars,  or  by  imprisonment  not  exceeding  one 
nioiit  h.*" 

'  I  reorgia,  '  lhapter  143  of  L895. 

New  York.  Sanitary  Code  (1899),  Sec  187: 

I  'hat  no  person  shall  leave  in  or  thrown  into  any  place  or  si  reet,  or  public  water, 
nor  offensively  expose  or  bury,  the  body  (or  any  part  thereof)  of  any  dead  or  fatally 
si.k  or  injured  animal;  nor  shall  anj  person  keep  anj  dead  animal  or  any  offensive 
meat,  bird,  fowl,  or  fish  in  a  place  where  the  same  nun  he  dangi  rous  to  the  life  or 
detrimental  to  the  healtb  of  any  person/1 

'  \ew  Fork,  Sanitarj  I  ode    1899     Sec.  139: 
1  hat   :  1 1 1  >  person  having  a  dead  animal  or  an  animal   past   recovery,  and  not 
killed  for  and  proper  for  use  as  meat  or  fish,  or  in  anj  offensive  condition,  or  sick 
with  aii   infectious  01   contagious  disease  on   his  premises  in  said  city,  and  everj 


762  REFUSE  DISPOSAL. 

In  smaller  cities  or  cities  where  open  land  is  accessible,  it  is  some- 
times required  that  dead  animals  shall  be  buried,  as  in  Hartford,  Jersey 
City,  Newport,  R.  I.,  and  Newton,  Mass.  In  Hartford  they  must  be 
buried  within  twelve  hours ;  in  Jersey  City  six  hours,  and  in  Denver 
three  hours.  In  other  cases  they  must  be  removed  at  the  expense  of 
the  city,  as  in  Bradford,  Penn.,  and  Ottumwa,  la.  In  Fitchburg  they 
are  to  be  carried  to  the  fertilizer  factory,  and  in  Bridgeport  they  may 
be  disposed  of  by  burial,  cremation,  or  rendering  in  a  proper  manner. 

In  a  number  of  cities  dead  animals  are  consumed  in  the  crematory. 
This  is  reported  to  be  the  case  in  Atlantic  City,  Columbus  Dayton, 
Evansville,  Jacksonville,  Lowell  (formerly),  Macon,  Muncie,  Inch,  New 
Brighton,  Portland,  Ore.,  Richmond,  Salt  Lake  City,  Savannah,  Scran- 
ton,  Yonkers,  and  Wilmington,  Del.  It  is,  however,  likely  that  in 
most  of  these  cities  the  larger  and  more  valuable  animals  are  not  so 
treated,  but  are  utilized.  Indeed  it  would  not  be  easy  to  get  a  whole 
horse  into  the  opening  of  an  ordinary  crematory.  In  Atlanta  it  is  ex- 
pressly stated1  that  few  large  animals  are  so  disposed  of,  but  in  1898 
there  were  cremated  2,992  dogs.  In  Columbus  in  1899  there  were 
cremated  2,366  dead  animals. 

When  there  are  reduction  works  for  the  disposal  of  garbage  dead 
animals  are  usually  taken  to  them  as  they  furnish  good  fertilizer 
material. 

The  most  common  method  of  disposing  of  the  larger  dead  animals 
is  by  skinning  in  order  to  save  the  hide,  and  rendering  the  rest  of  the 
body.  In  nearly  all  the  larger  cities  there  are  parties  engaged  in  this 
business,  but  in  smaller  places  where  there  are  not  enough  animals  to 
warrant  the  establishment  of  such  a  business,  the  animals  have  to  be 
buried.  The  regulations  governing  rendering  have  been  considered  in 
another  place. 

It  is  sometimes  prescribed,  and  even  when  it  is  not  the  law,  it  is 
often  the  custom  to  remove  dead  animals  in  covered  vehicles.2 


person  whose  animal  or  any  animal  in  his  charge  or  under  his  control  in  any  street 
or  place,  may  die  or  become  or  be  in  a  condition  past  recovery,  shall  at  once  remove 
or  cause  the  removal  of  such  animal,  dead  or  alive,  to  some  proper  place,  and  when 
such  place  may  be  designated  by  the  sanitary  superintendent  of  this  department,  to 
the  place  so  designated.'" 

1  Atlanta,  Board  of  Health  Report  (1898),  p.  29. 

2  District  of  Columbia,  Police  Regulations  (1896),  Art.  8,  Sec.  24: 

"  No  dead  animal  of  the  horse,  mule  or  jack  kind,  and  no  dead  cow,  goat,  calf, 
sheep,  dog  or  swine,  or  any  part  of  the  aforesaid  dead  animals,  shall  be  transported 
thi( nigh  any  street,  avenue,  alley,  or  public  space  within  the  City  of  Washington,  or 
the  more  densely  populated  suburbs  of  said  city,  unless  the  same  shall  be  conveyed 
in  vehicles  substantially  air  tight,  constructed  either  of  wood  or  metal,  or  both; 
nor  shall  any  such  dead  animal  or  part  thereof  be  deposited  or  left  upon  any  wharf, 


RE F L  sA'  UISP  0 SAL. 


'63 


Fig.  ln4. 
Wagon  used  in  the  District  of  Columbia  for  Dead  Horses. 


Fig.   105. 
Deadhorse  Wagon  used  in  Providence 


764  REFUSE  DISPOSAL. 

In  Pennsylvania  cities  of  the  second  class  steel  boxes  must  be  used 
which  must  be  water  tight  and  be  washed  and  disinfected   after  each 

trip. 

Other  Offensive  Substances. 

Besides  regulations  specifically  prescribing  the  manner  of  removal 
of  garbage,  ashes,  night  soil,  soap  grease,  etc.,  a  number  of  cities  have 
other  regulations  applying  to  offensive  matters  in  general  or  else  in- 
clude in  night  soil  and  garbage  regulations  general  phrases  intended  to 
include  all  kinds  of  offensive  substances.  Such  general  regulations 
almost  always  require  that  offensive  substances  must  be  removed 
in  tisfht  covered  vehicles  or  vessels,  that  the  work  must  be  done  in  a 
cleanly  manner,  and  that  a  license  or  permit  be  required  therefor.  The 
rules  from  Cleveland  are  a  good  example  of  such  regulations.1 

A  type  of  regulation  governing  the  manner  of  collection  and  re- 
moval, taken  from  the  sanitary  code  of  the  City  of  New  York,  is  given 
on  page  747.     See  also  the  Chicago  rules  on  page  692. 

Street  Cleaning. 
The  cleaning  of  the  city  streets  is  usually  in  charge  of  the  board  of 
public  works,  the  street  commissioners,  or  a  special  department.  Some- 
times, however,  it  is  made  a  part  of  the  duties  of  the  health  depart- 
ment. This  is  true  of  Atlanta,  Augusta,  Ga.,  Memphis,  Raleigh,  and 
Richmond.  In  Denver  the  health  department  removes  refuse  from 
alle}Ts  while  the  street  department  cleanses  the  streets. 

street,  avenue,  alley  or  public  place  within  said  city;  and  in  all  cases  where  such 
animal  or  part  thereof  is  transported  upon  the  Potomac  river  or  the  Eastern  branch, 
it  shall  be  unloaded  from  the  aforesaid  vehicle  directly  into  a  scow  provided  for  the 
purpose,  covered  and  closed  therein,  and  thereupon  immediately  conveyed  beyond 
the  District  of  Columbia,  or  to  such  place  within  the  said  district  as  may  be 
designated  by  the  health  officer,  and  there  so  disposed  of  as,  in  the  judgment  of  the 
health  officer,  not  to  be  injurious  to  health,  nor  offensive  to  sight  or  smell.  Pro- 
vided, That  this  section  shall  not  apply  to  the  transportation  of  animals  intended 
to  be  used  for  food." 

1  Cleveland,  Revised  Ordinances  (1892),  Chapter  80: 

"Sec.  493.  No  person  shall  transport  night  soil,  swill,  garbage,  fat,  bones, 
offal,  or  any  decayed  or  putrid  or  stinking  animal  or  vegetable  matter  through  any 
of  the  streets,  lanes,  alleys,  avenues  or  other  public  grounds  of  the  city,  except  by 
written  permit  of  the  director  of  police  or  health  officer,  and  the  same  shall  be 
transported  in  vehicles  or  barrels  that  shall  be  effectually  covered  and  water-tight, 
so  that  no  odors  or  liquids  shall  escape. 

"Sec.  532.  No  person  shall  sell,  barter,  or  give  away,  or  cause  to  be  sold,  bar- 
tered, or  given  away,  by  agent  or  otherwise,  any  house  offal,  slaughterhouse  offal,  or 
any  tilth,  or  any  refuse  substances  from  any  slaughter  house,  dwelling  house  or  other 
place  in  the  city,  or  the  carcass  of  any  dead  animal,  or  part  thereof,  not  killed  for 
human  food,  unless  the  person  or  persons  so  buying  or  receiving  the  same  shall 
have  a  written  permit  from  the  director  of  police  or  health  officer  to  remove  or 
carry  the  same  in  or  through  the  streets,  avenues,  squares,  courts,  lanes,  alleys,  or 
places  of  the  city." 


CHAPTER  XIV. 

MISCELLANEOUS    SANITARY    WORK. 
Communicable  Diseases  of  Animals. 

THIS  is  a  subject  that  receives  far  more  attention  from  the  stock 
raiser,  the  business  man,  and  the  economist,  than  it  does  from  the 
sanitarian.  Vast  numbers  of  animals  die  every  year  from  diseases 
which  are  not  communicable  to  man,  and  the  death  of  these  animals 
entails  pecuniary  losses  which  mount  into  the  millions.  Diseases  such 
as  pleuro-pneumonia,  Texas  fever,  hog  cholera,  and  sheep  scab  are  not 
directly  dangerous  to  man,  and  it  is  to  the  prevention  or  eradication  of 
such  diseases  that  the  attention  of  law  makers  has  been  chiefly  directed. 
The  subject  matter  of  the  great  body  of  laws  relating  to  the  diseases  of 
animals,  and  most  of  the  executive  work  of  boards  of  cattle  commis- 
sioners concerns  diseases  which  can  only  indirectly  affect  human  health, 
and  hence  are  of  no  special  interest  to  sanitary  officials.  Other  dis- 
eases which  fortunately  are  much  rarer  among  animals  are  sometimes 
transmitted  to  man,  and  hence  their  control  both  in  animals  and  man 
properly  comes  under  our  consideration.  Such  diseases  are  glanders, 
rabies,  anthrax,  actinimycosis  and  tuberculosis.  How  often  the  latter 
is  transmitted  from  animals  to  man  is  still  a  disputed  question,  but  all 
must  admit  that  the  probability  of  its  being  so  transmitted  is  sufficient 
to  warrant  health  officers  in  taking  the  liveliest  interest  in  the  methods 
which  arc  taken  for  the  eradication  of  the  disease  in  animals.  It  is 
these  diseases  which  are  common  to  men  and  animals  which  il  is  pro- 
posed to  consider,  and  the  laws  and  administrative  methods  which  can 
be  made  to  apply  to  them.     The   federal,  slate,  and   local  governments 

have  all  made  efforts  to  control  communicable  animal  disease.  The 
bureau  of  animal  industry  in  the  depart  incut  of  agriculture  has  power  to 
make  regulations  to  prevent  the  spread  of  these  diseases  and  it  has  made 
such   rules  and    also  enforced    them,  8 •limes  with    great   BUCCeSS,  as  in 

the  case  of  pleuro-pneumonia  and  Texas  cattle  fever;  but  this  depart- 
ment, engaged  as  it  ostensibly  is  in  the  interests  of  foreign  and  inter- 
state commerce,  has  given  comparativel)  little  attention  to  the  diseases 
that  are  here  under  consideration.  The  state  governments  have  \<\\ 
generally  interested  themselves  in  the  checking  of  glanders,  rabies,  and 


766  MISCELLANEOUS   SANITARY   WORK. 

particularly  tuberculosis,  and  have  done  much  work  in  the  attempt  to 
control  them,  and  some  of  our  cities  have  done  still  more. 

Legislation  concerning  communicable  disease  of  animals  may  be 
found  in  almost  every  state  and  territory  and  in  not  a  few  cities.  The 
regulations  of  the  latter  are  usually  adopted  by  local  boards  of  health 
under  their  general  grant  of  power,  but  sometimes  as  in  Massachusetts,1 
"  the  board  of  health  of  cities  and  towns  may  take  all  measures  neces- 
sary or  expedient  to  suppress  or  prevent  the  spread  or  introduction  of 
communicable  disease  among  animals  .  .  .  and  may  make  regula- 
tions in  writing  for  the  purpose  named."  Similar  powers  are  specifically 
granted  to  town  councils  in  Rhode  Island  and  local  boards  of  health  in 
Minnesota.  Statute  law  relating  to  this  subject  may  be  found  in  the 
annual  reports  of  the  bureau  of  animal  industry.  The  items  included 
in  such  legislation  so  far  as  it  concerns  our  subject  are  not  very 
numerous. 

Importation  of  Disease.  It  is  of  course  of  the  utmost  importance  to 
prevent  the  introduction  of  a  communicable  disease  into  a  country,  a 
state,  or  any  smaller  sub-division  which  is  free  from  it.  So  far  as  the 
whole  country  is  concerned  the  secretary  of  agriculture  is  authorized  to 
make  quarantine  regulations  for  the  control  of  foreign  importations,  and 
he  has  done  so,  and  they  are  enforced  by  the  bureau  of  animal  industry 
as  is  shown  in  its  reports.  A  large  number  of  states  also  forbid  the  im- 
portation of  animals  sick  with  communicable  disease  or  which  have  been 
exposed  to  such  disease,  and  some  cities  do  the  same.  Most  of  these 
laws  and  regulations  forbid  the  importation  of  communicable  disease 
without  further  specification,  but  glanders  is  mentioned  in  Arkansas, 
California,  Florida,  Iowa,  Maryland,  South  Carolina,  Tennessee,  and  in 
New  Orleans.  Rabies  may  not  be  imported  into  Florida  and  eighteen 
states  have  laws  against  the  introduction  of  tuberculosis. 

Many  of  the  state  laws  provide  that  the  cattle  commissioners,  or  in 
some  cases  the  governor,  shall  proclaim  quarantine  either  at  the  state 
boundary  or  against  an}'  infected  locality ;  but  such  power  is  rarely  ex- 
ercised against  any  of  the  diseases  that  are  here  considered.  In  Texas, 
however,  on  28  December,  1899,  the  governor  issued  a  proclamation 
against  the  importation  of  tuberculosis. 

Notification.  If  a  communicable  disease  once  breaks  out  in  a  com- 
munity, it  is  impossible  for  the  authorities  to  take  any  action  unless 
they  are  made  aware  of  the  facts.  As  in  human  so  in  animal  diseases, 
it  is  required  that  persons  having  a  knowledge  of  the  existence  of  such 
disease   or  suspecting  it,  shall  notify  the  board  of  health  or  the  cattle 


Massachusetts,  Chapter  491  of  1894,  Sees.  24-5. 


MISCELLANEOUS   SANITARY   WORK.  707 

commissioners  as  the  case  may  be.  Thus  the  owner  is  required  to  re- 
port in  Arizona.  Illinois,  Louisiana.  Maine,  Mississippi,  Ohio,  Rhode 
Island,  Tennessee,  and  Virginia,  any  person  who  knows  of  the  case  in 
Colorado,  Michigan,  and  Wisconsin,  and  veterinarians  in  Connectciut. 
I  usallv  such  reports  are  to  be  to  the  cattle  commissioners  or  similar 
officials,  but  in  Colorado,  Maine,  and  Tennessee  the  reports  are  to  be 
made  to  the  board  of  health,  and  in  Mississippi  to  the  county  super- 
visors. In  Massachusetts,  Maine,  New  Jersey,  and  Wisconsin  the  local 
board  of  health,  and  in  (  onnecticut  the  selectmen  are  to  notify  the  state 
officials  of  any  cases  which  come  to  their  knowledge.  In  a  number  of 
Massachusetts  cities  and  in  Charleston.  Jersey  City,  and  New  York 
City  the  owners  or  persons  having  knowledge  are  to  report  to  the  board 
of  health,  and  in  Minneapolis,  New  Orleans,  Xew  York  City,  and  Yon- 
kers,  veterinarians  are  to  report. 

It  has  been  found  in  practice  with  human  diseases,  impossible  to  rely 
upon  reports  from  the  friends  or  relatives  of  patients.  If  it  were  not 
for  physicians,  a  very  much  larger  number  of  cases  would  go  unreported 
than  does  now.  In  animal  diseases  there  is  usually  no  physician  to 
rely  upon.  The  owner  looks  after  his  animals  himself  and  usually  is 
unable  to  make  a  correct  diagnosis.  It  is  generally  for  his  interest  if 
lie  does  know  of  a  case  to  conceal  it.  and  concealment  of  animal  dis- 
eases is  comparatively  easy.  Hence  if  state  and  city  officials  relied 
upon  reports  from  owners  very  few  cases  of  animal  disease  would  come 
to  their  notice.  It  is  through  the  operation  of  special  inspectors  that 
most  cases  of  animal  disease  are  brought  to  light.  The  appointment 
and  duties  of  such  inspectors  will  be  referred  to  later.  In  some  of  the 
western  states,  ;is  Missouri,  the  law  provides  for  the  investigation  of 
rumors,  for  the  statute  provides  that  on  the  request  of  six  citizens,  who 
state  their  belief  that  communicable  disease  exists,  the  state  veterinary 
surgeon  shall  be  sent  to  investigate. 

Investigation  <m<l  Diagnosis.  Most  of  the  laws  which  provide  for 
any  executive  action  in  cases  of  communicable  disease  of  animals  pro- 
vide thai  the  officials  shall  investigate  cases  of  suspected  disease  and 
determine  its  nature  and  that  they  shall  for  this  purpose  have  free  access 
to  all  animals,  and  that  the  owners  shall  give  all  required  information, 
ami  shall  do  nothing  to  obstrucl  the  action  of  the  officers.  In  M 
chusetts  the  officials  are  authorized  to  put  the  witnesses  under  oath. 
In  some  states,  a-  Colorado,  Iowa,  and  .Maryland,  the  state  officer  is  a 
veterinarian,  and  in  must  states  the  cattle  commissioners  are  authorized 
t<>  employ  skilled  persons  to  determine  the  nature  of  the  disease.  Such 
cities  ;i^  Boston,  Lynn.  Minneapolis,  New  York,  St.  Paul,  and  San 
Francisco,  thai  have  attempted  to- deal  energeticallj  with  these  dis< 
eniplo\  a  veterinarian. 


768  MISCELLANEOUS   SANITARY    WORK. 

Isolation.  Probably  the  isolation  of  domestic  animals  can  never  be 
maintained  as  successfully  as  that  of  human  beings,  and  the  latter  all 
health  officers  know,  is  difficult  enough.  Nevertheless,  most  laws  require 
the  isolation  of  animals  affected  with  communicable  disease.  Nearly 
all  the  executive  officers  are  authorized  or  directed  to  quarantine  (with 
the  meaning  of  isolate)  cases  of  communicable  disease.  Moreover, 
the  laws  of  a  number  of  states1  lay  upon  the  owner  the  duty  of  isolation. 
Sometimes  the  owner  is  simply  required  to  isolate,  at  other  times  he  is 
forbidden  to  allow  the  animal  to  come  in  contact  with  others,  to  sell, 
barter  or  give  away,  to  slaughter  for  food,  to  allow  upon  the  high- 
way, to  move  or  transport  in  any  way,  or  it  may  be,  as  in  Maine  or 
Illinois,  the  transportation  companies  are  forbidden  to  carry  infected 
animals.  In  Illinois  the  penalt}7  for  violating  this  law  is  to  be  not  less 
than  $1,000  nor  more  than  <f  10,000.2  Glandered  animals  must  not  be 
driven  or  used.  It  is  sometimes  required  that  animals  that  have  been 
exposed  to  contagion  shall  be  isolated.  In  Alabama  dogs  that  have 
been  bitten  by  an  animal  suj)posedly  rabid  must  be  isolated  for  six 
months.  Among  the  more  explicit  isolation  regulations  may  be  men- 
tioned those  of  California,3  Maine,4  Massachusetts,5  and  New  Hamp- 
shire.*' The  expense  of  isolation  is  usually  to  be  borne  by  the  owner. 
In  Utah  if  an  owner  fails  to  isolate  an  animal  as  required  by  law  he  is 
not  only  liable  to  a  fine,  but  also  for  such  damages  as  may  accrue  to 
others  through  his  negligence. 

Killing  of  Diseased  Animal*.  Fortunately  the  state  can  largely 
overcome  the  difficulties  of  isolation  by  an  alternative  which  is  not 
admissible  in  the  case  of  human  diseases.  In  the  case  of  animals  suf- 
fering from  contagious  disease  it  is  allowable  to  effectually  prevent  the 
spread  of  the  disease  by  destroying  the  animal.  The  only  troublesome 
question  that  can  arise  is  that  of  compensation  to  the  owner.  In  Iowa, 
Washington,  and  Wisconsin  the  law  requires  the  killing  of  infected 
animals,  and  the  same  is  true  of  Massachusetts  with  the  exception  of 
tuberculosis,  and  of  the  ordinances  of  Denver  and  Minneapolis.  In 
California,  Connecticut,  Louisiana,  Utah,  Mississippi,  New  York  City, 
New  ( )rleans,  and   Omaha  all  glandered  animals  are  to  be   killed.     In 


1  Arkansas,  California,  Colorado,  Georgia,  Illinois,  Maryland,  Maine,  New  Hamp- 
shire, Massachusetts,  North  Dakota,  Ohio,  Oregon,  Rhode  Island,  Tennessee,  Utah, 
and  Vermont. 

-  Illinois,  Annotated  Statutes  (189G),  Chapters,  Sec.  22. 

3  California,  Chapter  219  of  1893. 

4  Maine,  Statutes,  Supplement  (1885-95),  Chapter  14(7)7. 

5  Massachusetts,  Chapter  491  of  1894. 

"New  Hampshire,  Public  Statutes  (1891),  Chapter  113. 


MISCELLANEOUS   SANITARY    WORK.  769 

most  states,  however,  the  question  of  killing  is  optional  with  the  execu- 
tive officers  of  the  state.  Almost  all  such  officers  are  authorized  to 
kill  if  they  deem  it  necessary.  Most  of  these  states  also  provide  for 
compensation  to  the  owner.1  Almost  every  one  of  them  (excepting 
Minnesota,  Michigan,  and  Illinois)  provide  that  the  value  of  the  animal 
shall  be  before  killing  determined  by  the  state  officers  and  owner,  or  in 
case  of  their  failure,  by  appraisal.  Usually,  however,  a  limit  is  set  to 
the  compensation  to  be  made.  In  Connecticut,  Michigan,  and  Oregon, 
it  is  the  value  at  the  time  of  killing,  in  Massachusetts  the  value  at  the 
time  of  killing  with  a  maximum  of  $40;  in  Xew  Jersey  for  tuberculosis 
three-fourths  of  the  value  at  time  of  killing  with  a  maximum  of  §100 
for  registered  animals,  and  840  for  non-registered  ;  in  Maine  one-half 
value  in  health,  with  a  maximum  of  8100  for  pedigree  animals  and  $50 
for  others:  in  New  Hampshire  one-half  value  in  health  up  to  8100 ; 
in  New  York  one-half  value  in  health  up  to  800  for  registered  cattle, 
and  $50  tor  horses,  but  for  tuberculosis  the  limit  is  825  for  non-registered 
cattle:  in  Pennsylvania  the  limit  is  $50  for  pedigree  animals,  and  *-~> 
for  others,  and  for  horses  840  and  one-half  value  in  pedigree  horses ; 
in  Rhode  Island  the  amount  is  one-half  value  when  well,  and  in  Ver- 
mont the  same  with  a  maximum  of  840.  In  Iowa  the  limit  is  $25,  and 
in  Kentucky  $50  in  cases  of  tuberculosis.  Several  states  attach  other 
conditions  to  the  payment.  In  Maine  the  animal  killed  must  have  been 
in  the  state  three  years,  in  Connecticut  six  months,  and  in  Rhode  Island 
three  months:  in  Michigan  and  New  Mexico  it  must  not  have  been 
imported,  and  in  Massachusetts  it  must  (in  tuberculosis)  have  been 
kept  in  a  sanitary  manner.  In  Maine  and  Xew  Hampshire  if  the  owner 
declines  to  accept  the  appraised  valve,  the  animal  is  "quarantined"  at 
his  expense  and  he  is  liable  to  a  heavy  penalty  for  breaking  the  quaran- 
tine. 

Disposal  and  Disinfection.  Several  of  the  states  have  laws  in  regard 
to  the  disposal  of  bodies  of  animals  dead  with  communicable  disease. 
In  Arizona  they  must  be  burned,  in  Louisiana,  Maryland,  and  Ohio 
burned   or  buried,  and  in    Delaware   the  owner  musl   cremate  cases  of 

anthrax    for  which    he  is  paid    by  the  state  $8  for  large  annuals,  and    $2 

for  swine,  and  $1    for  sheep.     In    Maine  and    North    Dakota  the^  must 

be  buried  within  twenty-four  hours,  and    in   North   Dakota  they  must  be 

buried  six  feel   below  the 'surface  of  the  ground.     In    Maine,  however, 

'hey  i r i ; i \     be  rendered    within    forty-eighl     hours  after  death,  but    in  all 

Imong  such  are  Connecticut,  Iowa,  Illinois,  Kentucky,  Maine,  Massachusetts, 
Michigan,  Minnesota,  Missouri,  \<-w  Hampshire,  New  Jersey,  Sen  Mexico,  New 
Fork,  North  Dakota,  Oklahoma,  Oregon,  Pennsylvania,  Rhode  island,  Tennessee, 
Texas,  Vermont,  Wes(  Virginia,  and  Wisconsin. 

4'.i 


770  MISCELLANEOUS   SANITARY   WORK. 

cases  in  that  state  the  cattle  commissioners  must  promptly  inject  the 
carotid  artery  with  kerosene.  In  New  York  the  flesh  of  slaughtered 
animals  is  sprinkled  with  kerosene. 

Connecticut  by  statute  requires  the  disinfection  by  the  owner  of 
premises  occupied  by  glanders,  but  most  of  the  states  leave  disinfection 
to  the  executive  officers. 

Various  methods  have  been  adopted  in  the  different  states  for 
executing  the  laws  relating  to  animal  diseases.  In  some  a  single  officer 
is  to  inspect  animals,  isolate  or  destroy  those  infected  and  otherwise 
enforce  the  laws.  Such  an  officer  may  have  assistant  -inspectors,  and 
must  do  so  if  his  work  is  to  be  efficient.  States  which  have  a  state 
veterinarian  are  Arkansas,  California,  Colorado,  Idaho,  Iowa,  Louisiana, 
Maryland,  Missouri,  Montana,  North  Dakota,  Oregon,  South  Carolina, 
South  Dakota,  Virginia,  Wisconsin,  and  Wyoming. 

In  other  states  the  executive  is  a  board  or  commission,  and  in  some 
of  those  above  named  there  is  nominally  such  a  board.  In  Delaware, 
Florida,  Kentucky,  Minnesota,  Mississippi,  Nebraska,  Utah,  Washington, 
West  Virginia,  and  New  York  the  state  board  of  health  is  charged  with 
these  duties,  but  in  Minnesota  and  Washington  the  veterinarian  of  the 
experiment  station,  and  in  the  others  the  veterinarian  of  the  agri- 
cultural college  is  to  have  charge  of  the  work.  In  New  York  the 
execution  of  the  animal  laws  relating  to  glanders  and  tuberculosis  is 
entrusted  to  the  state  board  of  health,  the  tuberculosis  committee  of 
which  looks  after  that  disease.  In  Georgia,  North  Carolina,  Rhode 
Island,  and  Vermont  the  state  board  of  agriculture  is  to  look  after  dis- 
eases of  animals.  In  New  York  the  commissioner  of  agriculture  attends 
to  all  diseases  except  tuberculosis  and  glanders.  In  Arizona,  Colorado, 
Connecticut,  Illinois,  Indiana,  Kansas,  Maine,  Maryland,  Massachusetts, 
Michigan,  Nevada,  New  Hampshire,  New  Jersey,  New  Mexico,  Ohio, 
Oklahoma,  Pennsylvania,  Tennessee,  and  Texas  a  special  commission  is 
created.  In  New  Hampshire  the  cattle  commissioners  consist  of  the 
secretary  of  the  board  of  health,  the  secretary  of  the  state  board  of 
agriculture  and  the  master  of  the  state  grange.  In  New  Jersey  the 
tuberculosis  commission  consists  of  the  president  and  secretary  of  the 
state  board  of  agriculture,  and  three  persons  appointed  by  the  presi- 
dent. 

Most  of  the  cattle  commissioners  are  appointed  by  the  governor  and 
serve  for  a  term  of  years.  Many  of  them  receive  a  compensation  of  $3 
t  ( >  $5  per  day  of  actual  service.  In  New  York  the  members  of  the  tuber- 
culosis committee  of  the  state  board  of  health  receive  $800  per  annum. 
When  a  veterinarian  is  the  executive  he  usually  receives  a  reasonable 
salary.      The  commissioners  are  usually  authorized  to  employ  inspectors 


MIS  <  EL  LA  NEO  Us    s.  YXU\  iRY    WO  UK.  771 

and  veterinarians,  and  it  is  through  these  that  the  actual  work  is  chiefly 
done.  In  Colorado  there  were,  in  1898,  seven  inspectors  :  in  Illinois, 
fifty-eight ;  in  Iowa,  twenty-three  :  in  Maryland,  fourteen  ;  in  Minnesota, 
six:  in  North  Dakota,  nine  :  in  Washington,  four:  in  Wyoming,  six. 
In  Massachusetts  at  one  time  465  inspectors  were  employed. 

Not  only  have  state  officials  done  something  towards  the  suppression 
of  communicable  disease  among  animals,  but  in  some  instances  the 
municipalities  have  aided  in  this  work  and  occasionally  gone  further 
than  the  state  officials.  In  Massachusetts.  Mulligan,  and  Minnesota 
the  local  boards  of  health  conjointly  with  state  boards,  are  charged  with 
the  duty  of  enforcing  the  laws  in  regard  to  the  communicable  diseases 
of  animals.  In  Massachusetts  also  the  local  boards  of  health  are 
required  to  appoint  inspectors  of  animals  and  provisions.  In  Boston, 
Lynn,  and  Brookline,  and  some  other  towns  these  inspectors  are  vet- 
erinarians. Veterinary  physicians  are  also  employed  by  the  board  of 
health  of  some  other  cities  to  look  after  the  contagious  diseases  of  ani- 
mals.  Among  such  are  the  District  of  Columbia,  Denver.  New  York 
City.  Minneapolis,  St.  Paul,  Omaha,  and  San  Francisco.  In  almost  all 
of  these  the  attention  of  the  officers  is  chiefly  devoted  to  tuberculosis, 
and  employment  of  the  officer  was  necessitated  by  the  attempt  to  con- 
trol the  health  of  the  animals  furnishing  the  milk  supply  to  the  city.  In 
other  cities  veterinarians  may  he  occasionally  employed  to  investigate 
special  outbreaks  as  of  glanders,  or  to  make  an  experimental  inspection 
of  dairy  cows. 

Tuberculosis. 

The  importation  of  tuberculous  cattle  into  the  Tinted  States  is 
guarded  against  by  the  inspectors  of  the  bureau  of  animal  industry. 
While  this  bureau  might  under  the  laws  attempt  to  prevent  the  passage 
of  tuberculosis  from  one  state  to  another,  it  has  not  as  yet  had  the 
means  tor  doing  so.     This   is   at    present    controlled   by  the  states  and 

eighteen  of  them  have  Laws  respecting  it.  ai ig  which  are  low  a.  Maine, 

Massachusetts,  Montana,  New  Hampshire,  New  Jersey,  Pennsylvania, 
Rhode  Island.  Texas,  and  Vermont  A  common  form  of  the  law  is  that 
requiring  that  no  animal  shall  be  imported  without  a  certificate  that  it  has 
been  inspected  and   tested   with   tuberculin   with   negative  results.1      In 

1  Rhode  tsland,  A.i  of  15  May,  1896: 

14 Sec.  2.  \ll  persons,  corporations,  or  companies  intending  n>  ship,  transport, 
or  i"  drive  cattle  into  the  state  must  produce  a  certificate  to  the  effect  that  the 
cattle  i"  be  shipped,  transported,  or  driven  are  free  from  tuberculosis  a-,  far  as  maj 
be  determined  bj  physical  examination  and  the  tuberculin  test  The  certificate 
shall  give  a  description  of  each  animal  brought  into  the  state  sufficiently  accurate 
for  identification,  and  shall  give  also  the  date  and  place  of  examination  of  each 
animal,  the  preparation  of  tuberculin  used,  the  quantity    injected,  1 1  * « -  temj  erature 


772  MISCELLANEOUS   SANITARY   WORK. 

Texas  cattle  must  not  be  imported  for  breeding  or  dairy  purposes,  but  an 
exception  is  made  in  favor  of  animals  certified  to  as  natives  of  Colorado 
or  Nebraska.  In  New  Hampshire  animals  may  be  brought  in  for  pas- 
turage only,  without  the  tuberculin  test,  provided  they  are  sound  on 
physician's  examination.  In  Connecticut,  when  any  one  imports  cattle 
from  an  adjoining  state  he  must  within  six  days  notify  the  commissioner 
on  domestic  animals. 

Very  little  work  has  been  done  in  eradicating  bovine  tuberculosis 
by  municipal  health  officers  except  in  connection  with  the  protection  of 
the  milk  supply,  as  was  noticed  in  the  chapter  on  dairy  products. 
Nearly  all  the  active  work  except  in  a  few  cities,  as  Indianapolis,  New 
York,  Minneapolis,  St.  Paul,  Rochester,  and  Lynn,  has  been  done  by 
state  boards  of  health,  and  hence  does  not  properly  belong  to  our  sub- 
ject ;  but  the  matter  is  one  of  such  moment,  and  is  one  which  so  many 
local  boards  of  health  are  considering,  that  it  is  worth  while  to  note 
what  the  states  are  doing.  Much  of  what  follows  is  taken  from  the 
seventh  report  of  the  state  veterinarian  of  Maryland. 

Illinois. 

"  The  live  stock  commission  has  been  conducting  tests  on  herds  where  the  own- 
ers apply  for  it.  All  animals  reacting  are  slaughtered  without  compensation,  the 
owners  having  whatever  proceeds  there  may  be  from  the  sale  of  the  hide  and  car- 
cass; where  the  disease  is  slight,  the  beef  may  be  sold,  if  fit,  for  food.  During  the 
year  1897,  thirty-six  herds  were  tested,  including  851  animals;  of  these  seventy-seven 
were  found  diseased,  or  about  nine  per  cent.  (This  percentage  includes  a  herd  of 
251  that  had  previously  been  tested.)  Of  the  seventy-seven  diseased  animals,  forty- 
one  carcasses  were  condemned  and  thirty-six  passed  as  fit  for  food." 

Massachusetts. 

"  Under  Chapter  491,  acts  of  1894,  some  four  hundred  and  sixty-five  inspectors 
were  appointed,  whose  duty  it  was  to  inspect  cattle  and  stables  and  report  the 
occurrence  of  any  contagious  disease.  All  cattle  visibly  affected  witli  tuberculosis 
were  killed  and  paid  for,  while  many  were  tested  at  the  state's  expense  at  a  cost  of 
$240,737.84.  This  does  not  include  the  cost  of  testing  many  more  cattle,  which  was 
made  at  the  expense  of  individual  owners. 

"  Condemned  cattle  were  paid  for  upon  written  application  for  the  test  to  be 
applied,  and  upon  the  promise  to  thoroughly  disinfect  their  premises,  and  to  in- 
troduce none  but  cattle  tested  (at  owner's  expense)  in  the  future.  This  led  to  an 
order  that  cattle  to'be  paid  for  must  be  tested  by  the  cattle  commissioners  or  their 
authorized  agent.     The  large  amount  of  money  spent  and  the  number  of  animals 

immediately  before  inoculation,  the  temperature  at  the  eleventh  hour,  and  every 
two  hours  subsequent  thereto  for  at  least  ten  hours  or  until  the  reaction  is  com- 
pleted. The  certificate  shall  be  signed  by  a  veterinarian  who  is  a  graduate  of  a 
recognized  veterinary  college,  and  shall  be  sent  immediately  to  the  secretary  of  the 
state  board  of  agriculture,  who  shall  immediately  notify  a  commissioner  of  the 
county  into  which  the  cattle  are  to  be  shipped,  transported,  or  driven,  and  said 
commissioner  shall  examine  the  cattle  to  identify  them.  Failure  to  comply  with 
the  law  shall  be  considered  a  misdemeanor,  punishable  by  a  fine  not  to  exceed  one 
hundred  dollars." 

The  above  law  was  recently  weakened  by  amendment. 


MISCELLANEOUS   SANITARY   WORK.  773 

destroyed  caused  great  opposition  and  resulted  in  a  change  of  policy.  It  is  now  re- 
quired by  law  that  each  town  and  city  shall  appoint  an  inspector  who  will  act  in 
conjunction  with  state  hoards. 

"This  work  may  he  considered  under  three  heads  : — 

"  1.     The  supervision  of  the  traffic  in  live  cattle  brought  into  the  state. 

'■  2.  A  general  inspection,  the  examination  of  cattle  quarantined  as  diseased  by 
the  local  inspectors  in  the  various  cities  and  towns,  and  the  payment  for  those  found 
to  be  infected  with  tuberculosis. 

•■  3.  Testing  entire  herds  for  the  purpose  of  permanently  eradicating  tubercu- 
losis from  the  premises.1' 

In  1899  175,000  was  appropriated  and  only  150,000  was  to  be 
asked  for  the  next  year.  Seven  hundred  and  eighty-five  tuberculous 
animals  were  killed  for  which  $17,277.69  was  paid.  Five  hundred  and 
sixty-five  animals  were  tested  for  owners  who  were  trying  to  free  their 
herds,  and  of  these  sixty-three  were  condemned. 

Maim  . 
■  Maine  was  the  first  of  the  New  England  States  to  adopt  the  system  of  placing 
quarantines  on  the  admission  of  out-of-state  cattle.  The  law  was  first  enforced  in 
1892  against  Massachusetts,  because  of  the  large  per  cent,  of  Massachusetts  cattle 
that  were  found-diseased.  Later  it  was  placed  on  all  out-of-state  territory,  except 
to  such  as  were  provided  witli  certificates  of  tuberculin  test.  The  authorities  in 
Maim-  test  herds  only  on  the  voluntary  application  of  the  owner.  The  owner  to 
receive  one-half  the  value,  as  determined  on  the  basis  of  health  before  infection,  t he 
limit  of  compensation  being  one  hundred  dollars  for  pedigreed  animals  and  fifty 
dollars  for  others.  The  commission  have  power  to  investigate  as  to  the  existence 
of  disease  and  to  condemn  and  destroy  such  as  show  physical  evidence  of  disease. 
During  the  year  1898    11")  head  of  cattle  were  destroyed  at  an  appraisal  of  $  18, 122." 

Michigan. 

u  Cattle  found  to  be  tuberculous  are  quarantined  and  killed.  The  law  does  not 
provide  compensation,  however,  and,  as  a  result,  the  commission  has  met  with  a 
good  deal  of  opposition.  The  commission  lias  followed  tin- plan  of  testing  with 
tuberculin  such  herds  as  have  been  brought  to  their  attention  as  suspicious,  killing 
such  ;is  react,  with  compensation. 

"  During  ls'.iT  and  ls'.is  the  commission  has  applied  the  tuberculin  lest  to  nearly 
1,000  head  of  cattle,  a  goodly  proportion  being  milch  cows.  In  fact,  a  larger  mini- 
1m  i  of  cattle  have  been  tested  for  tuberculosis  during  the  last  two  years  than  had 
previously  been  tested  since  the  tuberculin  test  was  adopted  by  the  commission. 

"  The  tuberculin  test  is  applied  only  when  suspicion  is  directed  toward,  or  com- 
plaint made  of,  either  a  single  animal  or  an  entire  herd.  The  records  of  tests  made 
show  but  a  small  percent  of  infected  animals,  and  when  we  consider  the  tact  thai 
onlj  suspicious  herds  are  tested,  we  feel  safe  in  estimating  that  less  than  two  per 
cent,  of  the  cattle  in  Michigan  are  affected  with  tuberculosis/1 

Minrti  %ota. 

11  All  cattle  which  show  symptoms  of  tuberculosis  must  be  quarantined  at  once 
and  the  entile  herd  tested  with  t ubeivulin.  When  cattle  have  ome  reacted  the 
owner  has  his  option  .  ,t  having  them  killed  or  continued  in  quarantine  for  a  period 
n..i  to  exceed  three  mouths,  when  they  are  again  tested,  ir  thej  read  on  the 
second  test,  they  must  be  killed  within  one  month.  The  owner  has  no  compensa- 
tion for  cattle  killed,  bul  he  is  allowed  to  have  them  killed  under  inspection,  and.  if 
they  pass,  he  oan  dispose  of  it  like  any  other  beef,  tn  1898,2,975  cows  mostly  fur- 
nishing milk  to  St.  Paul  were  tested  and  6.81  per  cent  were  condemned.'" 


774  MISCELLANEOUS   SANITARY    WORK. 

New  Hampshire.  Diseased  animals  are  reported  to  the  commission 
through  the  selectmen,  and  are  released  or  condemned  on  physical 
examination.  When  the  owner  applies  for  inspection  of  his  herd,  and 
where  there  is  reason  to  believe  the  disease  exists,  the  board  may  treat 
the  entire  herd,  the  owner  receiving  half  compensation.  In  1898  225 
herds  were  tested  and  148  animals  killed,  for  which  $2,894  was  paid. 

New  Jersey. 

"Sew  Jersey  has  a  commission  of  seven  members.  The  commission,  on  appli- 
cation from  the  owner,  the  state  board  of  health,  or  the  state  dairy  commission,  will 
make  an  examination  of  suspected  herds,  the  reacting  animals  to  be  condemned  and 
killed.  They  are  appraised  at  their  market  value,  not  exceeding  forty  dollars,  the 
owner  receiving  compensation  at  the  rate  of  three-fourths  of  their  valuation.'" 

In  1898  there  were  tested  1,438  cows,  of  which  245  were  con- 
demned. The  cost  of  inspection  was  $1,179,  and  the  amount  paid  for 
the  cows  was  $5,098.20. 

New  York.  In  New  York  State  tuberculosis  in  cattle  is  handled  by 
a  tuberculosis  committee  of  the  state  board  of  health.  No  appropria- 
tion has  been  made  by  the  legislature  for  the  use  of  this  committee, 
and  no  cattle  have  been  ordered  killed,  except  where  the  owners  have 
waived  all  right  to  compensation.  The  committee,  however,  have 
received  many  requests  from  owners  asking  to  have  their  herds  tested, 
and  also  to  test  the  animals  belonging  to  public  institutions. 

Pennsylvania.  It  has  been  the  practice  in  Pennsylvania  to  test 
herds  only  on  the  application  of  the  owner,  and  then  only  where  the 
disease  was  suspected  to  exist.  The  application  is  made  on  a  printed 
form,  and  in  making  the  application  the  owner  promises  to  observe  every 
direction  recommended  that  tends  to  the  purification  of  his  premises, 
If  he  has  to  tear  down  half  his  barn,  or  cut  windows  through  his  stables, 
or  put  in  new  floors,  he  agrees  to  do  that  before  the  examination  is 
made,  and  he  agrees  also  to  procure  his  animals  for  restocking  from  as 
healthy  a  source  as  possible.  It  has  been  impossible,  however,  to 
comply  with  all  the  requests  sent  in,  and,  as  far  as  possible,  the  worst 
herds  have  been  picked  out  for  testing.  Reacting  animals  are  all  con- 
demned and  compensation  given  the  owner. 

"At  the  time  of  publication  of  the  last  annual  report  the  average  appraisement 
for  cattle  condemned  was  twenty-four  dollars  and  lifty  cents.  Since  the  beginning 
of  the  last  fiscal  year  the  appraisement  has  been  twenty  dollars  and  forty-five  cents. 
The  total  payments  for  tuberculous  cattle  to  date  (January  1,  1898,)  amount  to 
$57,191.16  for  2,510  animals,  an  average  of  $22.78  per  head. 

"  In  Pennsylvania  the  number  of  cattle  tested  up  to  the  first  of  June,  1897,  was 
9,108;  the  number  condemned  as  tuberculous  was  1,839,  a  percentage  of  20.39. 
Since  the  first  of  June  4,887  cattle  have  been  tested;  of  these  671  were  found  to  be 
tuberculous  and  were  killed,  a  percentage  of  13.73.  All  parts  of  the  state  are  repre- 
sented among  these  herds,  as  only  herds  suspected  as  diseased  are  tested.     It  would 


MISCELLANEOUS    SANITARY   WORK.  775 

seem  to  be  fair  to  assume  that  many  of  the  worst  herds  have  been  discovered,  and 
that  the  percentage  of  tuberculosis  among  cattle  at  large  is  being  steadily  and 
rapidly  reduced.'" 

Rhode  Island.  Rhode  Island  has  a  commissioner  in  each  county, 
appointed  by  the  board  of  agriculture,  whose  duty  it  shall  be  to  inquire 
into  the  condition  of  any  animal  in  their  county  whenever  there  is  any 
reason  to  suspect  tuberculosis.  When  any  animal  is  thought  to  be 
tuberculous  by  a  commissioner,  he  shall  immediately  quarantine  and 
examine.  In  1898  496  animals  were  killed,  for  which  $9,014.50  was 
paid. 

I  rermont. 

"  Vermont,  with  itssmall  percentageof  diseased  animals,  lias  probably  been  more 
successful  than  any  other  slate  in  its  attempts  to  control  tuberculosis.  Since  Feb- 
ruary the  1st,  1897,  tin. 0110  have  been  tested  and  2,360  have  been  found  diseased  and 
killed,  a  percentage  of  disease  of  nearly  four  per  cent.  In  Vermont  no  animals  are 
tested  unless  the  owners  allow  the  entire  held  to  be  tested,  and  thereafter  every 
animal  admitted  to  the  herd  must  he  tested  and  the  stables  thoroughly  disinfected. 
The  commission  test  only  where  application  is  made  by  the  owner.  In  their  annual 
report  a  list  of  seventy-eight  retested  herds  is  given  in  which  tuberculous  animals 
were  found.  Twenty-three  herds  were  found  free  on  the  second  test,  and  twenty- 
three  hail  only  die  case  each  on  the  second  test.  Bight  of  the  remaining  herds  that 
were  found  diseased  <m  the  second  test  were  free  on  the  third  test.  The  report 
states  that l  the  proper  disinfection  is  a  more  difficult  matter  than  is  the  discovery 
of  the  diseased  animal." 

"The  commissioners  "have  found  that  cattle  buyers  from  slates  where  no  quar- 
antine was  enforced  have  purchased  many  suspected  animals  at  a  juice  a  little  less 
than  would  have  been  paid  if  not  suspected."1 

Wisconsin.  The  state  hoard  of  health  are  applying  the  tuberculin 
te8l  to  infected  herds  reported,  as  far  as  their  means  will  allow,  and 
Condemning  the  animals  that  react  10  the  test,  the  state  paying  two- 
thirds  of  the  appraised  value 

It  is  thus  seen  that  a  few  cities  haw  attempted  probably  with  a  very 
fair  degree  of  success  to  stamp  out  tuberculosis  among  the  cows  within 
their  limits  or  among  those  furnishing  the  milk  supply  to  the  city.  In 
Massachusetts  and  Vermonl  the  state  authorities  have  made  very 
Btrenuous  efforts  to  eradicate  the  disease.  In  this,  the  former  state  at 
leasl  has  not  been  very  successful,  and  by  the  efforts  made  createdgreal 
opposition  which  verj  decidedly  crippled  the  work  by  cutting  down  the 
appropriation.  All  of  the  states  named  attempt  at  present  to  destiny 
the    herds    most    affected,  and  to    help  those  who  really  desire  it,  to  tree 

their  farms  from  tuberculous  animals.  How  much  they  bave  really 
accomplished  in  this  direction  is  not  entirely  clear,  bul  some,  as 
Dr.  Pearson,  state  veterinarian  of  Pennsylvania,  and  the  state  officials  in 
Vermont,  are  optimistic  enough  to  believe  thai  the  course  pursued  in 
those  states  will  in  the  not  distant  future,  reduce  the  number  of  tuber- 
culous animals,  to  a  very  small  percentage. 


776  MISCELLANEOUS  SANITARY   WORK. 

Glanders. 

As  in  tuberculosis  so  in  glanders  a  number  of  states  specifically  for- 
bid the  importation  of  the  disease,  and  in  others  the  general  laws  against 
the  importation  of  any  communicable  disease  would  of  course  include 
this.  Alabama,  Arkansas,  California,  Iowa,  Louisiana,  Massachusetts, 
Michigan,  Mississippi,  Missouri,  New  York,  Oklahoma,  Tennessee, 
Washington,  and  Wisconsin,  provide  that  all  glandered  animals  shall 
be  isolated  or  killed,  and  usually  impose  upon  the  owner  a  penalty 
for  failure  to  do  this.  It  is  also  often  forbidden  to  drive  upon  the 
highway,  or  to  expose  in  public,  or  to  sell  a  glandered  animal.  The 
authorities  having  charge  of  such  matters  are  usually  empowered  to  kill 
glandered  animals,  and  sometimes,  as  has  been  noted,  compensation  is 
allowed.  It  is  often  required  that  owners  shall  report  glandered 
animals.  Besides  the  states  referred  to  many  cities  have  regulations  in 
regard  to  this  disease  among  which  may  be  mentioned  Atlanta,  Charles- 
ton, Chicago,  Cleveland,  Denver,  the  District  of  Columbia,  and  Omaha. 

These  laws  are  sometimes  enforced  by  state  boards  and  sometimes 
by  city  officials,  and  in  some  states,  as  Massach.usetts.and  Minnesota,  the 
state  and  local  officers  co-operate.  In  Michigan  the  live  stock  sanitary 
commission  in  its  report  for  1898-9  states  that  pursuing  a  policy  of 
exterminating  the  disease  has  nearly  eradicated  it  from  that  state.  The 
Illinois  state  board  killed  90  horses  in  1898  and  tested  many  more, 
using  mallein.  Pennsylvania  reports  very  little  glanders,  only  13  cases 
having  been  discovered  in  1898.  In  Minnesota  on  the  other  hand  in  1898 
507  suspected  cases  were  reported  of  which  317  were  killed  without 
compensation.  In  Massachusetts  also  the  disease  is  on  the  increase  and 
there  were  killed  543  animals,  much  more  than  ever  before.  In  Boston 
and  Lynn  the  control  of  glanders  and  rabies  is  vested  in  the  board  of 
health.  Bacteriological  examinations  are  made  in  cases  of  suspected 
glanders  in  Boston,  a  serum  tube  and  swab  being  used,  very  much  like 
a  diphtheria  outfit.  In  1899  193  animals  were  examined  and  killed. 
In  Lynn  14  horses  were  examined  and  8  killed.  The  New  York  City 
board  of  health  does  a  little  in  the  way  of  examining  horses  and  also 
prepares  mallein  for  the  purpose.  In  Minneapolis  and  St.  Paul  glanders 
receives  considerable  attention  from  the  health  department,  and  in  the 
former  city,  in  1899,  a  large  number  of  horses  were  examined,  of  which 
129  were  killed,  and  it  was  stated  that  the  disease  was  increasing. 

Rabies. 

This  disease  is  not  very  common,  being  unknown  in  some  parts  of 
the  country  but  sometimes  occurring  with  considerable  frequency  in 
others  ;    but  it  is  one  which  appeals  strongly  to  the    fears  of    many, 


MISCELLANEOUS   SANITARY   WORK.  777 

although  its  existence  is  denied  by  some.  There  is  not  much  statutory 
legislation  in  regard  to  it.  In  Florida  it  is  forbidden  to  import  it,  and 
in  that  state  and  in  Alabama,  Massachusetts,  and  Michigan  cases  must 
be  killed  or  isolated  (in  Alabama  for  six  months).  New  York  City, 
Minneapolis,  and  the  District  of  Columbia  have  similar  regulations.  In 
Boston  the  owners  of  rabid  animals  must  report  them  to  the  board  of 
health  and  the  latter  has  authority  to  investigate  and  condemn.  In 
most  states  the  same  action  could  be  taken  under  the  general  laws 
relating  to  the  communicable  diseases  of  animals.  In  Massachusetts 
every  dog  license  must  have  printed  upon  it  a  description  of  the 
disease.  Aldermen  and  selectmen  are  empowered  to  order  that  all  dogs 
shall  be  muzzled  and  the  health  officer  of  the  District  of  Columbia  has 
similar  authority. 

In  Pennsylvania  in  18981  there  were  fifty-five  authenticated  cases 
of  rabies  in  dogs,  three  in  horses,  six  in  cattle,  four  in  pigs,  one  in  a 
goat,  ten  iii  sheep,  and  four  in  human  beings.  Most  of  these  cases  were 
in  Allegheny  and  Beaver  counties,  and  the  live  stock  sanitary  board 
issued  an  order  for  the  muzzling  of  all  dogs  in  those  counties  for  sixty 
days.  In  Minnesota  from  1896  to  1900  at  least  eighty-four  cases  of 
rabies  came  to  the  knowledge  of  the  state  laboratory,  in  thirty-one  of 
which  the  diagnosis  was  proved.  Four  of  these  were  in  human  beings.2 
If  it  is  possible  to  secure  with  certainty  all  animals  bitten  by  a  rabid 
one  they  may  be  killed  or  quarantined,  but  if  it  is  suspected  that  in- 
fected animals  are  at  large  all  dogs  should  be  muzzled,  as  it  is  by  dogs 
almost  entirely  that  the  disease  is  spread.  The  adoption  of  these 
methods  is  said  to  have  almost  exterminated  the  disease  in  England. 
In  muzzling  a  considerable  area  should  be  included,  and  for  this  reason 
the  Massachusetts  law  which  leaves  it  to  the  towns  is  bad.  There  lias 
been  considerable  rallies  in  eastern  .Massachusetts,  and  the  towns  and 
cities  have  from  time  to  time  enforced  a  muzzling  ordinance.  In  Lynn, 
Boston,  Minneapolis,  St.  Paul,  ami  Denver,  in  1898,  numerous  animals 

were  killed  and  examined  for  rallies  by  laboratory  methods,  but  diffi- 
cult}   was  experienced  in  the  latter  city  owing  to  trouble  iii    getting  the 

necessary  rabbits  on  which  to  tesl  the  virus.  In  Massachusetts  of 
thirt\  cases  tested  iVoin  March,  L897,  to  December,  L898,  by  the 
pathologist  of  the  state  board  of  cattle  commissioners,  twenty  proved 
to  be  rab 

In  the  District  of  Columbia4  the  number  of  cases  of  rabies  in  dogs, 


1  Pennsylvania,  Report  of  State  Veterinarian  1898,  p.  12. 

i.i.  Wesbrook,  St  Paul  Medical  Journal,  October,  1900. 

Journal  ■•!  Boston  v"<  ietj  •■!  Medical  s'  iences,  Vol.  ••.  p.  B3. 
1  Bureau  of  Animal  Industry,  Department  "f  Agriculture,  Circular  No.  30,  1900. 


778  MISCELLANEOUS   SANITARY    WORK. 

as  demonstrated  in  the  laboratory,  was  in  1898,  seven  ;  in  1899,  nine- 
teen ;  in  1900  (to  March  31),  fifteen.  From  October,  1899,  to  30 
April,  1900,  twenty-four  human  beings  in  the  District  were  bitten  by 
rabid  animals.  A  six  months  muzzling  order  is  now  in  force,  but  was 
met  with  much  popular  opposition.  It  is  the  opinion  of  the  health 
officer  that  the  muzzling  should  continue  for  a  year.  At  the  present 
writing  (January,  1901,)  the  mayor  of  Rochester  has  just  issued  an 
order  that  all  dogs  shall  be  muzzled  for  six  months. 

In  some  cities,  as  Jersey  City  and  Hoboken,  the  licensing  of  dogs  is 
in  the  hands  of  the  local  board  of  health. 

School  Hygiene. 

The  sanitary  construction  of  schoolhouses  and  management  of 
schools  is  a  matter  of  vast  importance.  Yet  there  is  a  great  amount  of 
ignorance  displayed  in  both  the  construction  and  management.  Defects 
are  of  course  often  seen  by  school  boards  when  the}T  cannot  remedy 
them,  simply  because  they  have  no  money ;  but  oftentimes  the  reason 
why  the  defects  exist  is  because  they  are  not  seen.  The  primary  object 
of  our  school  system  is  of  course  the  mental  training  of  the  young,  and 
those  who  are  most  fitted  to  provide  this  are  not  always  the  best  fitted 
to  provide  for  the  physical  welfare  of  the  pupils.  Health  officials  who 
are  devoted  to  their  work  always  take  an  active  interest  in  the  schools 
of  their  district,  but  there  are  decided  limitations  to  the  good  which 
they  can  accomplish.  The  management  of  the  schools  is  hi  another 
department,  and  one  noted  defect  in  our  methods  of  municipal  govern- 
ment is  lack  of  co-ordination  between  its  different  departments.  The 
health  department  rarely  has  any  control  over  the  school  department, 
and  advice  is  usually  not  heeded.  Even  if  the  health  department  can 
issue  orders  to  the  school  board  it  would  rarel}T  be  wise  to  do  so,  for 
the  result  would  be  likely  to  be  a  quarrel  which  would  do  no  good  to 
either.  For  these  reasons  it  has  come  about  that  health  officials  have 
done  far  less  for  the  advancement  of  school  hygiene  than  might  have 
been  expected.  There  has  also  been  comparatively  little  legislation 
concerning  hygiene  of  schools.  A  compilation  of  the  laws  on  this  sub- 
ject was  made  by  the  United  States  commissioner  of  education  in  18941 
and  is  not  very  voluminous.  Laws  and  ordinances  in  regard  to  vaccin- 
ation and  communicable  diseases  have  already  been  considered.  Many 
states  also  have  laws  prescribing  the  strength  of  school  buildings  and 
how  they  shall  be  constructed  so  as  to  be  as  secure  as  possible  against 
fire.     Many  states  also  require  that  schools  shall  be  provided  with   fire 


1  Report  of  Commissioner  of  Education  (1893-4),  p.  1301. 


MISCELLANEOUS   SANITARY    WORK.  779 

escapes,  and  that  doors  shall  open  outwards.1     Such  regulations  hardly 
come  within  the  scope  of  this  work. 

One  of  the  most  important  means  of  improving  the  construction  of 
schoolhouses  would  he  to  have  the  plans  of  all  buildings  about  to  he 
constructed  submitted  to  some  competent  authority  which  could  com- 
pel such  plans  to  he  made  in  accord  with  recognized  sanitary  prin- 
ciples. Such  control  lias  not  generally  been  very  successful  in  the 
United  States,  because  it  is  not  easy  to  find  a  central  authority  which 
is  really  competent  to  pass  niton  schoolhouse  plans,  and  because  such 
an  interference  by  the  state  in  local  affairs,  or  such  control  of  one 
municipal  department  by  another  is  not  acceptable.  In  a  lew  states  as 
Colorado,  Denver.  Kansas,  Tennessee  and  Wisconsin  the  state  board  of 
health  is  authorized  to  advise  with  the  school  authorities  in  the  con- 
struction of  schoolhouses.  and  in  other  states  the  state  board  under  its 
general  grant  of  power  does  so  advise,  but  Vermont  is  the  only  state 
where  it  does  exert  any  direct  control.  In  California,  Kentucky, 
Virginia  and  West  Virginia  the  county  superintendent  of  schools,  and 
in  New  York  the  state  commissioner,  is  to  approve  all  schoolhouses, 
and  in  Pennsylvania  the  state  superintendent  of  schools  is  to  prepare 
plans  and  estimates  of  different  types  of  buildings  for  the  use  of  local 
school  boards.  Jt  is  only  in  .Massachusetts,  Connecticut,  and  Vermont 
that  any  efficient  control  of  school  construction  is  exercised  by  officers 
outside  the  school  department,  and  even  then  the  supervision  only 
covers  construction,  lire,  and  ventilation.  In  Massachusetts  the  factory 
inspectors  who  are  state  officers  are  to  approve  all  schoolhouse  plans, 
alter  which  no  change  can  lie  made  in  them.'-'  h  is  further  provided 
in  Massachusetts-  that  the  factory  inspectors  may  compel  changes 
in  the  ventilation  of  school  buildings,  and  any  school  or  other  official 
who  fails  to  obey  an  order  of  a  factory  inspector  within  four  weeks  is 
to  be  lined  not   to  exceed  $100.      The  act  establishing  a  board  of  health 

in  Detroit  gh es  that  board  similar  power.     In  <  Oklahoma  the  rules  of  the 


Liuong  states  which  have  such  laws  are  <  lolorado,  Connecticut,  Illinois,  Indiana, 
Massachusetts,   .Maine,   Michigan,    Missouri,    Nebraska,   Nevada,   New   Hampshire, 
Niw  Jersey,  Ohio,  Pennsylvania  and  Wisconsin. 
-  Massachusetts,  Chapter  388  <.r  1894. 

Massachusetts,  Chapter  508  of  1894,  Sec.  12: 
••  Whenever  it  shall  appear  to  an  inspector  of  factories  ami  public  buildings  that 
furl  lire  or  differenl  sanitary  provisions  or  means  of  ventilation  are  required  in  any 
public  building  or  Bchoolhouse  in  order  to  conform  to  the  requirements  of  this  act, 
and  thai  the  same  can  be  provided  withoul  incurring  unreasonable  expense,  such 
inspector  maj  issue  a  written  order  e*  the  proper  person  or  authority  directing  such 
sanitary  provisions  or  means  of  ventilation  i"  be  provided,  and  they  shall  thereupon 

he  provided  in  accordance  with  Buch  order bj   the  public  authority,  corporati r 

m  having  charge  of,  owning  "i  [easing  such  public  building  or  Bchoolhouse." 


780  MISCELLANEOUS   SANITARY   WORK. 

state  board  of  health  give  this  right  to  local  boards,  and  in  Connecti- 
cut the  state  board  of  education  has  similar  powers.  The  insertion  of 
the  terms  "  without  unreasonable  expense  "  in  the  Massachusetts  law  it 
is  to  be  feared,  makes  it  difficult  to  improve  those  houses  that  most 
need  it.  In  Vermont1  the  state  board  of  health  is  directed  to  issue  a 
circular  of  information  on  schoolhouse  construction  and  the  statute 
provides  that: 

"All  school  houses  hereafter  built  shall  be  constructed  in  respect  to  lighting, 
heating,  ventilation  and  other  sanitary  arrangements  according  to  regulations  fur- 
nished by  the  state  board  of  health." 

In  New  York  cities  of  the  second  class  the  health  officer  can  stop 
the  erection  of  any  public  building  which  is  not  satisfactory. 

Nine  states,  Connecticut,  Iowa,  Kansas,  Massachusetts,  Maryland, 
Nebraska,  Nevada,  New  York,  and  Pennsylvania  require  that  school- 
houses  shall  be  provided  with  a  suitable  number  of  privies,  water-closets 
or  earth-closets.  A  number  of  the  states  require  that  privies  for  the 
two  sexes  shall  be  provided  and  that  they  shall  be  separated,  and  in 
Pennsylvania2  unless  they  are  at  remote  distances  the  approaches  and 
walks  shall  be  separated  by  a  substantial  close  fence  not  less  than  seven 
feet  high.  The  Massachusetts  law3  requires  that  "  every  schoolhouse 
shall  be  kept  in  a  cleanly  state  and  free  from  effluvia  arising  from  any 
drain,  privy,  or  other  nuisance."  Pennsylvania4  goes  further  and  pre- 
scribes how  the  schoolhouses  shall  be  kept  clean. 

Most  of  the  labor  of  keeping  the  schoolrooms  clean  seems  to  be  lost 
if  the  children  are  allowed  to  remain  filthy.  In  the  country  the  prob- 
lem of  keeping  the  children  clean   is  not  so  serious  a  one,  but  in  city 

1  Vermont,  Chapter  102  of  1896. 

2  Pennsylvania,  Chapter  279  of  1893. 

3  Massachusetts,  Chapter  508  of  1894,  Sec.  4. 

4  Pennsylvania,  Chapter  165  of  1895 : 

"  Section  1.  Be  it  enacted,  etc.,  That  the  boards  of  school  directors  and  con- 
trollers of  each  school  district  of  this  commonwealth,  be  and  they  are  hereby  re- 
cpiired  at  least  once  during  each  school  term,  and  prior  to  the  first  of  January  of  each 
year,  and  within  thirty  days  after  the  close  of  each  annual  school  term,  to  have 
taken  out,  removed  and  hauled  away  all  excrement  and  waste  matter  from  every 
out-house  or  water-closet  connected  with  or  standing  upon  the  premises  of  every 
public  schoolhouse  in  the  commonwealth,  or  have  the  same  properly  disinfected; 
and  they  are  required  to  have  every  out-house  or  water-closet  properly  scrubbed, 
washed  out  and  cleaned,  the  inside  walls  whitewashed,  and  the  vaults  or  receptacles 
covered  with  a  layer  of  fresh  dirt  or  dry  slacked  lime  within  ten  days  of  the  opening 
of  each  annual  school  term. 

"  Sec.  2.  That  the  president  of  each  board  of  school  directors  or  controllers  is 
required  each  year  to  certify  in  the  regular  form  provided  for  that  purpose,  that  the 
requirements  of  this  act  have  been  fully  carried  out  before  the  district  can  draw  its 
annual  appropriation  from  the  state." 


MIS  C  ELLA  NEO  Us   &  i  NIT  A  BY    II  rORK.  781 

schools  in  the  poorer  sections  of  the  city  it  is  more  difficult  Many  of 
the  city  school  boards  have  rules  fori  lidding  children  to  he  in  school 
who  are  unclean  in  person  or  dress.  Such  a  rule  is,  however,  not  easy 
to  enforce,  and  children  are  rarely  sent  home  for  failure  to  comply  with 
its  requirements.  Boston,  in  one  school,  the  Paul  Revere  School,  seems 
to  have  solved  the  problem,  at  least. so  far  as  cleanliness  of  person  is 
concerned.  Shower  baths  have  been  constructed  in  the  basement  of  the 
school  for  the  use  of  the  pupils.  On  the  boys'  side  the  baths  are  all  in 
one  room  around  the  sides  of  which  are  arranged  benches  on  which  the 
boys  may  sit  while  undressing,  and  above  are  hooks  on  which  they  may 
hang  their  clothes.  On  the  girls'  side  separate  dressing  rooms  and  sep- 
arate bathrooms  are  provided,  making  the  girls'  outfit  much  more  expen- 
sive than  the  boys'.  Soap  and  towels  are  free.  Bathing  is  not  com- 
pulsory, but  practically  all  the  children  use  the  bath.  For  this  purpose 
each  room  is  given  one  hour  a  week  of  the  regular  school  time.  Similar 
baths  have  recently  been  put  in  a  public  school  in  New  York  City. 

The  heating  and  ventilation  of  schoolrooms  is  of  the  utmost  import- 
ance, but  there  is  practically  no  statutory  legislation  in  regard  to  it,  ex- 
cept that  of  Massachusetts  and  Connecticut  above  referred  to.  New 
York  City,1  Chicago,  and  some  others  following  them,  have  a  general 
rule  which  requires  that  the  ventilation  and  heating  as  well  as  every- 
thing else  about  schoolhouses  shall  be  managed  as  well  as  possible, —  a 
rule  so  genera]  in  its  provisions  that  it  is  probably  of  little  use.  In  the 
school  board  rules  of  several  cities  regulations  are  found  concerning 
ventilation,  heating,  temperature  of  the  rooms,  form  and  size  of  scats. 
methods  and  manner  of  cleaning,  etc.,  but  rarely  or  never  are  these 
matters  regulated  by  the  department  of  health.  None  of  these  matters 
appear  to  be  touched  by  statute  law  except  in  Kentucky.2 

The  thorough  inspection   of  schoolhouses   is  desirable   to  discover 
what  detects  ought  to  be  remedied  and  what  can  be  remedied  at  a  rea- 


1  city  of  New  Fork,  Sanitary  Code  (1899),  Sec.  190. 
Kentucky,  Statutes  1 1894) ; 

"Sec.  1440.     .     .     .     Each  schoolhouse  hereafter  erected  shall  have  a  rl 'space 

of  not  less  than  ten  square  feel  to  each  pupil  in  the  district;  shall  be  at  least  tea 
feet  between  floor  and  ceiling;  shall  have  at  hast  four  windows,  one  or  more  fire- 
places, with  chimneys  made  entirely  "i  brick  or  stone,  or  a  sufficient  aumbei  of 
stoves  or  other  beating  apparatus,  with  safe  thus,  to  warm  the  room  in  the  coldest 
weather.  .  .  .  The  trustees  shall  furnish  cadi  schoolhouse  with  at  least  the  fol- 
lowing  articles  .,i  furniture  and  apparatus,  ...  a  seat,  patent  '>■■  otherwise, 
with  back,  for  each  child,  the  height  of  the  Beat  and  its  hack  to  suit  the  age  "t  the 

child.      .      .      . 

14  Sec.  W47.  .  .  .  They  shall  see  that  a  sufficient  supply  of  g I  water  is  fur- 
nished within  easy  access  of  the  Bchoolhouse  foi  the  benefit  "f  the  school  during  the 
term  of  school.    .    .     .-1 


782  MISCELLANEOUS   SANITARY    WORK. 

sonable  expense.  Massachusetts  has  provided  for  such  inspection  by 
its  state  factory  inspectors  and  in  Ohio1  local  boards  of  health  are  "  re- 
quired to  inspect  semi-annually  and  oftener  if  in  the  judgment  of  the 
board  it  shall  be  deemed  necessary,  the  sanitary  condition  of  all  schools 
and  school  buildings  within  its  jurisdiction/'  Other  boards  of  health, 
both  local  and  state,  have  considered  such  inspection  to  be  within  their 
field  of  work,  even  if  not  expressly  so  stated  by  statute.  Sometimes 
school  inspection  is  undertaken  by  special  committees  appointed  for 
that  purpose  as  in  Boston  in  1896  by  a  committee  appointed  by  the 
mayor,  or  in  Philadelphia  by  an  expert,  Prof.  S.  H.  Woodbridge,  ap- 
pointed by  the  Woman's  Health  Protective  Association.  Sometimes 
such  inspections  are  made  by  the  state  board  of  health,  as  in  South 
Carolina2  and  Wisconsin.3 

More  often,  however,  the  inspection  of  schoolhouses  is  undertaken 
b}"  the  local  board  of  health.  Such  an  inspection  may  or  may  not  be  of 
much  value.  To  be  of  value  it  should  be  thorough  and  the  inspector 
should  be  sure  of  his  conclusions  and  wise  in  his  advice.  Furthermore, 
such  inspection  is  of  much  greater  usefulness  when  conducted  with  the 
hearty  co-operation  of  the  school  board.  If  there  is  any  antagonism  be- 
tween the  health  officers  and  the  school  officers,  or  if  the  criticisms  of  the 
health  officers  are  directed  as  much  at  the  school  board  as  at  the  school- 
houses,  little  good  is  likely  to  come  of  the  exposure  of  defects.  In  a 
word,  little  good  can  be  accomplished  unless  the  two  departments  act 
in  harmony.  Usually  it  may  be  assumed  that  school  boards  desire  to 
have  the  houses  in  the  best  possible  sanitary  condition.  What  they 
need  is  money  to  put  them  in  this  condition,  and  the  health  officer  if 
lie  acts  with  tact  can  do  much  to  help  them  to  get  the  money.  Among 
local  boards  of  health  which  have  made  such  inspections,  may  be 
mentioned  Alameda,  Cal.,  in  1888,  District  of  Columbia  in  1807,  Law- 
rence in  1888,  Lowell  in  1888,  Lynn  in  1888,  Manchester,  N.  H.  in  1897, 
Mansfield,  O.  in  1891,  Minneapolis  in  1890,  Reading  in  1801,  Provi- 
dence in  1886  and  1896,  Rochester  in  1897,  Sacramento  in  1897, 
St.  Louis  in  1896-7,  LTtica  in  1807.  Among  the  most  complete  of  these 
inspections  are  those  of  the  District  of  Columbia,  Providence,  Rochester, 
and  Reading.  School  inspections  should  in  order  to  increase  knowledge 
of  schoolhouse  sanitation,  and  to  carry  more  weight  to  the  councils  to 
whom  they  are  addressed,  be  quantitative  as  well  as  qualitative.  The 
measuring    tape    and    the    anemometer,   but    particularly    the    former, 


ioliio,  Annotated  Statutes  (1900),  Sec.  2135. 

2  South  Carolina,  Report  of  State  Board  of  Health  (1895),  pp.  01-89. 

;  Wisconsin,  State  Board  of  Health  Report  (1889),  p.  53,  of  seq. 


MIS  C  EL  L .  J  NEO I  rS   &  t  XI T.  IMY    W  OllK.  783 

should  be  always  in  the  hands  of  the  inspector.  The  report  of  the  in- 
spection in  Reading  is  an  excellent  example  of  what  can  be  done  in 
this  direction,  and  the  tabular  statement  of  results  is  the  most  complete 
that  the  writer  has  met  with  in  any  health  report.  In  Providence  the 
anemometer  was  used  in  every  school,  and  in  some  tests  a  recording 
anemometer  was  used  tor  a  number  of  days.  Special  attention  in  that 
city  was  given  to  the  alleged  ••  back  draughts  "  of  the  ••  Smead  System'' 
and  to  investigate  this  a  recording  instrument  was  used  to  indicate  any 
reversal  of  the  air  current.  Various  schedules  have  been  devised  to  be 
used  in  the  inspection  of  schools.1  The  following  was  the  schedule  used 
in  Providence : 

SCHOOLHOUSE    T  N  ^  PECTION. 

Name.     Location.     Character  of   site. 

Dale.      Temperature  outside.     Direction  of  Wind.      Force  of  Wind. 

Number  of  Room.     Size.     Number  of  pupils. 

Recitation  Rooms,     size.     Number  of  Pupils.  Heating.     Ventilation.     Lighting. 

Cloak  Rooms.     Ventilation. 

Stairs.     Position.     Width.     Tread.     Rise. 

Fire  Escapes. 

Doors  inside,  open  in  or  out.    <  hit  side,  open  in  or  out. 

Ventilation  and  Heating  System. 

Position  of  Inlets,     size.     Kate  of  Flow.     Open  or  closed  (how  regulated). 

Posil  ion  of  <  >ui  lets.     Size.      Rate  of  Flow.     <  >pen  or  closed  (how  regulated). 

Size  of  Fresh  Air  Inlet.     Size  Of  Outlet  Shaft. 

Temperature.     .Method  of  Regulating. 

Windows.     Number,     size.     Height  from  Floor. 

•■shutters.      Blinds.     Curtains. 

Storm  Windows.     Weatherstrips.     Window  Ventilation. 

Plumbing.     Set  Bowls.     Waste  Pipes.     Soil  Pipes.     Traps. 

Water  Closets.     Latrines.     Sewer  Connection. 

Water  for  Drinking.     Filters.     Cups. 

Excreta  Disposal.     Method. 

1  >esks. 

In  Rochester  the  amount  of  carbon  dioxide  determined  by  the 
Wmckler  apparatus,  and  the  humidity  by  wel  and  dry  bulb  were  aoted 
for  curb  room. 

In  Philadelphia  and  Milwaukee  the  regular  medical  inspectors  have 
been  required  to  make  inspections  of  the  public  schools.  These  routine 
inspections  are  of  course  qoI  us  thorough  us  those  jusl  referred  to,  but 
are  carried  <>n  in  order  to  correct  minor  delects  in  management  and  to 
discover  the  smaller  structural  defects,  though  of  course  the  larger 
defects  it' not  corrected  are  noted  again  and  again.  It  had  been  hoped 
by  the  writer  thai  the  dail}  medical  inspection  of  bc! Is  would  furnish 

1  I. v poii  of  1  .  s.  Commissioner  of  Educal  ion  (1898-4),  p.  1348. 


784  MISCELLANEOUS   SANITARY   WORK. 

a  means  of  doing  much  to  assistant!  correct  janitors  and  teachers  in  their 
care  of  the  schoolhouse,  but  it  does  not  appear  from  reports  that  much 
has  vet  been  done  in  this  line. 

Medical  Inspection  of  Schools. 

To  Dr.  Samuel  H.  Durgin  of  the  Boston  board  of  health  is  due  the 
credit  of  inaugurating  this  method  of  improving  the  sanitary  condition 
of  school  children.  The  principal  aim  in  undertaking  this  inspection  was 
to  bring  to  light  unrecognized  cases  of  communicable  disease,  and  it 
was  hoped  thus  to  do  much  to  check  the  spread  of  these  diseases  among 
school  children ;  but  it  has  been  shown  that  much  good  is  accomplished 
in  other  directions,  and  it  is  not  unlikely  that  the  control  of  communi- 
cable diseases  will  come  to  be  considered  as  a  very  minor  part  of  school 
inspection.  Such  an  inspection  was  urged  by  the  Boston  board  of 
health  as  early  as  1890,  but  was  not  set  in  operation  until  1  Novem- 
ber, 1894.1  Parochial  as  well  as  public  schools  are  included  in  the 
scheme.  The  city  is  divided  into  fifty  districts  and  an  inspector  is  ap- 
pointed for  each  district.  There  does  not  seem  to  be  any  difficulty  in 
securing  enough  competent  physicians,  and  vacancies  are  easily  filled. 
The  salary  is  $200  per  annum,  but  the  inspector  is  required  to  visit  at 
their  homes,  at  least  twice,  all  cases  of  diphtheria  and  scarlet  fever  re- 
ported in  his  district.  Each  inspector  has  four  or  five  schools  and  about 
2,000  children.  The  inspector  visits  each  school  soon  after  the  opening 
of  the  morning  session.  The  teacher  has  already  noted  whether  any 
child  appears  to  be  ill  or  in  airy  way  to  need  the  advice  of  the  inspector. 
Sometimes  the  teachers  agree  to  put  a  card  in  the  window  when  the 
inspector  is  needed  so  that  he  may  not  have  the  trouble  of  entering  the 
building  unless  it  is  necessary.  The  principal  receives  early  in  the 
session,  from  each  of  the  teachers,  a  notice  of  any  child  which  may  re- 
quire attention. 

It  will  be  seen  that  after  all  the  teacher  has  the  most  responsibility 
in  these  inspections.  If  the  teacher  is  intelligent  and  observing,  the 
work  will  be  successful,  otherwise  not.  In  Boston  it  is  found  that  the 
teachers  with  a  little  instruction  become  very  adept  in  recognizing  cases 
that  need  attention  ;  and  the  teachers  appear  to  greatly  appreciate  the 
aid  which  is  given  by  this  inspection.  While  it  has  given  them  a  new 
duty  to  perform  each  morning,  it  has  relieved  them  of  the  burden  of 
deciding  what  to  do  with  the  doubtful  cases. 

In  Boston  at  first  a  book  was  kept  in  which  were  entered  the  cases 


1  Paper   read  by   Samuel  II.  Durgin,  M.  D.,  before   the   Massachusetts    Medical 

Society,  9  June,  1897. 


MISCELLANEOUS   SANITARY   WORK.  >:, 

to  be  sent  to  the  inspector,  but  slips  like  that  shown  below1  have  been 
substituted  for  it. 

In  New  York  it  is  required  by  a  rule  of  the  board  of  education  that 
if  the  teacher  suspects  that  a  child  may  have  a  communicable  disease, 
it  is  to  be  isolated  in  a  separate  room  until  the  inspector  arrives. 
Doubtless  the  same  plan  is  followed  in  other  cities.  Unless  the  case  is 
suspected  to  be  a  communicable  disease  or  unless  the  teacher  feels  that 
it  is  too  sick  to  remain  even  a  short  time,  the  pupil  goes  on  with  its 
tasks  as  usual.  In  Boston  the  inspectors  see  the  majority  of  the  sus- 
-  in  the  hallway,  but  if  small  rooms  are  available  they  may  he 
need.  If  the  inspector  finds  the  child  too  ill  from  any  cause  to  remain 
at  school  he  advises  the  teacher  to  send  the  child  home  for  the  observa- 
tion and  care  of  its  parents  and  family  physician.  In  New  York  when 
a  child  is  sent  home  a  card  is  sent  with  it.  stating  the  reason  for  ex- 
clusion. If  the  illness  is  a  dangerous  communicable  disease,  the  child 
is  at  once  ordered  home.  In  Philadelphia  where  the  inspection  is  not 
under  the  health  department,  a  special  form  of  report  card  is  used  for 
communicable  disease.  Of  course  many  cases  of  sore  throat  are  seen, 
and  in  these  it  is  the  routine  practice  to  take  a  culture  before  sending 
the  child  home.  In  Boston  the  inspectors  frequently  do  not  carry  cul- 
ture outfits,  but  take  the  suspects   to  the    nearest   culture    box   station. 

Of  course,  often,  perhaps  USUally,  the  inspector  desires  to  see  the 
teacher  and  give  some  explanation  of  the  case,  but  in  any  event  lie  tills 
out  the  slip  relating  to  the  case  and  returns  it  to  the  teacher.  The  in- 
spectors are  not  allowed  to  have  any  of  the  pupils  sent  to  their  own 
offices  for  consultation,  but  they  must  be  examined  in  the  schools  or 
sent  to  their  own  physician  or  to   the  hospitals. 

"  The  school  inspectors  do  net  give  professional  treatment   in  any  case.     They 
merely  point  out  the  need  of   professional  treatment   where  the  need   <\isis.     The 


19 


Keep  on   I'ii.i:. 

Ti    \'  in  B's   Si  \  i  i  \h  \  i 


School. 


Advia 


I'm  »n  i  \  \-  s  i  \  ii  .mi  si. 


786  MISCELLANEOUS   SANITARY   WORK. 

treatment  itself  must  be  received  from  the  family  physician,  or  in  the  hospitals,  or 
in  the  dispensaries,  and  great  care  is  necessary  to  avoid  giving  offence  to  physicians 
and  their  families.11 

The  inspectors  vaccinate  some  in  Boston  but  not  very  much  and 
only  the  poor;  only  260  vaccinations  were  performed  in  1898,  but 
many  arms  were  examined  and  1,142  certificates  of  vaccination  filled 
out.  The  inspector  carries  with  him  a  report  sheet  on  which  he  tallies 
the  cases  that  he  meets  with  and  at  the  end  of  the  month  he  writes  out 
this  report  on  a  new  sheet  and  sends  it  to  the  board  of  health.  See 
Appendix  122.  On  the  back  of  this  is  printed  a  classification  of  dis- 
eases. A  similar  but  simpler  form  is  used  in  New  York,  but  a  separate 
report  must  be  made  out  each  day  for  each  school. 

In  Boston,  as  indeed  in  other  cities,  much  trouble  has  been  caused 
by  pediculosis,  and  in  these  cases  it  is  not  considered  necessary  to  send 
to  the  family  physician  for  treatment.  The  following  card  is  sent  to 
the  parent  in  each  case  : 

"  School. 

"Boston, 189 

has  been  reported 
by  the  Medical  Inspector  of  Schools  as  showing  evidence  of  parasites  in  the  hair, 
and  I  am  therefore  obliged  to  request  that  the  child  be  kept  out  of  school  for  a  few 
days  until  the  disease  is  cured. 

"  Master. 

"The  following  method  of  treatment  for  killing  parasites  and  nits  is  recom- 
mended by  the  Board  of  Health :  — 

"Wet  the  hair  thoroughly  with  crude  petroleum,  of  which  half  a  pint  may  be 
obtained  at  a  drug  store.  (Set  accompanying  prescription.)  Keep  it  wet  for  three 
hours.  Then  wash  the  whole  head  with  warm  water  and  soap.  Repeat  this  process 
on  three  successive  days.  The  nits  may  then  be  removed  by  combing  the  hair  very 
carefully  with  a  fine  toothed  comb  wet  witli  vinegar.  Repeat  the  combing  for 
several  days  until  no  more  nits  can  be  found.  To  make  the  treatment  easier  and 
more  thorough,  the  hair  may  be  cut  short  if  there  is  no  objection. 

"All  the  children  in  a  family  are  likely  to  be  affected,  and  should  also  be  treated 
as  above. 

"  Brushes  and  combs  should  be  cleansed  by  putting  them  in  boiling  water  for  a 
few  minutes.11 

A  more  simple  form,  printed  in  three  languages  is  used  in  New 
Bedford. 

The  child  is  then  not  admitted  to  school  until  he  brings  the  follow- 
ing slip  signed  by  the  parent  : 

'•I  hereby  declare  that  on  three  different  days  during  the  past  week  I  have 
applied  crude  petroleum  to  my  child's  hair,  as  directed  on  the  card  received.11 


To  be  signed  by  Parent  or  Guardian. 


MISCELLANEOUS   SANITARY   WORK.  787 

While  the  more  important  communicable  diseases  are  not  discovered 
perhaps  as  often  as  was  expected,  outbreaks  are  sometimes  checked  as 
shown  by  the  report  of  one  of  Boston's  inspectors.1 

In  1n(.»7  the  board  of  health  of  New  York  City  inaugurated  an 
inspection  similar  to  that  in  Boston,  to  include  both  the  public  and 
parochial  schools.  At  present  (1899)  there  are  205  inspectors  of  which 
14"  are  in  Manhattan  and  38  in  Brooklyn,  at  a  salary  of  $36< '.  with  a  chief 
at  a  salary  of  $2,500.  The  appointment  of  a  chief  inspector  seems  to  be 
almost  a  necessity  in  large  cities.  The  work  of  inspection  requires  a 
good  deal  of  special  knowledge  and  much  can  be  done  to  increase  the 
efficiency  of  the  inspectors  by  a  capable  chief.  Moreover  with  a  large 
corps  of  inspectors  there  are  sure  to  be  some  that  are  negligent  or  ineffi- 
cienl  and  these  need  to  be  disciplined  or  discharged,  [n  a  small  city  the 
executive  officer  of  the  health  department  may  well  supervise  this  work 
of  school  inspection,  but  in  large  cities  a  special  supervision  is  necessary 
and  lias  been  supplied  in  New  York.  In  Boston  the  need  of  it  is  felt. 
In  that  city  the  inspectors  have  attempted  to  improve  their  service  by 
having  meetings  every  two  months  for  the  discussion  of  matters  con- 
nected with  their  work. 

Temporary  inspection  of  schools  on  the  foregoing  plan  was  carried  on 
during  outbreaks  of  communicable  diseases  in  Brookline,  Mass.,  in  1894 
and  in  1895.2 

A  similar  inspection  was  begunin  Hartford  in  1899,  during  an  out- 
break of  diphtheria  and  the  two  inspectors  have  continued  their  work 
ever  since.     In  1899  21,973  children  were  examined. 

In    Philadelphia,8  in    1898  the  board  of  health   directed    its  fifteen 

.nil   medical  inspectors  to  inspect  one  school  each  day  in  accordance 

with  the  system  employed  in  Boston.     This  was  done  in  order  to  show 

the  benefits  of  the  scheme  and  secure  its  final  application  to  all  scl Is. 

The  cit\  has  not  yei  established  a  paid  service,  bu1  recently  the  board  of 
public  education  has  instituted  a  daily  inspection  by  the  voluntary  ser- 
vices of  physicians,  though  not  enough  have  offered  for  all  the  schools. 
In  that  city  a  circular  was  sent  to  each  principal  explaining  the 
system. 

In  St.  Louis3  some  of  the  public  spirited  physicians  undertook  tin1 
same    work    tor  a    lew    schools    and    with    the  same  end  in   view,  but  no 

public  inspection  has  yet  been   inaugurated. 


Article  bj  II.  I».   Arnold,  M.  D.,  Annals  of  Gyna logy  and  Pediatrics,  January, 

'Brookline,  deports  of  Board  of   Health   for  years  ending  31  January,  1895  and 
1896. 

Report  "i  I  .  N.  <  "i issioner  of  Education  (1897-8),  i>.  1492 


788  MISCELLANEOUS   SANITARY   WORK. 

In  Chicago,1  owing  to  lack  of  funds,  the  health  department  was  not 
at  first  able  to  establish  a  daily  examination  of  each  school,  but  in 
September,  1896,  the  city  was  divided  into  eight  districts,  each  covering 
an  area  of  about  twenty-two  square  miles,  with  an  inspector  for  each. 
These  inspectors  were  to  devote  their  entire  attention  to  the  schools  and 
were  to  look  after  the  vaccinal  condition  of  the  children  and  to  super- 
vise all  cases  of  communicable  disease  reported  among  the  school 
children,  visiting  the  schools  which  the  children  attended  and  inspecting 
the  pupils  when  necessary.  But  hi  January,  1000,  a  daily  inspection 
was  begun.  This  work  is  under  the  technical  direction  of  the  board  of 
health,  but  it  is  attached  to  the  compulsory  education  department  of 
the  public  school  system,  and  is  thus  operated  under  the  joint  jurisdic- 
tion of  the  department  of  health  and  the  board  of  education.  There  are 
fifty  inspectors  who  receive  $50  a  month.  They  work  from  nine  in  the 
morning  until  twelve  noon.  School  districts  are  sub-divided  so  that 
each  inspector  has  a  certain  number  of  schools  to  visit  each  day. 
Children  are  excluded  who  are  found  to  be  suffering  from  contagious 
diseases,  and  all  children  who  have  been  absent  for  four  days  or  more 
are  required  to  submit  to  an  examination  of  their  throats  before  they 
can  return  to  their  class  rooms. 

An  inspection  similar  to  that  formerly  practiced  in  Chicago1  was 
inaugurated  in  Milwaukee  in  1898,  the  city  being  divided  into  five  dis- 
tricts and  an  inspector  appointed  for  each  district.2  The  next  year  the 
number  of  districts  was  increased  to  twelve,  with  five  schools  in  each 
district,  and  twelve  inspectors  were  appointed.  In  each  school  a 
"quarantine  room"  is  provided, to  which  all  suspected  children  are  sent 
and  which  is  used  for  nothing  else.  All  children  who  have  been  out  of 
school  two  days  or  are  sick  must  be  seen  by  the  inspectors  before  they 
are  readmitted. 

In  Newton,  Mass.,3  seven  school  inspectors  are  appointed  at  a  salary 
of  850  per  annum,  who  visit  the  schools  at  the  beginning  of  each  term 
and  inspect  the  children,  giving  especial  attention  to  vaccination  and  the 
existence  of  communicable  disease.  During  the  term  time  suspicious 
cases  if  noticed  by  the  teacher  are  reported  to  the  health  department, 
and  so  far  as  possible,  examined.  This  is  doubtless  done  in  other  cities, 
but  probably  only  in  the  more  important  diseases,  as  scarlet  fever  and 
diphtheria. 


1  Chicago,  Report  of  Department  of  Health  (1895-6),  p.  75. 

-Milwaukee,  Report  of  Health  Commissioner,  year  ending  April,  1899,  p.  32,  and 
Report  for  the  year  ending  April.  1900,  p.  30. 

Newton,  Mass..  Report  of  Hoard  of  Health  (1898),  p.  16. 


MIS CEL LA  XEO I ~s    sA NIT.  VR  Y    WORK. 


789 


The  results  of  school  inspections  are  fairly  shown  by  the  following 
table  taken  from  the  Boston  board  of  health  report  :  ' 

Number  of  pupils  examined  in  the  schools 17.440 

Number  recommended  to  be  sent  home 2,583 

Number  consultations  with  teachers  (about  pupils  returning  to  school,  etc.).     3,089 
Note.—  In  further  diagnosis  the  nomenclature  of  Osier's  Practice  of  Medicine  is  recommended. 


I. —  Specific  Infectious  Diseases. 


Diphtheria 

Scarlet  fever 

Measles 

Whooping  cough . 

Mumps 

Smallpox 

Chicken-pox 

[nfluenza 

Erysipelas 

Syphilis 

Tuberculosis 

Malaria 


II. —  DlSE  VSES       OF        1111.       OBAX 

Respibatobi    Tbact. 

/.     Mouth. 
Stomatitis: 

a     Simple  (eryl  bematous) .... 

Aphthous  (herpetic) 

I  riceratn  e 

d)   Parasitic  (1  brush,  etc  i . . . . 
Alveolar  abscess 


13 

•"> 

So 

134 

7, 

82 
61 

1 


468 

AND 


Pharynx. 

Acute  pharyngitis 

Hypertrophic   pharyngitis  (acute 

ami  rlir.  .nil) 

Tonsils. 

Ann.-  follicular  tonsillitis 

Hypertrophic  tonsillitis 

Abscess   


-_'*; 


:;:; 


1,285 

55<  i 


Utnh 


Elongal  ion. 


Acute  ihinit  is 

( Ihronic  rhinitis 

Purulent   rliinit  is.  . 

<  tzaena 

I  u-\  i;ii  inns  oi  sepl  urn, 

I'.  1 1  i  s  t  a  x  i  s 


:;i 


13 


<;.     Naso-Pharynx. 

Naso-pharyngitis   (Post-nasal  ca- 
tarrh)   

Adenoid  disease 

Larynx. 

Acute   laryngitis 

<  hronie  laryngitis 

x.     Bronchi. 

Acute  bronchitis 

( 'hronie  bronchitis 

'.elite  pleurisy 


25 

■'7 


:;;• 


141 


III.        1)1-1.  V.SES    OF     rm.;    ]■;  \k. 

Foreign  bodies  (cerumen,  etc.  i . . 

''tin's  media,  catarrhal,  acute... 

<  'tit i ss   media,  chronic 

Otitis,  media,  suppurative,  acute 

<  Hit  is  media,  suppurative,  chronic 

Mastoiditis 

Imperfect  hearing  (without  visi- 
ble   cause) 

IV.—  DlSE  \-i  s    OF    l  ill      El  l.. 

/.     Foreign    Bodies. 

ign  bodies 

Eyelids. 
Illepbaritis 

Stye 

1  'tnsi.s 

Trichiasis 

Lachrymal  Organs. 

'  >>st  ruction  of  duct 

A  bscess 


121 


11 
144 


13 

1 

1 


'  onjunctica. 

<   on  juiiei  i\  itis  : 


\cutc  catarrhal 
Puruleni  

■  i   Phlj  ctenular 

•  /    < .  ranular  , 


I  is 


1  Boston,  Report  of  Hoard  of  Health,  (1890),  p.  51. 


790 


MISCELLANEOUS   SANITARY   WORK. 


5.     Cornea. 

Interstitial  keratitis 5 

Ulcer 16 

Opacity 6 

6.     Iris. 

Iritis 1 

Synechia  

7.    Muscles. 

Strabismus 10 

Nystagmus 2 

Paralysis  of  extra-ocular  muscles 
Imperfect  sight  (without  visible 

cause) ITS 

Unclassified i; 

4:51 
V. —  Diseases  of  the  Skin. 

Acne 28 

Alopecia  areata 10 

Dermatitis 55 

Eczema 288 

Erythema  multiforme 2 

Erythema  simplex 18 

Furunculus 20 

Herpes    {  simplex 7" 

(  zoster 4 

Impetigo   contagiosa 199 

Pediculosis 2,292 

Pemphigus 4 

Pityriasis  maculata  et  circinata  . . 

Pruritus 2 

Psoriasis :, 

Purpura — 

Scabies 39 

Seborrhoea 32 


f favosa 13 

Tinea  -<J  tricophytina 104 

(_  versicolor 

Urticaria 31 

Verruca 6 

Unclassified 10 

3,252 
VI. —  Miscellaneous  Diseases. 

Anaemia 86 

Debility 94 

Headache  (habitual) 170 

Cervical  adenitis -. 78 

Chorea 17 

Ulcer 25 

Deformities  '.' ' ' 

(  extremities 

Dislocations 2 

Sprains 47 

Fractures 2 

Contusions 49 

Wounds 68 

Abscess 33 

Dental  caries  (painful) 27 

Neuralgia 37 

Epilepsy 8 

Rheumatism 21 

Cardiac  diseases 8 

Gastric  diseases 97 

Intestinal  diseases 25 

Urinary  diseases 8 

Vaccinations  (performed) 1,016 

Certificates  of  vaccination 1.896 

"No  disease,"    (no   pediculi,   no 

vaccination  marks,  etc.) 6,510 

Unclassified 85 

10,413 


In  New  York  in  18981  139,965  children  were  examined  and  7,606 
were  excluded.  Of  these  118  had  diphtheria,  25  croup,  328  scarlet 
fever,  253  measles,  380  chicken  pox,  517  mumps,  1,627  contagious  dis- 
eases of  the  eyes,  703  contagious  diseases  of  the  skin,  3,502  parasites  of 
the  head,  and  152  parasites  of  the  body.  The  average  daily  attendance 
was  456,394. 

In  Cambridge  in  1899  there  were  excluded  372  children,  of  whom 
4  had  diphtheria,  5  scarlet  fever,  24  measles,  18  mumps,  18  chicken  pox, 
and  57  pediculosis. 


I  Medical  News,  21  October,  1899,  p.  535. 


MISCELLANEOUS   SANITARY    WO  EX.  791 

In  Chicago  during  the  first  four  months  of  1900,  16,805  children 
were  examined  of  which  4,539  were  excluded.  Of  these  170  had  diph- 
theria, 401  scarlet  fever,  648  measles,  ob  whooping  cough,  670  chicken 
pox.  and  1,160  purulent  eyes. 

Public  Baths. 

Public  baths  belong  properly  to  the  department  of  public  works,  but 
they  are  here  considered  because  a  number  of  public  baths  in  American 
cities  are  in  charge  of  the  health  department,  and  because  the  health 
officers  are  usually  greatly  interested  in  this  public  improvement  and 
are  often  instrumental  in  securing  it.  It  is  doubtless  because  of  this 
active  interest  of  health  officials  that  the  construction  and  maintenance 
of  baths  is  placed  in  their  hands.  While  municipal  baths  are  common 
in  Europe  they  are  not  in  this  country.  Public  baths  constructed  by 
private  effort  are  found  in  several  cities.  Some  of  these  are  intended 
as  public  charities,  the  fee  charged  not  being  sufficient  to  pay  the  run- 
ning expenses.  Examples  of  such  baths  are  the  People's  Baths,  9 
Centre  Market  Place,  New  York,  the  Baron  de  Hirsch  Bath,  corner 
Henry  and  Market  streets.  New  York,  and  the  Riverside  Baths,  259  West 
Sixty-ninth  street,  New  York.  It  lias  been  felt  by  many  that  public 
baths  should  not  be  left  to  private  initiative  but  that  the  best  and  surest 
way  to  secure  this  civilizing  agent  is  through  municipal  action.1 

Summer  It'ttJis.  In  a  number  of  cities  which  are  so  fortunately 
situated  as  to  permit  it.  floating  baths  have  been  in  use  for  many  years.1 
These  are  moored  in  rivers  or  harbors  and  of  course  can  be  used  only 
during  a  few  months  in  the  summer.2 

In  Lowell  and  Brookline  they  had  to  be  abandoned  on  account  of 
the  contamination  of  the  water.  In  New  York  the  first  floating  baths 
were  constructed  in  1*70.  In  L897  there  woe  fifteen  such  baths 
maintained  by  the  department  of  public  works.  They  are  usually  kept 
open  from  the  middle  of  June  to  the  first  of  October.     The  hours  are 

5  A.  M.  to  9    P.    M..  except    Sundays,  when    they    (dose    at    noon.      Mon- 
days, Wednesdays,  and  Fridays  are  set  apart   for  women  and   children. 

••  All  bathers  excepting  children  are  required  to  Eurnish  themselves  with  bathing 

s,  and,  to  avoid  infection,  no  towels  or  « >i h«r  toilel  articles  can  be  hired  ;tt  the 

baths.     Two  male  attendants  are  in  charge  of  each  batb  on  the  days  set  aparl   for 

males,  and  two  female  attendants  on  the  other  Ways.     A  male  guard  at  each  bath  on 

women's  days,  a  policeman  to  keep  order,  and  a  keeper  at  each  bath  at   night  are 


'See  Report   on   Public  Baths  and  Comfort   Stations,  Mayor's  Committee,  New 
Fork  1 1897).     Most  of  the  facts  here  given  ami  the  quotations  are  from  this  report. 

-  ich  baths  have  been  maintained  in  Boston,  Brookline,  Mass.,  Brooklyn,  < 
bridge,  Charleston,  Cleveland,   Hartford,   Lowell,  Milwaukee,  Newton,  Mass..  New 
Fork,  Portland,  Providence,  Taunton,  Watertown,  Mass.,  and  Worcester. 


792 


MISCELLANEOUS    SANITARY   WORK. 


employed.  Each  bath  lias  an  average  of  sixty-three  dressing  rooms,  a  reception, 
toilet  and  retiring  room,  and  is  lighted  by  gas.  The  baths  have  a  supply  of  ice 
water  and  are  thoroughly  swept,  scoured  and  washed  down  nightly.  .  .  .  The 
average  cost  of  construction  and  equipment  of  each  bath  is  .$13,000  and  the  annual 
cost  of  maintenance  and  repairs  for  the  fifteen  baths  is  $48,000,  including  $30,000  for 
the  salaries  of  attendants.  In  1896  there  were  3,895,755  male  bathers  and  1,658,143 
female;  total  5,553,898." 


Fig.  106. 

A  Floating  Bath,  West  Boston  Bridge,  Boston.     From  a  plate  loaned  by 
the  Commissioners  of  Baths. 


IT 

1             1            ,~.^T.-i         .,    „ 

nTH 

>1M 

<■ 

Fig.   107. 

New  type  of  Floating  Hath.  Harvard  Bridge,  Boston.       From  a  plate 
loaned  by  the  Commissioners  of  Baths. 


The  first  floating  bath  house  in  Boston  was  built  in  1866.  In 
1898  there  were  eighteen  houses  which  until  that  year  were  maintained 
by  the  board  of  health,  but  at  that  time   were  transferred  to  a  special 


JUS f  ELLA XA'O  US    &  J  XI TA 11  Y    11  r0R K. 


93 


i  »e 


Fig.  108. 

Swimming  Pool,  Orchard  Park,  Roxbury,  Boston.      From  a  plate  loaned  bj  the  Com- 
missionei  s  of  Baths. 


l-'i...    109. 
A  River  Bath,  Boston.     From  a  plate  loi d  bj  the  Commissioners  oi  Bath* 


794  MISCELLANEOUS   SANITARY   WORK. 

commission.  During  1897  there  were  657,275  bathers  of  whom  120,- 
915  were  women  and  girls.  The  total  expense  for  maintenance  for 
that  year  was  $23,768.31.  In  that  year  there  were  thirteen  floating 
houses.  The  old  style  floating  houses  are  about  sixty  by  thirty  feet 
with  twelve  feet  posts.  They  are  four  feet  six  inches  under  water  and 
are  supported  by  tanks  holding  8,000  gallons.  Sometimes  casks  are 
used  to  float  the  house.  They  last  several  years  but  are  recoopered 
annually.  The  baths  accommodate  about  seventy-five  bathers  at  a 
time.1 

The  new  style  of  floating  bath  is  open  to  the  sky,  thus  ensuring 
better  ventilation.  There  are  also  in  Boston  six  beach  baths  and  two 
swimming  pools  and  two  river  baths. 

"  The  swimming  pools  were  established  to  supply  summer  baths  to  the  sections 
of  the  city  without  water  frontage.  One  of  the  pools  is  at  Orchard  Park,  a  small 
open  space  with  grass  and  trees  in  the  midst  of  the  tenement  districts  of  Roxbury. 
It  consists  of  a  tank  made  of  concrete,  eighty  feet  in  length  by  thirty  feet  in  width 
and  four  feet  in  depth;  to  which  fresh  water  is  supplied  from  the  city  pipes.  This 
tank  is  enclosed  merely  by  a  high  board  fence.  Two  or  three  polling  booths  tem- 
porarily fitted  up  for  the  purpose  afford  the  necessary  dressing  accommodations. 
Great  care  is  taken  to  keep  the  water  clean.  The  surface  is  drawn  off  several  times 
daily,  and  once  each  day  the  tank  is  completely  emptied  and  washed  out.  Every 
bather  before  entering  the  pool  must  use  the  shower  bath.  Between  eighty  and 
ninety  thousand  gallons  of  water  are  used  daily." 

The  number  of  bathers  accommodated  at  all  the  Boston  baths  in  1899 
was  1,920,368. 

In-door  Baths.  While  the  summer  or  out-door  baths  are  excellent, 
they  can  only  be  used  about  one-third  of  the  year  and  even  then  are  not 
so  desirable  for  cleansing  as  are  shower  baths.  It  is  very  generally 
agreed  that  the  rain  bath  is  the  best  form  for  general  public  use,  though 
tub  baths  and  plunge  baths  have  their  place  in  public  plants.  As  was 
above  stated,  public  baths  of  this  kind  were  first  established  by  private 
philanthropic  enterprise,  but  there  are  now  municipal  works  in  a  number 
of  cities.  Massachusetts2  has  permitted  her  towns  to  construct  such 
baths,  and  New  York3  has  required  cities  of  the  first  and  second  class 
to  establish  baths  of  hot  and  cold  water  which  shall  be  open  fourteen 
hours  each  day.  These  baths  are  to  be  constructed  as  the  board  of 
health  may  require.  Baths  have  been  built  under  this  law  in  Buffalo, 
Rochester,  New  York,  and  Utica.  The  first  municipal  bath  of  this 
character  was  the  Carter  H.  Harrison  Bath  in  Chicago,  which  was 
opened  in  March,  1893. 


1  Boston,  Report  of  Department  of  Baths  (1899). 

-  Massachusetts,  Chapter  125  of  1898. 

3  New  York,  Revised  Statutes  (1896),  p.  433. 


MISCELLANEOUS   SANITARY   WO  UK.  795 

"It  is  a  handsome  structure  of  pressed  brick  and  brown  stone,  twenty-five  feet 
wide  by  one  hundred  and  ten  feet  deep.  In  the  basement  are  the  laundry  and  two 
furnaces,  one  for  heating  the  building,  the  other  for  heating  the  water  for  the  baths. 
In  the  front  of  the  main  floor  is  a  waiting  room  sixteen  feet  square,  seating  forty 
people.  Beyond  this  are  the  bath  rooms,  with  necessary  toilet  accommodations. 
There  are  sixteen  shower  and  two  tub  baths,  and  a  plunge  twenty  by  thirty  feet. 
This  last  has  not  been  a  success,  owing  to  its  small  size  and  to  the  aversion  of  peo- 
ple to  sharing  so  small  a  body  of  water.  Allowing  twenty-five  minutes  to  each 
bather,  the  capacity  of  the  bath  is  2,000  persons  a  week.  Two  minutes  are  allowed 
for  undressing  after  entering  the  bathroom,  when  the  water  is  turned  on  for  eight 
minutes.  One  minute's  notice  is  given  before  the  water  is  turned  off,  to  allow  time 
for  a  rinse  off.  Fifteen  minutes  are  allowed  for  dressing.  Women  are  allowed  to 
use  the  baths  two  days  a  week,  men  using  them  the  remainder  of  the  time.  For 
women  the  temperature  is  105  degrees,  and  on  days  for  men,  100  degrees.  Many 
people  resort  to  this  bath,  not  o.ily  for  the  purpose  of  cleanliness,  but  for  relief  for 
rheumatism  and  other  diseases,  with,  as  they  claim,  good  results." 

The  bath  cost  $10,856,  and  the  operating  expenses  in  1898  were 
$4,434.72,  the  total  expense  for  each  bath  averaging  four  and  one-tenth 
cents.  During  ls'.ts.  1  (h;.l'.;:,)  baths  were  given.  25,608  to  women  and 
girls.  In  July.  18(,Mi,  the  remarkable  number  of  11,250  baths  were 
recorded. 

The  following  account  of  the  .Madden  bath  is  from  the  report  of  the 
Chicago  Health  Department  for  1897-8,  p.  (.»i>: 

"The  Martin  B.  Madden  bath,  at  39th  street  and  Went  worth  avenue,  was  opened 
to  the  public,  April  17,  1897.     The  dimensions  of  this  building  are  as  follows: 

■•  The  I' in. lit  part  of  the  building,  which  ((insists  of  waiting  rooms  and  office,  is  30 
feci  by  19  feet  6  inches;  winy  part,  which  is  the  bath  proper,  is  26  by  To  feet,  and 
contains  31  separate  dressing  rooms  and  shower  baths,  one  tub  hath,  and  all  nec- 
essary  toilet  arrangements  annexed.     The  basement  is  divided  into  a  boiler  r o, 

laundry  and  soup  kitchens. 

••  Baths  given  in  1898  (288  days,  closed  67  days,  including  holidays.  Sundays  and 
for  repairs) : 

To  males,  96,461;  females  L2,461  :  total 108,922 

Cost  of  maintenance,  (including  wages) 14,040  31 

Average  cost  per  hath  given 0  o:!,7,, 

Daily  average  of  baths  given 3741 

Two  more  baths,  one  with    two  Bwimming   i ls,have   since   been 

built. 

The  bath  built  by  the  town  of  Brookline,  Mass..  is  a  mosl  remark- 
able example  of  public  spirit.  This  town  with  a  population  of  less  than 
20,000,  built  a  public  bath  at  a  coat  of  about  143,000,  exclusive  of 
land,     h  was  opened  in  January,  bs'.,7. 

•  The  main  part  of  the  building  contains  the  natatorium,  spectators1  gallery,  run- 
ning I  ra.k  and  dressing  rooms,  and  is  well  lighted,   well  ventilated,  and  en  in Ik.  us. 

The  mam  tank  is  80  feel  long  and  26  feet  wide,  and  has  an  average  of  i  1  -  feet  of 
water.  The  bottom  of  the  tank  slopes  gradually,  and  isfourfeet  deep  at  one  end 
and   seven   feet  at  the  other.     Ground  the  Bwimming    ball   are  forty-two  dressing 


796 


J//.v  (  EL  L .  I  NE  0 1  rS    S.  I XJ  TARY    WORK. 


Fig.  110. 

Brookline  Public  Bath.      From  a  plate  loaned  by  the  Committee  mi  tin-  Public  Bath. 

rooms,  with  a  passageway1  cm  either  side.  At  one  end  of  the  swimming  hall  are 
three  rain  baths,  at  the  other,  two:  these  are  for  the  preliminary  cleansing  hath  re- 
quired of  all  before  entering  the  swimming  tank.  On  the  right  of  the  entrance  is  the 
instruction  room,  containing  a  small  tank  22  by  10  feet,  with  water  of  an  average 
depth  of  :;  1-2  feet;  six  large  (double)  dressing  rooms  and  a  rain  bath  (s).  On  the 
left  of  the  entrance  is  a  large  room  (c)  containing  six  rain  and  foot  baths,  and  three 
bath  tubs  with  an  overhead  rain-bath  attachment,  and  nine  dressing  rooms.  The 
rain  baths  are  of  the  "  Gegenstrom"  pattern,  and  there  are  lifteen  of  them  in  all.  in 
various  parts  of  the  building,  with  space  for  three  more  when  needed." 

Rules  for  the  conduct  of  the  bath  are  given  in  the  1st  Report  of  the 
Bath  Committee.  1896.  The  fee  for  a  hath  is  ten  cents  which  includes 
towels  and  soap,  hut  on  two  days  in  the  week  the  bath  is  free.  In  1899 
there  were  49,391  bathers.  The  running  expenses  were  $7,600  and 
the  receipts  were  $5,230  making  the  net  cost  $2,370. 

Buffalo  lias  a  brick  hath  house  which  cost   $14,800.      It  has  twenty 

shower  baths.      Powdered  soap  is  used,  and  only  enough  for  one  bath  is 

issued  to  each  person.     The   hath  is  entirely  free.     The  following  data 

were  kindly  furnished  by  the  health  commissioner: 

Statistics    Pebtaining    to    Free    Pcblic    Bath    House.    No.   1, 
liriT.u.o,  X.  Y. 

Cost  of  land -$0,500  00 

Cost  of  building 8,000  00 

Cost  of  equipment 300  00 

814,800  00 

of  those  using  the  bath  during  1800,    00,029  were  men,  2,588  women,  and  10,170 
children. 

3,166  persons  took  advantage  of  the  laundry  privileges. 

1  The  stone  floors  of  the  passageway  and  dressing  rooms  are  kept  warm  by  spec- 
ial steam  pipes  underneath. 


MISCELLANEOUS   SANITARY    WORK. 


797 


798 


MISCELLANEOUS   SANLTARY    WORK. 


A.  Swimming  Bath.  B,  Plunge  Bath.  C,   Private  Baths. 

E,    Swimming  School.  D,  Dressing  Rooms.         s,   Rain  Baths. 

Fig.  112. 

Ground  Plan  of  Bath-house,  Brookline.     From  a  plate  loaned  by  the  Committee 
on  the  Public  Bath. 


A  second  free  public  bath  house  to  cost  $15,000  is  now  under 
construction  in  the  Polish  tenement  district,  on  land  which  cost 
$2,600. 

Yonkers  built  a  bath  in  1897,  at  a  cost  of  #9,400,  exclusive  of  land. 
There  are  twenty  shower  baths  and  two  tub  baths.  The  building  is  of 
brick,  25  by  53  feet.  Five  cents  is  charged  for  towel  and  soap.  Another 
bath  has  since  been  constructed.     In    1899   there  were    22,989  bathers, 


MISCELLANEOUS    SAJSTITAR  Y   WORK. 


799 


16,648    male,    6.541    female.       The    operating    expenses    were    about 
00. 

The  bath  in  Rochester  was  open  27  July,  1899.  It  cost  $15,028 
including  land.  When  purchased  it  was  a  dwelling  house  and  $4,700 
of  the  above  was  used  in  altering  it  and  fitting  it  up.  There  are  seven- 
teen baths,  and  a  place  where  bathers  can  wash  their  shirts  and  have 
them  dry  while  bathing.  No  fee  is  charged  and  soap  and  towels  are 
furnished.      The  operating  expenses  are  about  $3,500  per  year. 


Fig.   II::. 
i:  ,i      i  o  '"ii.      From  a  plate  loaned  bj  the  Commissioners  ol  Baths 


The   Dover  Streel    bath   in    Boston,  waa  opened  II   <  >ctober,  L899. 
It  cosl  $86,000,  of  which  $1  1,15  1.25  waa  for  land. 


8(10  MISCELLANEOUS    SANITARY   WORK. 

"  The  building  is  a  simple  but  imposing  structure  43  feet  wide  by  110  feet 
deep.  .  .  .  On  the  first  floor  are  separate  waiting  rooms  for  men  and  women  with 
the  laundry  and  engine  room  in  the  rear.  On  the  second  floor  are  separate  bath 
rooms  for  men  and  women.  The  third  floor  in  the  front  part  of  the  building  con- 
tains an  apartment  for  the  manager  of  the  baths  and  his  family.  .  .  .  There  are 
thirty  sprays  and  three  tubs  for  men,  and  eleven  sprays  and  six  tubs  for  women. 
All  the  baths  are  enclosed.  Each  shower  cabin  contains  a  dressing  alcove,  with 
seat.     A  Gegenstrom  apparatus  is  used.1' 

A  charge  of  one  cent  is  made  for  towels  and  soap,  but  the  bathers 
may  bring  them  if  they  prefer. 

There  are  two  public  baths  in  Milwaukee  with  large  swimming 
pools.  The  one  on  the  south  side  cost  124,363.36.  In  1899  the 
operating  expenses  were  |4,270.49,  and  172,061  bathers  were  accom- 
modated. The  west  side  bath  cost  -123,135.89.  In  1899  the  operating 
expenses  were  $4,755.66  and  the  number  of  bathers  was  191,245. 

Newark  has  two  public  baths  which  cost  together  about  $15,000, 
and  proposes  to  build  another  at  a  cost  of  87,200. 

"The  pools  are  about  IS  by  60  in  size;  the  baths  are  heated  by  steam  from 
boilers  to  a  certain  temperature  both  in  summer  and  winter;  only  one  of  these  bath 
houses  is  used  in  winter,  and  is  heated  by  steam;  in  one  house  there  are  eight 
shower  baths.  Outlet  and  inlet  pipes  for  the  pools  are  running  continually,  thereby 
allowing  all  scum  and  filth  that  might  collect  on  the  top  of  the  water  to  run  off;  a 
pi  n't  inn  of  the  water  is  run  off  every  day  and  the  baths  are  emptied  and  thoroughly 
cleansed  twice  a  week;  the  use  of  snap  is  not  allowed  in  the  pools;  there  are  sixty 
small  lockers  for  the  use  of  those  persons  wishing  a  private  place  to  disrobe,  five 
cents  being  charged  for  the  use  of  them,  including  towels  and  tights;  the  baths  are 
open  two  days  in  the  week  for  women  and  the  remainder  for  men."1 

It  cost  in  1899  to  operate  the  two  baths  for  salaries  85,085.25,  for 
coal  $776.50,  for  incidentals  $284.64.  A  superintendent  and  assistant, 
a  fireman  and  a  matron  are  required  for  each  bath.  The  receipts  for 
the  use  of  rooms  and  suits  which  are  hired  at  the  option  of  the  bather 
was  $300.  The  attendance  in  1S99  was  100,039  males  and  15,086 
females. 

Control  of  Barbers. 

Five  states,  Michigan,2  Minnesota,3  Missouri,4  Nebraska,5  and  Ore- 
gun.'1  have  recently  attempted  to  regulate  the  barber's  trade  lyy  statutes 
enacted  ostensibly  for  the  protection  of  the  public  health,  but  it  is  to  be 
feared  intended  rather  to  strengthen  the  trade.  All  of  these  acts  pro- 
vide for  a  state  licensing  board  to  examine  candidates  and  issue  licenses. 

1  Letter  from  the  Health  Officer  of  Newark.  24  February,  1900. 
-  Michigan,  Chapter  212  of  1899. 
3Minnesota,  Chapter  186  of  1897. 

4  Missouri,  Act  of  5  May,  1899. 

5  Nebraska,  Chapter  53  of  1899. 

,;  <  >regon,  Act  of  23  February,  1899. 


MISCELLANEOUS    SANITARY    WORK,  801 

These  boards  are  to  be  appointed  by  the  governor,  except  in  Nebraska, 
where  the  board  consists  of  the  governor,  attorney  general,  and  auditor, 
and  in  Missouri  the  appointees  must  be  examined  b}*  the  state  board  of 
health  and  approved  by  it.  In  Nebraska  the  board  appoints  two  barbers 
■retaries  who  do  the  examining.  In  Missouri  the  law  only  applies 
to  cities  of  over  50,000  inhabitants.  The  members  of  the  board  receive 
three  dollars  per  day  for  actual  services  and  their  expenses.  In  Nebraska 
each  applicant  is  to  pay  the  secretaries  live  dollars.  All  persons  acting 
as  barbers  at  the  time  of  the  passage  of  the  act  can  receive  a  license  on 
payment  of  one  dollar,  and  all  others  must  pass  an  examination  and 
must  be  free  from  contagious  or  infectious  disease.  In  Missouri  and 
Nebraska  the  barbers  must  conduct  their  business  in  accordance  with 
rules  to  be  made  by  the  stale  hoard  of  examiners  for  barbers,  which  rules 
must  be  approved  b\  the  state  board  of  health.  In  Oregon1  barbers  are 
required  to  disinfect  their  tools. 

The  Michigan  law  has  been  sustained  by  the  supreme  court.2 
At  a   meeting  of  the   board   of  health  of  Boston,  4  May,  1900,  the 
regulation  respecting  barber  shops  shown   below  was  adopted  under  the 
general  sanitary  authority  granted  the  board.3 

(i.\s  Fitting. 

The  Boston  board  of  health  found  that  leaky  gas  pipes  in  dwellings 

are  very  coi in,  occurring  in  as  many  as  eighty-nine  per  cent,  of  the 

dwellings  in  that  city.4     Rightly   believing  that    such   leaks   are   more 

Oregon,  A<  t  of  23  February,  L899,  Sec  12: 

••Any  person  who  slums  another  person  afflicted  with  syphilis,  eczema,  blood 
poison  or  any  skin  disease,  who  does  nol  before  he  again  uses  his  tools,  towels,  or  v»  ater, 
subject  them  to  such  disinfection  as  may  remove  any  virus,  scale,  or  filth  that  may 
be  "ii  such  tools,  towels,  or  instruments,  shall  be  guilty  of  a  misdemeanor,  and  upon 
conviction  thereof  be  punished  by  a  fine  of  not  less  than  ($20)  twenty  dollars  nor 
more  than  ($50  I  fifty  dollar-,  or  by  imprisonment  in  the  county  jail  not  less  than  ten 
days  nor  more  than  twenty-five  days,  oi  by  both  tine  and  imprisonment." 

-  N.  W.  Reporter  82*,  p.  234,  Wass  d«.  Michigan  Hoard  of  Examiners  for  Barbers. 
•Tin-  place  of  business,  together  with  all  the  furniture,  shall  be  kept,  at  all 
ti  mes,  in  a  cleanly  condition. 

"  Mugs,  shaving  brushes,  and  razors  shall  be  sterilized  l>y  immersion  in  boiling 
waor  alter  e\  cry  separate  use  thereof. 

A  separate,  clean  towel  shall  be  used  for  each   person. 

•■Alum,  or  other  material,  used  to  stop  the  How  of  blood  shall  be  so  used  only  in 
powdered  form,  and  applied  on  a  towel. 
••  The  use  of  powder  puffs  is  prohibited. 

The  U-.  ..i  sponges  is  prohibited. 
"Everj  barber  shop  shall  be  provided  with  running  hoi  and  cold  water. 
\.i  person  shall  he  allowed  to  use  any  barber  shop  as  a  dormitory. 

Everj  barber  shall  cleanse  his  hands  thoroughly  imi liately  after  serving  each 

customer.11 

1  Host, ,n.  Report  of  Board  of  Health  1 1897),  p.  50. 

51 


802  MISCELLANEOUS    SANITARY    WORK. 

liable  to  do  harm  than  is  leaky  plumbing,  application  was  made  to  the 
legislature  and  an  act  secured  which  authorized  the  examination  and 
licensing  of  gas  fitters  in  Boston.1  This  act  is  patterned  after  the 
plumbing  act,  and  provides  for  the  appointment  of  a  board  of  examiners  to 
consist  of  the  building  commissioner,  the  chairman  of  the  board  of  health, 
and  a  gas  fitter  of  five  years'  experience  to  be  appointed  by  the  board  of 
health.  The  last  named  member  is  to  receive  five  dollars  per  day  for 
his  services.  Both  master  and  journeymen  gas  litters  must  be  examined 
and  licensed,  the  former  paying  two  dollars,  and  the  latter  fifty  cents. 
The  licenses  are  good  until  revoked.  New  work  must  be  done  under 
the  supervision  and  with  the  approval  of  the  building  commissioner. 
The  law  contains  certain  requirements  as  to  the  cutting  of  timbers  and 
the  location  of  brackets,  but  other  rules  governing  the  work  are  to  be 
made  by  the  board  of  health  and  building  commissioner.  The  board  of 
health  is  to  inspect  and  order  changes  in  old  gas-fittings.  In  1898  of 
400  applicants  for  gas  fitters'  licenses,  258  were  rejected  for  failure 
to  pass  the  examination. 

Lying-in  Hospitals. 
Both  Massachusetts2  and  Pennsylvania3  have  enacted  laws  for  the 
regulation  of  lying-in  hospitals  under  the  direction  of  the  health 
officials.  In  Massachusetts  the  licenses  are  issued  by  the  selectmen  on 
the  approval  of  the  board  of  health,  but  in  Pennsylvania  the  license  is 
issued  by  the  board  of  health,  and  the  application  must  be  endorsed  by 
six  citizens.  The  license  is  for  two  years.  In  Philadelphia  the  board 
of  health  have  made  rules  for  these  hospitals.4  They  must  be  in- 
spected every  month  and  must  keep  a  record  in  the  form  prescribed  by 
the  board  of  health,  of  all  cases,  and  must  within  five  days  report  each 
birth  to  the  board  of  health,  and  must  also  report  when  the  child  is  re- 
moved from  the  hospital.  In  Boston  in  1898  sixteen  lying-in  hospi- 
tals were  licensed,  and  in  them  there  were  376  confinements. 

Baby  Farms. 

Massachusetts,5  Rhode  Island,6  Connecticut,7  and  New  York,8  have 
enacted  laws  "  for  the  protection  of  infants "  who  are  placed  out  to 
board.     In  Rhode  Island  and  New  York  the  persons  who  are  to  receive 

1  Massachusetts,  Chapter  265  of  1897. 

2  Massachusetts,  Public  Statutes  (1882),  Chapter  80,  Sees.  56-69. 

3  Pennsylvania,  Act  of  26  April,  1893. 

4  Philadelphia,  Rules  of  the  Board  of  Ilealth  (1S95),  Sees.  112-115. 

5  Massachusetts,  Public  Statutes  (1882),  Chapter  80,  Sees.  60-1. 

6  Rhode  Island,  Chapter  464  of  the  Public  Laws  (20  May,  1897.) 

7  Connecticut,  General  Statutes  (1888),  Sees.  2610-11. 

w  Xew  York,  Revised  Statutes  (1SU6),  Public  Health  Laws,  Sec.  206. 


MISCELLANEOUS   SANITARY   WORK.  803 

infants  to  board  must  first  be  licensed.  In  New  York  the  license  is  to 
be  issued  by  the  board  of  health  or  the  mayor,  and  in  Rhode  Island  by 
the  state  board  of  charities,  but  it  must  first  be  approved  by  the  board 
of  health  of  the  town  or  city  in  which  the  applicant  resides.  In  Rhode 
Island  the  application  must  also  be  approved  by  two  citizens.  In 
Connecticut  and  Massachusetts  the  law  does  not  require  a  license,  but 
the  person  who  receives  the  infants  to  board  must  make  report  to  the 
selectmen  in  Connecticut,  and  to  the  board  of  health  in  Massachusetts. 
In  Rhode  Island  the  law  is  applicable  to  every  one  who  takes  a  single 
child  under  two  years  of  age,  but  in  the  other  states  it  is  only  applicable 
to  cases  where  two  or  more  are  taken,  and  the  maximum  limit  of  age  is 
three  years  in  Massachusetts  and  New  York  and  ten  years  in  Con- 
necticut. The  premises  must  be  open  to  inspection  by  the  board  of 
health  in  Massachusetts,  the  society  for  the  prevention  of  cruelty  to 
children  in  New  York,  the  town  officers,  state  board  of  charities  or 
Connecticut  Humane  Society  in  Connecticut,  and  in  Rhode  Island  the 
health  officer  is  required  to  inspect  annually.  In  Rhode  Island  in 
1899  thirty  such  licenses  for  children  were  issued  of  which  thirteen 
were  in  Providence.  Irresponsible  baby  tanners  have  by  this  law  been 
pretty  thoroughly  suppressed  in  that  city. 

Pbeventhxn  of  Bijndness. 

Ophthalmologists  have  shown  that  a  large  proportion  of  blindness 
is  due  to  the  purulent  infection  of  the  eyes  of  infants  at  or  soon  after 
birth.  Owing  to  the  exertions  of  physicians  interested  in  diseases  of 
the  ityc->,  laws  intended  to  prevent  this  injury  have  been  adopted  in 
Connecticut,  .Michigan.  New  Jersey,  Ohio,  Pennsylvania,  and  Rhode 
Island. 

The  laws  do  imt  differ  very  much  and  arc  fairly  represented  by  the 
one  given  below ; '  but  in  some  of  the  law  s  as  in  New  Jersey,  the  health 
officer  is  nol  to  treat  the  child  as  in  Pennsylvania,  but  has  it  placed  in 
charge  of  a  physician  or  the  cifrj  physician.  In  New  Jersey  copies  of 
the  law  are  to  be  sent  to  physicians  as  well  as  nurses.  In  Rhode  Island 
the  nurse  is  to  reporl  to  a  physician. 

1  Pennsylvania,  Chapter  263  of  1895: 
-i  i  i  [o»  i.  Be  il  ena<  ted,  &c,  Thai  sli"ulil  one  or  both  eyes  of  an  infant  be- 
come inflamed  or  swollen  or  reddened  at  anj  time  within  t\\"  weeks  after  birth,  it 
shall  be  the  duty  of  the  midwife  or  aurse,  or  other  person  having  the  care  of  such 
infant,  to  reporl  in  writing,  within  six  hours  after  the  discovery  thereof,  to  the 
health  officer  or  legally  qualified  practitioner  of  the  city,  town  or  district  in  which 
the  mother  "f  1 1 1  *  -  child  resides,  the  faci  thai  such  inflammation  or  swelling  i 
aess  exists. 

"Sectios  ■-.    Thai  it  shall  be  the  duty  <>f  Baid  health  officer,  immediately  upon 
receipt  of  said  written  report,  to  notify  the  parents  or  the  person  liaving  chai 


804  MISCELLANEOUS   SANITARY   WORK. 

Nursing  Bottles. 

The  rubber  tubes  of  long  tube  nursing  bottles  are  difficult  to  clean 

and  sterilize,  and  health  officers  and  physicians  have  long  opposed  their 

use  ;  but  they  are  more  convenient  than  the  short  nipple  and  hence  are 

demanded  by   many  mothers.     Buffalo    is    the    only    city    which    has 

attempted  to  prevent    their  use.1     Dr.   Wende,   the    energetic   health 

officer  of  that  city,   has   pretty  thoroughly  succeeded  in  enforcing  the 

ordinance,   though  he   met  with  strong  opposition  from  some  of  the 

dealers. 

Excursions  for  Sick  Children. 

No  board  of  health  has,  so  far  as  the  writer  knows,  provided  such 
excursions  out  of  its  own  funds,  but  some  have  assisted  private  philan- 
thropists in  this  work.  In  New  York  City  the  "  summer  corps  "  of 
physicians  to  the  tenement  poor,  distribute  tickets  to  the  excursions  on 
the  harbor  of  the  St.  John's  Guild.  In  1806  15,887  of  these  tickets 
were  thus  distributed.  In  Lowell  in  18972  the  board  of  health  through 
private  subscriptions  was  enabled  to  provide  eight  such  excursions  on 
the  river,  furnishing  not  only  transportation  but  milk,  ice,  nursing 
bottles,  and  medical  and  other  attendants.  The  amount  expended  was 
$138.48  and  500  children  were  taken  on  the  excursions. 

Protection  of  Working  Children. 

The  state  of  New  York,  like  many  others,  has  laws  for  the  pro- 
tection of  children  who  are  put  to  work  at  too  early  an  age.  Unlike 
most  of  the  laws,  that  of  New  York  puts  upon  the  health  department  a 
large  part  of  the  administrative  work  connected  with  the  enforcement 
of  the  act.     According  to  Chapter  415  of  1897,  Sees.   102-163  : 


said  infant  of  the  danger  to  the  eye  or  eyes  of  said  infant  by  reason  of  said  condition 
from  neglect  of  proper  treatment  of  the  same,  and  he  shall  also  enclose  to  them 
directions  for  the  proper  treatment  thereof. 

"  Section  3.  Every  health  officer  shall  furnish  a  copy  of  this  act  to  each  person 
who  is  known  to  him  to  act  as  midwife  or  nurse  in  the  city  or  town  for  which  such 
health  officer  is  appointed,  and  the  Secretary  of  State  shall  cause  a  sufficient  num- 
ber of  copies  of  this  act  to  be  printed  and  supply  the  same  to  such  health  officers 
on  application. 

"  Section  4.  Any  failure  to  comply  with  the  provisions  of  this  act  shall  be 
punishable  by  fine  not  to  exceed  two  hundred  dollars,  or  imprisonment  not  to  ex- 
ceed thirty  clays,  or  both." 

1  Buffalo,  Ordinances,  Chapter  25,  Sec.  81: 

"And  it  shall  be  unlawful  for  any  person  or  persons  to  use  or  to  engage  in  the 
sale  of  any  bottle,  mechanism  or  other  device  for  the  artificial  feeding  or  nursing  of 
infants  or  children  under  three  years  of  age,  that  has  connected  therewith  a  rubber 
tube,  hose  or  similar  contrivance.'1 

2  Lowell,  Report  of  Board  of  Health  (1897),  pp.  30  and  33. 


MISCELLANEOUS    SANITARY   WORK.  805 

"A  child  under  the  age  of  fourteen  years  shall  not  be  employed  in  any  mercantile 
establishment,  except  that  a  child  upwards  of  twelve  years  of  age  may  be  employed 
therein  during-  the  vacation  of  the  public  schools  of  the  city  or  district  where  such 
establishment  is  situated.  No  child  under  the  age  of  sixteen  years  shall  be  em- 
ployed in  any  mercantile  establishment,  unless  such  child  shall  produce  a  certificate 
issued  as  provided  in  this  article,  to  be  tiled  in  the  office  <>f  such  establishment. 

"Certificate  for  employment;  how  issued.  —  Such  certificate  shall  be  issued 
by  the  executive  (.hirer  of  the  hoard,  department  or  commissioner  of  health 
of  the  city,  town  or  village,  where  such  child  resides  or  is  to  be  employed,  or  by 
such  other  officer  thereof  as  may  he  designated,  by  resolution  for  that  purpose,  upon 
the  application  <>f  the  child  desiring  such  employment." 

At  the  time  of  making  the  application  the  child's  parents  must  rile 
an  affidavit  as  to  its  age,  and  the  certificate  is  not  to  he  issued  by  the 
health  officer  unless  he  is  satisfied  that  the  child  is  of  the  age  stated 
and  is  physically  able  to  do  the  work.  A  certificate  of  school  attend- 
ance must  be  furnished  by  the  school  which  the  child  has  attended. 
The  forms  used  for  this  work  in  the  City  of  New  York  are  shown  in 
Appendices  1  25-6. 

Certain  exemptions  are  made  for  work  during  the  Christmas  holi- 
days and  for  this  "  vacation  certificates "  are  granted.  This  same  act 
provides  for  water-closets  and  wash  rooms  for  women  and  children. 
Seals  must  he  provided  for  female  employees  and  women  and  children 
shall  not  ho  employed  in  a  basement  except  with  the  permission  id'  the 
health  department.  All  these  provisions  arc  to  he  enforced  by  this 
department. 

Institutions  foe  Children. 

In  Now    York  in  18861  an   act   was    passed    which    was   amended   in 
-      !  and  which  was  intended  to  provide  lor  the    better   cmv    of    all    in- 
stitutions, receiving  dependent  children.     This  law-  provides  tor  monthly 
reports  to  the  hoard  of  health,  and  also    provides    that    when    the    hoard 
of    health     finds    ••anything   therein    dangerous    to    life    or   health"    it 

shall  " cause  the  evil  to  be  remedied   without  delay."     The  hods  must 

be  two  loot  apart  and  there  must  lie  600  cubic  loot  of  air  space  lor  each 
bed.  In  New  York  City8  this  law  has  not  been  a  dead  letter  hut  the 
institutions  have  been  under  ;i  constant  supervision,  a  medical  inspector 
being  detailed  to  inspect  them.  In  tins  waj  great  improvements  have 
been  made  in  plumbing,  ventilation,  heating,  bathing,  dietaries,  etc., 
ami  in  every  way  the  condition  id'  the  children  is  far  better  than   before. 

As  unlimited  visiting  bj  parents  and  friends  was  found  to  he  a  fertile 
source  of  communicable  disease  ;  this  has  been  limited  to  monthly  visit- 


1  \.-\n  Y.ok.  Chapter  >;.:::  oi  lg 

'  n.-u  n  ork,  Rei  ised  Statutes  ( 1896),  p.  --ns  ,  Public  Health   Law,  Se<  s.  208  6). 
\.u  \  or*  <  ity,  Report  ol  Department  of  Health  i  L896),  p.  868 


806  MISCELLANEOUS    SANITARY   WORK. 

ing  days  in  most  asylums.  Much  attention  has  been  given  to  the  pre- 
vention of  contagious  ophthalmia  and  there  has  been  a  marked  diminu- 
tion in  this  disease.  In  order  to  prevent  the  introduction  of  communi- 
cable disease,  every  institution  must  appoint  a  physician  who  must  ex- 
amine all  children  before  the}'  are  admitted  and  certify  that  they  are 
free  from  communicable  disease.1  The  physician  must  also  make  a 
monthly  report  to  the  board  of  health  on  the  sanitary  condition  of  the 
institution.  In  Denver2  no  child  is  admitted  to  an  institution  until  the 
throat  has  been  examined  and  pronounced  free  from  diphtheria  bacilli. 
In  Michigan3  the  law  requires  that  every  child  shall  be  examined  for 
contagious  disease  before  entering  a  public  institution. 

Public  Institutions. 
(Other  than  those  previously  mentioned. ) 

Public  markets  are  under  the  exclusive  control  of  the  health 
department  in  Cincinnati.  This  department  has  charge  of  the  leasing 
of  the  stalls  and  appoints  the  market  masters,  market  police,  and  all 
other  employees.  In  this  way  a  very  firm  control  can  be  maintained 
over  the  goods  sold. 

In  San  Francisco  and  St.  Louis  the  poor  house  is  administered  by 
the  health  department  and  in  the  latter  city  the  public  hospitals  also  are 
in  charge  of  this  department. 

Cigar  Factory  Supervision. 

Most  of  the  supervision  of  manufacturing  whether  it  be  in  factories 
or  in  dwellings  (sweat-shops),  is  done  for  the  protection  of  the  opera- 
tives and  is  under  the  direction  of  factory  inspectors,  usually  appointed 


1  New  York,  Revised  Statutes  (1896)  p.  2418  (Public  Health  Law,  Sec.  203): 
"...  The  officer  of  every  such  institution,  upon  receiving  a  child  therein, 
by  commitment  or  otherwise,  shall,  before  admitting  it  to  contact  with  the  other 
inmates,  cause  it  to  be  examined  by  such  physician,  and  a  written  certificate  to  be 
given  by  him,  stating  whether  the  child  has  diphtheria,  scarlet  fever,  measles, 
whooping  cough,  or  any  other  contagious  or  infectious  disease,  especially  of  the 
eyes  and  skin,  which  might  be  communicated  to  other  inmates,  and  specifying  the 
physical  and  mental  condition  of  the  child,  the  presence  of  any  indication  of  heredi- 
tary or  other  constitutional  disease,  any  deformity  or  abnormal  condition  found 
upon  the  examination  to  exist.  No  child  shall  be  so  admitted  until  such  certificate 
shall  have  been  furnished,  which  shall  be  filed  with  the  commitment  or  other  papers 
on  record  in  the  case,  by  the  officers  of  the  institution,  who  shall,  on  receiving  such 
child,  place  it  in  strict  quarantine  thereafter  from  the  other  inmates,  until  dis- 
charged from  such  quarantine  by  such  physician,  who  shall  thereupon  indorse  upon 
the  certificate  the  length  of  quarantine  and  the  date  of  discharge  therefrom." 

-  Denver,  Report  of  Bureau  of  Health  (1897-8),  p.  68. 
;  Michigan,  Compiled  Laws  (1807),  Sec.  2027. 


MISCELLANEOUS   SANITARY   WORK.  807 

by  the  state.  Sometimes,  however,  inspection  is  intended  to  protect  the 
product  as  well,  as  in  the  bakery  laws,  and  such  laws  are  often  en- 
forced by  local  sanitary  officials.  In  San  Francisco1  an  ordinance  was 
adopted  for  the  supervision  of  cigar  making  which  was  intended  to  pro- 
tect the  cigars  rather  than  the  Chinese  who  make  them.  The  ordinance 
provides  that  each  maker  must  obtain  a  certificate  from  the  health 
officer,  that  no  person  with  communicable  disease  shall  be  allowed  to 
work  in  the  shop,  no  opium  shall  be  smoked  in  it,  no  person  shall  sleep 
in  it.  no  cigar  shall  be  touched  to  the  lips  or  tongue,  tobacco  is  not  to 
In-  sprayed  with  the  mouth,  expectoration  on  the  floor  is  forbidden,  and 
it  is  forbidden  to  dry  tobacco  on  the  floor.  A  special  inspector  was 
appointed  for  this  work  and  he  reported  that  conditions  found  in  the 
Chinese  shops  were  very  bad. 

Laundry  Inspection. 

In  1897  the  board  of  supervisors  of  San  Francisco-  adopted  an 
ordinance  forbidding  the  moistening  of  clothes  in  laundries  by  spraying 
water  from  the  mouth.  A  special  inspector  of  laundries  was  appointed 
who  was  to  see  to  the  enforcement  of  this  ordinance,  and  also  to  see 
that  the  laundry-men  did  not  sleep  under  the  ironing  tables  and  to 
sccniv  the  proper  cleansing  of  the  premises.  Cement  floors  were  re- 
quired in  all  wash  rooms.  In  1898  the  inspector  made  1,750  inspections 
of  forty-two  laundries.  In  New  Orleans  in  1899s  a  similar  ordinance  was 
adopted  and  a  fee  of  twenty-five  cents  is  charged  for  each  inspection. 

Kerosene. 

The  control  <»t'  the  sale  of  kerosene  or  similar  illuminating  oils  is  usu- 
ally  given  to  special  inspectors  independent  of  the  health  department  ; 
but  in  New  Jersey4  the  Law  concerning  kerosene  authorizes  both  the  state 

board  of  health  and  local  boards  of   health  to  enforce  it.      In   New  York 
City  the  Hash  test    for  oil  is  fixed  by  the  sanitary  code."' 

Public  Urinals. 
The  maintenance  of  public  urinals  it  might  be  supposed,  would  be 

in  charge  of  the  department  of  public  works  and  it  is  so  rn  many  cities. 

As  these  fixtures  are.  unless  properly  constructed  and  cared  for.  certain 


San  Francisco,  Report  of  Health    Department  (1807-8),  p.  259  (Ordinance  of   IT 

.tunc-.    I>''- 

San  Francisco,  Report  of  Health  Department  (1896-7),  p.  6. 

\.w  Orleans,  Ordinance  No.  15709,  Council  Series,  15  November,  1899. 

\.-\    !■  neral  Statutes  (1896),  pp.  2454-5. 

\«w  Fork,  Sanitarj  Code  (1899),  Sec.  105. 


808  MISCELLANEOUS   SANITARY    WORK. 

to  become  nuisances,  it  is  in  some  cities  thought  best  to  place  the  health 
department  in  charge  of  them.  This  is  clone  in  Cambridge,  Lawrence, 
Providence,  and  in  Boston  until  1898.  In  most  instances  these  urinals 
are  simply  iron  affairs  which  are  supposed  to  be  kept  clean  by  running 
water,  but  unless  very  carefully  looked  after,  they  are  more  or  less 
offensive  and  filth}^. 

Decent  urinals  and  decent  water-closets  are  rarely  provided  at  public 
expense  in  American  cities  and  the  public  are  forced  to  rel}~  upon  the 
facilities  furnished  by  hotels,  restaurants,  railroad  stations,  and  public 
institutions.  Boston  and  New  York  are  notable  exceptions,  for  these 
cities  have  built  and  maintained  in  good  condition,  first-class  toilet 
rooms  for  both  men  and  women. 

Sick  Poor. 

The  care  of  the  sick  poor  is  in  a  number  of  cities  wholly  or  partially 
in  the  charge  of  the  health  department.  In  most  cases  it  is  the  care  of 
the  out  poor  or  dispensary  work  which  is  given  to  the  health  department. 
In  rarer  instances  this  department  manages  the  public  general  hospitals. 

There  are  excellent  reasons  why  the  care  of  the  sick  poor  at  their 
homes  or  in  dispensaries  should  be  a  part  of  health  department  work. 
Almost  invariably  medical  men  are  in  control  of  this  department  and 
are  thus  better  fitted  to  select  physicians  to  the  poor,  and  to  supervise 
their  work  than  are  laymen.  Then,  too,  the  work  of  poor  physicians  is 
such  that  the}'  can  do  much  to  assist  the  health  department  in  regard 
to  vaccinations,  communicable  diseases,  investigation  of  causes  of  death 
and  nuisances.  Whatever  may  be  said  in  favor  of  such  an  arrangement, 
it  has  not  been  adopted  in  most  cities.1  But  in  Ohio2  the  board  of  health 
is  authorized  by  statute  to  "  appoint  as  many  ward  or  district  physicians 
as  it  may  be  deemed  necessary  for  the  care  of  the  sick  poor." 

In  most  of  the  cities  named  below  there  are  several  district  physi- 
cians appointed  to  care  for  the  sick  poor  in  their  districts.  These 
physicians  are  usually  required  to  live  in  their  districts  and  to  have  cer- 
tain office  hours.  They  are  often  required  to  keep  records  of  their  cases 
and  to  make  monthly  or  weekly  reports.  Specific  rules  for  their  guid- 
ance are  to   be  found  in  Cleveland3  and  Cincinnati,4  and  the  District  of 


111  It  has,  however,  been  in  Buffalo,  Colorado  Springs,  Cleveland,  Cincinnati. 
Charleston,  District  of  Columbia,  Denver,  the  larger  Indiana  cities,  Kansas  City, 
Jersey  City,  Knoxville,  Memphis,  Xewark,  Richmond,  San  Francisco,  St.  Louis,  and 
Savannah." 

2  Ohio,  Annotated  Statutes  (1900),  Sees.  2115  and  2135. 

s  Cleveland,  Rules  of  the  Health  Division,  Department  of  Police,  Rule  6. 

*  Cincinnati,  Manual  of  Department  of  Health  (1898),  Sec.  281. 


MISCELLANEOUS   SANITARY   WORE,  809 

Columbia  lias  excellent  printed  instructions.  In  a  number  of  cities,  as 
Colorado  Springs,  Cleveland,  and  Memphis,  the  district  physicians  are 
required  to  give  medical  attendance  in  police  stations  or  jails.  In  Col- 
in-ado Springs,  Cleveland,  Cincinnati,  and  Kansas  City,  they  are  to  per- 
form the  public  vaccinations.  In  Cincinnati  the  district  physicians 
perform  certain  sanitary  work  in  regard  to  the  control  of  communicable 
disease  and  the  report  of  nuisances.  In  that  city  the  health  officer  lias 
monthly  conferences  of  these  physicians  at  which  the  details  of  their 
work  and  public  health  matters  are  discussed.  The  following  shows 
the  number  of  physicians  employed  in  several  cities: 

Vein.  city.  Number  of  Physicians. 

1897    Buffalo    8 

1898   Cleveland    12 

1898  Cincinnati     21 

1899  Charleston    6 

1898  District  of  Columbia   22 

L898  Jersey  City    S 

1898  Kansas  City    2 

1897  Newark    11 

1898  Richmond    4 

1890  Savannah    4 

189G  Toledo 5 

1899  Troy     ."> 

Ill  Colorado  Springs,  Kno\ ville,  and  Memphis  there  is  only  one 
physician  to  look  after  the  out  patient  poor.  In  Memphis  this  is  the 
secretary  of  the  hoard  of  health.  In  Spokane  the  health  officer  is  to 
visit  the  sick  poor.  The  salary  of  the  physicians  to  the  poor  varies 
from  $29.16  per  annum  in  Toledo,  to  $850  in  Charleston.  It  is  $300 
in  Cleveland  and  Cincinnati,  $360  in  the  District  of  Columbia,  and  $400 
in  Newark.      The   number  of    visits    made    by    the  city  physicians  upon 

the  poor  in  their    h \s  semis   to  vary  greatly  in  different  cities.      This 

doubtless  depends  upon  the  character  of  the  population,  the  care  with 
which  patients  able  to  pay  are  sifted  out,  and  the  amount  of  aid 
furnished  by  private  charities  : 

Year.                        «  Ity.                             Bultations.  Patients. 

L899.  Charleston 32,087 

L898.  Cincinnati is. 212  5,314 

1899.  District  of  Columbia 20,025  7,583 

1899.  [ndianapolis   21,61 1 

L898.  J(  rsej   Citj         3,118  1,641 

1898.  Kansas  Citj 28,065 

L898.  Memphis i,949 

L899.  Newark 30,160 

i-'.''.'.  Richmond,  Va 21,896  1,700 

Some  cities,  instead  of  requiring   the  district    physicians  to  receive 

patients  at    their    offices,  estahlish,  under    control  of    the    health    depart- 


810  MISCELLANEOUS   SANITARY   WORK. 

ment,  public  dispensaries  to  which  all  patients  who  are  able,  shall  go  for 
medical  advice.  In  Indianapolis,  Memphis,  Mobile,  Newark,  St.  Louis, 
and  San  Francisco  this  is  done.  In  the  latter  cit}r  there  are  two  branch 
dispensaries  as  well  as  a  central  one,  and  apparently  from  the  reports, 
very  few  patients  are  treated  at  their  homes.  In  Indianapolis  only  3,242 
patients  were  visited  at  their  homes,  and  in  Newark,  8,700  persons, 
while  in  District  of  Columbia,  13,905  persons  were  treated  at  home. 
There  are  various  ways  in  which  the  medicines  may  be  furnished. 
Probably  the  most  unsatisfactory  and  expensive,  way  is  to  have  the  pre- 
scriptions filled  at  contract  druggists  as  is  done  in  Buffalo,  Charleston, 
and  Savannah.  Another  way  is  for  the  physicians  to  furnish  as  much 
of  the  medicines  as  possible  and  this  can  be  largely  done  with  tali- 
lets.  In  this  way  the  expense  of  medicines  has  in  Cincinnati  been  re- 
duced from  13,818.70  per  annum  (1880-1893)  to  1221.03  (1891-1898). 
Where  dispensaries  are  established,  the  medicines  are  usually  furnished 
there  by  an  apothecary  employed  for  the  purpose.  In  Nashville  there 
is  a  "  city  prescriptionist "  in  the  health  department  who  puts  up  med- 
icines for  out  patients  treated  free  at  the  city  and  other  hospitals,  but 
it  does  not  appear  from  the  reports  that  the  health  department  controls 
the  medical  attendance  of  the  sick  poor. 

In  Mobile  the  health  officer  is  police  and  jail  surgeon  and  also 
admits  patients  to  the  city  hospital.  In  Boston,  Lynn,  and  Omaha  the 
"  city  physician  "  is  a  member  of  the  health  department.  In  Omaha  he 
looks  after  accident  cases  chiefly,  in  Boston  and  Lynn  he  is  a  police 
surgeon  and  in  the  latter  city  attends  to  vital  statistics. 

In  accordance  with  the  provisions  of  Chapter  501,  Section  1,  of  the 
Laws  of  New  York(1879),  the  sum  of  $10,000  must  annually  be  expended 
in  New  York  City  for  the  medical  inspection  of  tenements  during  the 
summer.  In  July  and  August  fifty  physicians  are  employed  to  visit 
every  tenement,  especially  in  the  poorer  quarters,  to  prescribe  for  the 
helpless  sick,  give  needful  advice,  and  distribute  circulars  for  the  care  of 
infants.  In  189(3  there  were  treated  37,160  persons  and  271,712  visits 
were  made.  A  similar  plan  has  been  followed  in  Hartford  where  two 
physicians  are  employed. 

So  far  as  the  writer  knows  general  hospitals  are  controlled  by  the 
health  department  only  in  Indianapolis,  Kansas  City,  Memphis,  San 
Antonio,  San  Francisco  and  St.  Louis.  Accounts  of  the  administration 
of  these  institutions  may  be  found  in  the  reports  of  those  cities. 

Office  Librae y. 
Every    health    officer    has,  or  certainly  every  health  officer  should 
have,  a  library  of  works  relating  to  sanitation.     If  a  health  officer  could 
feel  that  he  would  remain   in  office   as  long  as  he   proved   faithful  and 


MISCELLANEOUS    SANITARY    WORK.  811 

efficient,  he  would  probably  at  his  own  expense  and  by  bis  own  efforts, 
collect  such  a  library ;  but  with  the  uncertain  tenure  of  office  which 
prevails,  it  is  rare  that  the  health  officer  deems  it  worth  while  by  study 
to  make  himself  better  fitted  for  his  office.  Not  only  are  standard  works 
and  text  books  useful  in  such  a  library,  but  reports  of  work  done  in 
other  cities  and  states  should  form  an  important  part  of  it.  Much  can 
be  learned  from  both  successes  and  failures  of  others.  Here  again  the 
constant  changes  in  health  officials  makes  it  difficult  to  keep  up  files  of 
reports.  Nevertheless,  some  cities  do  attempt  to  maintain  a  library  and 
accounts  of  such  may  be  found  in  the  reports  of  St.  Louis,1  District  of 
Columbia,  and  Minneapolis.  In  St.  Louis  an  index  has  been  kept  of 
the  contents  of  various  reports  received  and  placed  in  the  library. 
This  index  is  not  as  full  as  it  might  be,  but  is  a  move  in  the  right 
direction,  and  it  would  be  well  if  organized  effort  could  be  made  to 
index  all  sanitan    reports. 

Advancement  of  Knowledge. 

It  is  the  duty  of  every  physician  and  of  every  health  officer  to  take 
advantage  of  each  opportunity  that  may  offer  to  add  his  mite  to  the 
sum  of  human  knowledge.  Such  duty  is  not  confined  to  men  of 
scientific  pursuits,  but  is  incumbent  upon  every  one;  but  the  scientific 
man  is  daily  making  use  of  the  cumulative  studies  of  thousands  of  his 
predecessors  without  which  his  own  work  would  be  impossible,  he  well 
knows  how  inestimable  may  be  the  value  of  a  single  new  fact  dis- 
covered, and  he  is  constantly  seeing  new  lines  of  investigation  invite  his 
labors.  He  must  indeed  be  a  selfish  man  who  would  freely  receive 
from  others  the  priceless  legacy  of  modern  science  and  make  no  effort 
to  show  his  gratitude  in  the  only  way  he  can  show  it,  by  striving  to 
increase  the  sum  of  human  knowledge  for  the  benefil  of  those  who  are 
to  come  after. 

In  one  sense  this  effort  to  advance  the  science  of  sanitation  is  by 
far    the    mosl    important   w  oik  that    the  health  officer  can  do.      It   was   a 

far  more  useful  thing  for  the  members  of  the  New  York  health  depart- 
ment  to  show    how  to  make  a  concentrated  antitoxin    than    it    would    be 

to  tear  down  a  hundred  tenements  or  to  disinfect   a   thousand  houses; 

and  loi  the  Massachusetts  board  of  health  to  show  the  world  how  to 
filter  water  and  sewage  is  ten  fold  more  important   than  all    the    routine 

work  ever  done  l>\  that  board,  useful  enough  though  the  latter  has 
been. 

With  some  truth  it  may  be  said  that  the  municipal  health  officer 
does  not   have  the  opportunity    or    the  time    for    investigation,    and    that 

St  Louis,  Report  of  Health  Depar mi  (1895-6),  p.  281. 


812  MISCELLANEOUS   SANITARY   WORK. 

such  work  had  best  be  done  by  the  federal  or  state  governments  or  by 
the  universities.  Original  research  certainly  would  be  a  leading  function 
of  a  national  board  of  health  if  we  had  one,  and  is  made  an  important 
part  of  the  work  of  many  state  boards.  It  is  also  true  that  certain 
lines  of  investigation  which  are  of  a  general  character  do  not  belong  to 
the  work  of  the  local  health  officer.  The  study  of  filtration  as  pursued 
in  Massachusetts,  properly  belongs  to  a  state  board.  Yet  sometimes 
even  cities  may  be  forced  to  undertake  work  of  this  nature.  Because  a 
certain  method  of  filtration  had  not  been  studied  at  Lawrence  (chiefly 
from  lack  of  opportunity),  municipal  investigation  became  necessary  at 
Providence,  Louisville,  Cinncinnati,  and  Pittsburgh.  So  the  work  of 
the  New  York  board  of  health  on  vaccine  virus  and  antitoxin  might 
have  been  expected  of  a  state  board  of  health  or  a  university,  but  was 
undertaken  by  a  local  board  because  no  one  else  would  do  it;  but  there 
are  certain  lines  of  investigation  which  can  be  best  followed  by  local 
health  officers.  Problems  connected  with  the  mechanism  of  the  spread 
of  communicable  disease  can  be  best  studied  by  those  who  can  per- 
sonally follow  the  history  of  many  cases.  The  relation  between  de- 
fective plumbing  and  sickness,  or  between  privy  vaults  and  the  spread 
of  typhoid  fever  is  to  be  learned  best  Ivy  the  man  who  has  charge  of  the 
inspections.  The  local  health  officer  can  alone  determine  the  necessity 
for  disinfection  and  the  value  of  methods  proposed.  He  can  best  de- 
termine the  degree  and  duration  of  the  immunity  conferred  by  vaccine 
or  antitoxin. 

Every  one  cannot  expect  to  make  a  great  discovery,  and  to  solve 
completely  an  important  problem  need  not  be  one's  aim.  Facts  care- 
fully recorded  and  carefully  published  are  always  useful  and  may  be- 
come invaluable.  Much  of  the  routine  work  of  the  municipal  health 
department  may  be  done  in  such  a  way  as  to  give  it  a  permanent  use- 
fulness, or  it  may  be  done  in  such  away  that  its  momentary  value  is  its 
only  value.  Care  and  thought  applied  to  the  recording  of  all  work 
done  should  be  a  health  officer's  first  duty.  Reliable  data  in  regard  to 
garbage  cremation  are  hard  to  find  in  this  country,  but  if  every  city 
which  operates  a  crematory  had  kept  and  published  the  work  of  the 
crematory  as  carefully  as  was  done  in  Lowell  for  several  years,  a  very 
correct  estimate  of  the  cost  of  construction  and  operation  might  by  this 
time  have  been  available. 

Many  health  officials  have  done  work  for  the  advancement  of 
knowledge.  The  recording  of  vital  statistics  and  cases  of  sickness  is 
such  work.  Most  local  officers  do  not  do  much  in  this  direction  be- 
sides record  the  bare  number  of  cases  and  deaths  from  different 
diseases.     Tabulation   is  left  for  those  who   handle  larger  masses    of 


MISCELLANEOUS   SANITARY   WORK.  813 

figures,  as  the  state  registrars.  In  some  local  reports,  especially  in 
those  cities  where  registration  was  established  before  it  was  required 
by  statute,  the  causes  of  death  are  subjected  to  a  more  or  less  exten- 
sive analysis  as  in  Baltimore,  Boston,  Charleston,  District  of  Columbia, 
New  York,  Philadelphia,  Providence,  St.  Louis,  and  San  Francisco. 
The  most  elaborate  tables  are  those  of  Providence  which  were  begun  in 
1855  by  Dr.  E.  M.  Snow  who  was  the  first  health  officer  and  registrar. 

A  good  many  cities  have  carefully  inspected  the  sanitary  condition 
of  all  houses  where  communicable  disease  is  reported.  Some  few 
health  officers  have  analyzed  the  results  of  these  inspections.  Among 
cities  where  this  has  been  done  is  Boston.  Investigations  in  Boston 
have  shown  that  scarlet  fever  and  diphtheria  are  as  likely  to  occur  in 
clean  houses  and  houses  free  from  defective  plumbing  and  sewer  gas  as 
they  are  in  bouses  where  these  conditions  are  found.  Furthermore, 
such  unsanitary  conditions  are  shown  by  house  to  house  inspection  to  be 
as  common  in  those  houses  where  the  diseases  in  question  are  not,  as 
they  arc  in  houses  where  these  diseases  exist.  In  a  word,  it  is  shown 
by  most  excellent  statistical  evidence  that  there  is  no  causative  relation 
between  unsanitary  conditions  and  scarlet  fever  and  diphtheria.  Un- 
fortunately, the  Boston  board  of  health  has  not  seen  fit  to  publish  the 
details  of  its  investigations,  but  merely  its  conclusions. 

The  record  of  communicable  diseases  and  as  many  tacts  concerning 
location,  exposure,  duration,  number  in  family  and  house,  extension  of 
infection  to  others,  etc.,  is  of  great  scientific  importance;  but  it  is 
equally  important  that  the  results  of  such  investigations  should  be  pub- 
lished. It  is  an  excellent  thing  to  plat  each  ease  of  communicable 
disease  on  a  map.  but  it  is  more  important  to  study  the  map  when 
made  and  during  its  making.  Thus  only  could  the  board  of  health  of 
New  York  City  determine  the  important  tact  that  phthisis  is  more 
prevalent   in  some  houses  than  in  others,  and  that   some  houses    seem  to 

be  thoroughl}  infected.     In   Providence  b\  a  careful  study  of  the  eases 

occurring  in  tenement  houses  it  was  learned  that  scarlet  fever  and  diph- 
theria do  not    spread  in  such  houses    more  than    in    neighboring    houses, 

and  thai  children,  except  in  the  infected  family,  may  safely  be  allowed 
in  school,  [f  everj  health  officer  would  record  and  publish  everj  case 
where  a  well  person  apparently  carried  a  communicable  disease  to 
another,  every  instance  where  there  was  a  recurrence  alter  disinfection, 
and   every   instance   where   the  patient    remained   infectious  for  a  long 

period,  as  BllOWE  by  his  infecting  others,  much  light  would  soon  be 
shed    on     the    \erv    BeriouS    problems    which     are    troubling    the    health 

officer. 

The  value  of  methods  of  disinfection  can  best   be  tested   in   routine 


814  MISCELLANEOUS   SANITARY    WORK. 

work.  It  may  be  clone  by  exposing  bacteria  in  the  rooms  or  in  the 
goods  to  be  disinfected.  Such  work  has  been  done  in  a  number  of 
cities,  as  Asbury  Park,  Boston,  Chicago,  Concord,  Fitchburg,  New- 
ton, Pittsburgh,  and  Providence.  Some  of  the  most  valuable  of 
these  experiments  have  been  carried  on  at  Boston  in  connection  with 
formaldehyde  disinfection.  The  methods  employed  are  shown  in  the 
report  for  1898,  page  ninety-one,  and  1899,  page  eighty-three.  In 
Pittsburgh  a  test  culture  is  put  in  every  room  disinfected  and  the 
results  are  published,  but  unfortunately  the  methods  employed  are  not 
fully  given. 

The  investigation  of  local  outbreaks  of  communicable  disease  is  a 
duty  which  should  be  faithfully  performed  by  every  health  officer.  He 
must  keep  careful  watch  of  his  returns  and  when  any  unusual  increase 
occurs  he  should  seek  out  its  cause  and  if  necessary  should  call  in  ex- 
pert assistance.  Many  examples  of  such  investigations  may  be  found 
in  municipal  reports,  as  for  example,  New  Haven,  1896;  Boston,  1892  ; 
Providence,  1888;  New  Bedford,  1893;  Springfield,  Mass.,  1892; 
Manchester,  N.  H.,  1894 ;  Syracuse,  1892;  Burlington,  Vt.,  1895;  Dis- 
trict of  Columbia,  1895;  Worcester,  1894;  Montclair,  N.  J.,  1897; 
Paterson,  1892-1893  ;  Minneapolis,  1893.  The  above  are,  of  course, 
only  a  few  of  the  cases  where  the  origin  of  an  outbreak  has  been  studied 
by  local  health  officers. 

The  establishment  and  maintenance  of  laboratories  gives  a  fine  op- 
portunity for  scientific  work  under  the  direction  of  the  health  officer. 
The  chemist  is  employed  to  test  water,  milk,  and  other  foods  and  to 
detect  impurities  and  adulterations,  but  he  ought  to  do  more  than  mere 
routine  work.  If  his  analyses  are  carefully  recorded,  summarized,  and 
published  he  cannot  help  doing  something  for  the  advancement  of 
science,  even  if  he  makes  no  brilliant  discovery.  But  the  bacteriologist 
has  the  widest  range  of  problems  clearly  mapped  out  for  him.  Only 
the  larger  laboratories  like  those  of  Boston,  Chicago,  and  Philadelphia, 
and  especially  New  York,  can  be  expected  to  take  up  systematically 
the  newer  problems  of  pathology.  The  New  York  laboratory  with  its 
exceptional  facilities  has  been  able  to  accomplish  much,  both  of  prac- 
tical and  theoretical  importance  :  but  certain  problems  can  be  and  should 
be  attacked  in  every  laboratory.  Tests  of  disinfection,  investigations  of 
the  distribution  among  the  well,  and  outside  of  the  body,  of  the  specific 
organisms  of  typhoid,  diphtheria,  and  tuberculosis,  their  persistence  in 
each  individual,  and  their  virulence  under  varying  conditions,  give 
promise  of  furnishing  the  greatest  aid  in  developing  a  scheme  for  the 
management  of  these  diseases.  Unfortunately,  very  little  has  yet  been 
done  along  these  lines.  The  investigation  of  the  connection  between 
malaria  and  the  mosquito  can  well  be  taken  up  by  health  officials. 


MISCELLANEOUS   SANITARY   WORK.  815 

The  thorough  and  systematic  inspection  of  schoolhouses  before  re- 
ferred to,  is  an  example  of  good  scientific  work.  So  is  the  examination 
of  springs,  ice,  and  water  supplies.  In  this  connection  may  be  men- 
tioned the  fifteen  wells  in  Asbury  Park  in  which  for  many  years  the 
height  of  the  ground  water  has  been  noted  at  stated  intervals.  It  is  a 
good  thing  to  distribute  pasteurized  milk,  but  it  is  a  better  thing  to  fol- 
low the  lives  of  the  children  to  whom  it  is  given  and  show  that  the 
practice  saves  lives. 

A  leading  educator  has  been  quoted  as  saying  that  the  first  duty  of 
a  school  superintendent  is  to  secure  the  aid  of  the  local  press.  There 
is  no  doubt  that  the  health  officer  can  do  much  to  secure  the  advance- 
ment of  sanitation  if  he  can  gain  the  hearty  cooperation  of  the  news- 
papers. Judgment  and  tact  here  count  for  much  and  the  health  officer 
should  always  advertise  his  department,  not  himself. 

Another  method  of  teaching  the  public  is  by  means  of  circulars  of 
information.  Many  of  these  circulars  have  been  referred  to  and  ex- 
amples given.  Circulars  in  regard  to  the  various  communicable  dis- 
eases, in  regard  to  disinfection  and  vaccination  and  the  care  of  infants, 
are  distributed  in  nearly  every  city.  Before  plumbing  laws  were  SO 
generally  enacted,  circulars  in  regard  to  good  plumbing  were  often  sent 
out.  The  establishment  of  bacteriological  laboratories  necessitates  the 
issusingof  explanations  of  the  purposes  of  the  laboratory  and  directions 
h<>\\  to  make  use  of  its  facilities.  The  passage  of  new  laws,  or  the 
adoption  of  new  methods  along  any  line  of  sanitary  work,  render  it 
advisable  to  issue  an  explanatory  notice  which  may  be  sent  to  the  par- 
ties must  interested,  or  in  some  cases  to  the  general  public.  It  is  often 
unwise  to  rely  upon  the  educational  effect  of  a  single  issue,  but  it 
should  he  repeated  from  time  to  time.  It  is  often  necessary  to  print 
circulars  of  information  in  several  Languages.  State  boards  of  health  as 
a  rule,  provide  more  thoroughly  for  this  educational  work  than  do  local 
boards.  They  have  to  instruct  local  boards  as  well  as  the  public  and 
their  circulars  of  information  cover  a  wider  range  of  subjects.  Ex- 
amples of  circulars  lor  the  care  of  infants  are  shown  in  Appendices 
I  23  4. 

Man)  cities  issue  weekly  or  month  reports  bj  their  health  officials. 
Among  those  which  issue  the  former  maj  he  mentioned:  Baltimore, 
Charleston,  Philadelphia,  Pittsburgh,  and  New  York  City.  Monthly 
reports  are  issued  in  Brockton,  Buffalo,  Chatanooga,  Chicago,  Cleve- 
land, Detroit,  Evansville,  Fitchburg,  Hartford,  Houston,  Knoxville, 
Lawrence,  Lincoln,  Los  Angeles,  Cal.,  Lynn.  Macon,  Ga.,  Manchester, 
N.  II..  Milwaukee.  New  lla\cii.  New  Orleans,  Oakland,  Cal.,  Omaha, 
Paterson,  Portland,  Ore.,  Rochester,  Sacramento.  San    Diego,  Scranton, 


816  MISCELLANEOUS   SANITARY   WORK. 

Seattle,  and  Yonkers.  These  reports  are  of  every  conceivable  form  and 
size  from  a  postal  card  to  the  monthly  report  of  the  San  Francisco 
board  of  health  which  is  9  \  by  11  \  inches  and  contains  twenty-seven 
pages.  These  sheets  would  be  exceedingly  annoying  to  file  if  any  one 
thought  it  worth  while  to  attempt  it.  Most  of  these  weekly  and 
monthly  reports  contain  merely  vital  statistics.  Scarcely  any  two  are 
arranged  alike,  and  they  are  useless  for  purposes  of  comparison.  The 
writer  believes  they  are  useless  for  any  purpose.  As  was  stated  else- 
where, the  monthly  report  issued  in  Providence  was  discontinued  by  the 
writer  and  its  value  was  indicated  by  the  fact  that  only  one  person  after- 
wards wrote  to  inquire  about  it.  It  was  a  report  above  the  average  in 
quality  as  the  writer  is  free  to  say,  as  it  was  entirely  the  work  of  his  prede- 
cessor. Some  of  the  monthly  reports  include  other  items  beside  those 
of  vital  statistics,  such  as  reports  of  communicable  disease,  nuisances, 
plumbing,  market  and  milk  inspections,  disinfections,  garbage  collec- 
tions, scavenger  work,  meteorological  reports,  and  sick  poor  reports,  re- 
ports of  chemical  and  bacteriological  work,  lists  of  sanitary  officials,  and 
in  some  cities  general  municipal  statistics  are  included.  In  fact  every- 
thing that  should  properly  be  included  in  a  complete  report  of  health 
department  work  may  sometimes  be  found  on  these  ephemeral  reports. 
Even  the  results  of  original  scientific  investigations  are  sometimes  in- 
cluded as  in  Buffalo  and  Chicago.  Usually  only  the  mere  statement  of 
work  done  is  made  without  any  explanation.  It  is  difficult  to  find  two 
reports  that  are  alike  either  in  form,  subject  matter,  or  arrangement. 
Some  cities,  as  Chicago,  Buffalo,  and  Omaha,  have  published  no 
other  reports  for  several  years.  The  writer  looks  upon  these  reports  as 
an  insufferable  nuisance.  They  are  extremely  unsatisfactory.  If  a 
person  desires  to  know  what  is  done  in  his  own  or  another  city  he  will 
never  learn  from  a  monthly  health  report.  The  proper  time  division 
for  the  consideration  of  all  sanitary  matters  is  a  year,  not  a  month  or  a 
week.  It  matters  little  how  the  deaths  from  influenza  this  week  com- 
pare with  the  week  before  last,  or  how  many  loads  of  garbage  were  col- 
lected in  August  as  compared  with  January.  Annual  compilations 
only  are  useful,  and  furthermore,  a  mere  numerical  statement  of  facts 
without  any  text  is  of  little  use  to  any  one.  Even  if  a  person  should 
take  any  interest  in  the  monthly  reports,  as  the  writer  has  done  in  those 
of  Chicago  and  Buffalo  (simply  because  annual  reports  were  not  avail- 
able) he  would  find  difficulty  in  keeping  files  of  them  as  they  are  mailed 
as  second  class  matter,  and  a  considerable  number  are  sure  to  be  cast 
into  the  waste  basket  together  with  the  advertisements  of  patent  disin- 
fectants, etc.,  which  they  are  made  to  resemble  by  the  one-cent  postage 
stamp  which  is  affixed  to  them.     If  the  money  that  is  spent  in  printing 


MISCELLANEOUS    SANITARY    WORK.  SI  7 

and  mailing  these  ephemeral  sheets  were  spent  in  publishing  or  strength- 
ening an  animal  report,  it  would  be  a  distinct  advantage. 

Annual  reports  should  present  a  summary  of  the  work  done  by  the 
health  department  during  the  year,  with  the  necessary  explanation  and 
discussion  of  the  same,  and  also  suggestions  for  desired  improvements. 
These  reports  are  issued  first  to  serve  as  an  official  record  of  work  done, 
second  to  give  information  concerning  this  work  to  all  members  of  the 
city  government  and  to  the  citizens,  and  third  to  furnish  information  to 
tin-  officials  and  citizens  of  other  cities.  The  last  is  a  function  which  is 
not  recognized  as  legitimate  by  the  average  councilman.  He  calls  it  a 
waste  of  money  to  print  a  report  which  may  be  useful  to  others.  He 
sees  nothing  dishonest  in  taking  all  the  information  he  can  get  from 
others  and  giving  nothing  in  return ;  but  whether  a  report  is  intended 
for  use  in  the  city  of  its  publication  or  in  other  cities,  its  form  and  con- 
tents should  be  the  same. 

All  municipal  documents  should  be  of  uniform  size,  and  all  cities 
should  adopt  the  same  size.  Most  cities  have  adopted  the  octavo,  but 
there  are  a  few  exceptions.  Reports  sent  by  mail  should  never  be  rolled. 
An  envelope  costs  no  more  than  a  wrapper,  and  takes  less  time.  Reports 
should  have  the  different  subjects  arranged  in  the  same  way  year  by 
year.  Jt  is  then  much  easier  to  find  what  is  wanted.  All  publications 
of  fifty  pages  and  over  should  have  an  index,  or  at  least  a  table  of 
contents.  Some  quite  bulky  reports,  as  those  of  Baltimore,  Milwaukee. 
and  Philadelphia,  are  without  this. 

Certain  municipal  statistics  should  lie  included,  as  the  population, 
area,  parks,  streets,  sewer  connections,  vaults,  wells,  houses,  tenements, 
etc.  A  large  number  of  health  departments  include  registration  among 
their  duties,  and  such  departments  usually  include  vital  statistics  in 
their  reports,  though  sometimes,  as  in  Providence,  a  separate  registra- 
tion report  is  issued.  If  a  full  report  of  births,  marriages,  and  deaths 
is  not  included  in  an  annual  report,  at  least  the  total  number  of  deaths 
should  lie  given  and  the  death  rate  and  the  deaths  from  tin'  more  im- 
portant diseases,  particularly  the  communicable  diseases.  These  details 
should  be  lovcii  tor  a  number  of  years.  In  fact.  nearl\  all  the  facts 
given  in  numerical  form  in  the  report  should  lie  in  tables  including  a 
series  of   years.       This    iseo;uall\    i  mporlant   and     valuable   for  the  health 

officer  who  makes  the  report,  tin'  members  of  the  council   or  the  mayor 

to  whom  it  is  made,  the  citizen  who  pays  for  it.  and  the  worker  in  the 
other  cities.        |f    ii     is    objected     that     it     makes  t  he   report     too     lai^eaiid 

expensive,  it  maj  be  remarked  that  i ley  may  be  saved  b)  discontinu- 
ing the  monthly  sheet.        \    perusal  of    many  reports  will    show     padding 

in    the   form  of  general   remarks  (often   quoted)  on   sanitary  subjects, 


818  MISCELLANEOUS   SANITARY   WORK. 

which  might  well  be  omitted  in  favor  of  the  summaries.  It  is  a  good 
plan  to  give  in  the  first  part  of  the  report  a  list  of  the  officers  of  the 
department.  Whoever  opens  the  report  at  all  will  probably  be  interested 
in  this.  %  It  is  found  in  most  reports,  but  not  in  those  of  Boston,  the 
District  of  Columbia,  Denver,  Philadelphia,  and  a  number  of  smaller 
cities.  A  statement  of  the  expenses  of  the  health  department  should 
be  made.  This  should  be  given  in  some  detail  showing  the  amounts 
expended  for  salaries,  for  hospital  expenses,  ambulances,  vaccination, 
disinfection,  carriage  hire,  office  expenses,  removal  of  ashes,  garbage  or 
night  soil,  registration  and  laboratory  expenses.  If  any  of  these  mat- 
ters, which  are  usually  in  the  health  department,  happen  to  be  in 
another  department,  it  would  be  well  to  note  this  and  also  the  amount 
expended  by  that  department.  It  is  sometimes  deemed  inadvisable  to 
publish  salaries,  but  it  is  usually  best  to  do  so,  and  a  good  way  to  give 
the  expense  items  of  the  health  department  is  to  state  that  so  much  was 
spent  for  such  and  such  a  department,  as  plumbing  inspection,  and  then 
under  that  specify  the  salaries  of  the  inspectors. 

Two  faults  are  frequently  found  in  financial  statements.  One  is 
that  little  or  no  detail  is  given,  the  other  is  that  too  much  is  given.  It 
is  important  to  know  just  how  much  it  cost  to  remove  so  many  tons  of 
garbage,  but  not  that  John  Smith  was  paid  #75  for  a  horse,  and  John 
Doe  ninety-seven  cents  for  a  whip. 

In  reporting  the  working  of  the  department  each  year  it  is  not 
practicable  to  go  into  details  in  regard  to  everything  which  is  done 
where  the  same  methods  are  followed  year  by  year,  but  it  is  a  good  plan 
to  have  such  a  complete  account  in  at  least  one  report,  and  refer  to  it 
by  year  and  page  in  those  subsequently  issued.  New  methods  and  new 
investigations  should  always  be  explained  in  the  clearest  possible  man- 
ner. 

Statistics  of  communicable  disease  should  be  made  as  full  as  possible 
and  should  cover  a  number  of  years.  It  is  of  advantage  to  give  them 
by  months  but  it  should  not  be  forgotten  that  the  totals  should  be  given 
also.  In  some  reports  the  only  way  the  reader  can  get  totals  is  to  add 
the  columns.  The  annual  rate  per  10,000  of  the  population  is  also 
desirable.  It  should  be  made  clear  whether  croup  is  included  with 
diphtheria  or  not.  Nearly  every  health  officer  is  in  a  position  to  secure 
antitoxin  statistics,  and  they  should  be  published  as  carefully  as 
possible.  Immunization  statistics  are  particularly  desirable.  Special 
cases  throwing  light  on  disputed  points  concerning  the  period  of  in- 
cubation or  infection,  or  concerning  the  manner  of  infection  should  be 
reported  in  full.  At  the  present  time  accurate  accounts  of  disinfection 
are  very  desirable.     The  collection  and  disposal  of  garbage   and  other 


MISCELLANEOUS    SANITARY    WORK.  819 

refuse  should  receive  careful  attention.  The  manner  in  which  the 
work  is  done,  the  amounts  handled  and  the  cost  should  be  clearly  in- 
dicated. It  is  very  unsatisfactory  to  read  of  loads  of  garbage  without 
knowing  how  large  the  loads  are.  and  the  cost  of  collection  should,  if 
possible,  always  be  separated  from  that  of  disposal.  Laboratory  work 
should  be  reported  in  detail,  and  methods,  particularly  if  they  are  new 
ones,  fully  described. 

It  may  be  objected  that  this  plea  for  comprehensive  reports  made  by 
the  wiitei-  is  due  simply  to  his  own  personal  need  for  such  reports  while 
preparing  the  foregoing  pages  ;  but  it  is  not  alone  the  student  of 
municipal  affairs  that  desires  good  reports.  The  average  citizen  who 
desires  to  look  into  the  workings  of  a  department,  the  councilman  or 
mayor  to  whom  the  reports  are  technically  made,  or  the  health  officer 
in  another  city,  all  desire  that  a  report  which  they  take  up  shall  tell 
them  what  is  done,  and  how  it  is  done,  and  shall  convey  this  knowledge 
clearly  and  fully,  taking  nothing  for  granted. 

Finances. 

The  appropriation  available  for  most  health  departments  is  entirely 
dependent  upon  the  will  of  tin-  council  or  other  appropriating  body. 
Much  or  little  may  be  given  as  seems  fit.  Sometimes  the  amount  is 
specifically  divided  by  the  act  of  appropriation,  so  much  being  set  aside 
for  salaries,  so  much  for  hospital  expenses,  so  much  lor  the  disposal  of 
garbage,  etc.  In  other  cases  the  particular  use  which  is  to  be  made  of 
the  appropriation  is  left  entirely  to  the  board  of  health,  but  of  course. 
subject  to  the  ordinances.  The  latter  plan  is  followed  in  the  city  of 
the  writer  and  he  sees  no  reason  to  desire  a  change,  but  members  of 
health  boards  in  other  cities  have  spoken  to  him  of  the  disadvantage  of 
having  the  appropriation  divided  by  outside  officials  who  cannot  possibly 
foresee  all  the  exigencies  that   may  arise. 

I  sualTj  ;i  council  may  witliold  all  appropriation  if  it  chooses,  but 
some  states  have  provided  thai  the   local  sanitary    administration  shall 

each  year  have  a •  available  funds.       In  Iowa.1  Ohio,2  Wisconsin.''  and 

.Minnesota1  it  is  provided  that  the  expenses  incurred  under  the  pro- 
visions of  the  act  providing  for  the  establishment  and  operations  of 
boards  of  health   must    be   met.        No   attempt    is   made    ill    the   above  slates 

except  iii  Minnesota  to  !i\  the  amount   available.     In  other  states  the 

Iowa,  Code    L807  ,  Sec.  2571. 

I  >hio,   Annotated  Statutes  (It ,  Sec.  21  U). 

Wisconsin,  Statutes  (1808),  s«'--.  1 121. 
i  Minnesota,  Statutes  1 1894),  Se< ,  7078. 


XJIi  MISCELLANEOUS   SANITARY    WORK. 

amount  is  fixed,  or  at  least  the  minimum.  This  is  the  case  in  Florida1 
and  New  Jersey.2  In  Florida  where  local  health  administration  is  in 
the  hands  of  the  state  board  of  health  that  board  may  expend  for  sani- 
tary purposes  other  than  quarantine  one-half  mill  on  each  dollar  of  the 
assessed  valuation.  In  Minnesota  the  amount  is  one  mill  on  each  dol- 
lar. The  New  Jersey  law  allows  the  expenditure  of  -ftlOO  per  annum 
for  2,000  inhabitants  and  an  increase  according  to  population.  The 
law  is  given  below.3 

Several  laws  in  these  and  other  states  make  provisions  for  expendi- 
tures for  specific  purposes,  as  the  care  of  communicable  .disease,  main- 
tenance of  quarantine,  building  of  hospitals,  establishment  of  baths, 
licensing  of  plumbers,  destruction  of  diseased  animals,  inspection  of 
milk,  etc. 

It  is  extremely  difficult  if  not  impossible  to  prepare  a  comparative 
statement  of  the  amounts  expended  for  sanitary  purposes  in  different 
cities.  The  following  table  is  taken  from  the  September  Bulletin  of  the 
Department  of  Labor  (1900).  It  is  not  definitely  stated  in  this  report, 
but  it  so  appears  from  a  study  of  the  items,  that  expenditures  for  gar- 
bage and  other  refuse  disposal  and  for  hospitals  for  communicable 
diseases  are  not  included,  except  where  it  is  so  specified.  Other  items 
such  as  expenditures  for  plumbing  inspection,  food  inspection,  for 
the  care  of  the  sick  poor,  for  maritime  quarantine,  and  for  the  recording 
of  births,  marriages,  and  deaths,  are  in  some  cities  included  and  in  others 
not.  It  was  found  impossible  owing  to  lack  of  printed  reports  from 
many  cities  and  to  the  unsatisfactory  character  of  the  reports  of  others 
to  make  the  desired  corrections.  The  table  then  must  be  considered  as 
only  a  rough  indication  of  the  sanitary  expenditures  of  the  different 
cities. 


1  Florida,  Chapter  :J2  of  1809. 

-  New  Jersey,  Revised  Statutes  (1805).  p.  1650,  See.  80. 

;  New  Jersey,  Act  of  31  March,  1887,  Sees.  34-35: 

"That  the  local  board  of  health  of  each  township  in  this  state  may  expend 
annually  the  sum  of  one  hundred  dollars  in  the  care  of  the  public  health,  and  in 
addition  thereto  fifty  dollars  for  each  one  thousand  of  the  inhabitants  thereof  over 
two  thousand,  as  returned  by  the  last  preceding  census,  if  in  its  judgment  such  ex- 
penditure shall  be  required  for  the  purpose,  and  itemized  bills  for  such  expenditure, 
having  been  approved  by  the  president  and  secretary  of  such  board,  shall  be  paid 
by  the  usual  disbursing  officer  of  the  township,  and  if  in  case  of  any  emergency  or 
of  any  special  need  for  the  protection  of  the  public  health  such  board  shall  consider 
the  expenditure  of  a  greater  sum  necessary,  the  board  shall  so  certify  to  the  town- 
ship committee,  and  with  their  consent  and  approval  may  incur  such  further  ex- 
pense as  said  committee  may  authorize,  and  if  the  funds  at  the  disposal  of  the 
township  committee  are  not  sufficient  to  cover  such  expenditure,  said  committee  is 
hereby  authorized  to  borrow  money  for  the  purpose  on  the  credit  of  the  township, 
and  is  directed  to  place  the  amount  in  the  next  annual  tax  levy,  and  with  the 
money  so  raised  to  pay  the  debts  so  incurred.1' 


MISCELLANEOUS    SANITAR  V    WORK. 


821 


Table  Showing  the  Expenditures  for  the   Health  Department  in  Cities 
of  Over  30,000  Inhabitants. 


Bulletin  of  the  Department  of  Labor,  .September,  1000. 


New  York.  N.  Y $1,070,546 

Chicago,  111 190,844' 

Philadelphia.  Pa 240,928 

St.  Louis,  Mo 134,201 

Boston,  Mass 145,021 

Baltimore,  Md 91,641 

Cleveland,  Ohio 35,532 

Buffalo,   X.  Y 4:;.TT1 

San  Francisco,  Cal 111,137 

Cincinnati,  <> 40,446 

Pittsburgh    Pa 81,507 

New  <  Cleans,   La 20,250 

Detroit,  Mich 38,079 

Milwaukee,  Wis 34,193 

Washington,  D.  C 44.u:,4 

Newark,  X.  J 56,615 

Jersey  ( !ity,  X.  .1 7,766 

Louisville,  Ky 9,638 

Minneapolis,  Minn 23,340 

Providence,  R.  I 20,270 

Indianapolis,  Ind 10,000 

Kansas  City,  Mo 36,1982 

St  Paul,  Minn 9,011 

Rochester,  \.  V 28,359 

I)<'ii\  .i.  ( !olo 41,530 

Toledo,  Ohio 14,895 

Allegheny,  Pa 15,337 

(  iolumbus,  O 55,340 

Worcester,  Mas-, 11,502 

S3  racuse,  \.   V ~r,.-j>-j 

X.w  Haven,  Conn B,023 

Paterson,  N.  .1    7,112 

Fall  River,   Mass 23,619 

St  Joseph,   Mo 6,478 

Omaha.  Neb 10,  195 

Los   Angeles,  Cal 36, 156 

Memphis,  Tenn 60,664  ' 

Bcranton,   Pa ".Too 

Lowell,  Mass                     40,820 


Albany,  X.  Y $9,539 

Cambridge,  Mass 22,048 

Portland,  <  >re 4.121 

Atlanta,  Ga 103,779" 

Grand  Rapids,  Mich 4,639 

Dayton.   <> T.'.Mi:; 

Richmond,  Ya 67,469s,* 

Nashville,  Tenn 7,322 

Seattle,  Wash 8,798 

Hartford,  Conn 10,476 

Reading,   Pa 2,965 

Wilmington,  Del 7. To] 

Camden,   X'.  J 3,500 

Trenton,  N.  J 4,500 

Bridgeport,  Conn 4,000 

Lynn,  Mass 4..~>2s 

Oakland.   Cal 10,446 

Lawrence,  Mass 28,184 

New  Bedford,  .Mass 5,513 

Des  Moines,   la 6,360 

Springfield,  Mass 6,801 

Somerville,  Mass 8,079 

Troy,  V  Y 7,610 

Hoboken,   N.  J 2,332 

Evansville,  Ind 2,123 

Manchester,  X.  II 1,594 

Utica,  V.   Y L3,334 

Peoria,  111 6,253 

Charleston,  S.  C 13,500 

Savannah.    La 29,409 

Salt   Lake  City.  I'tah 12,202 

San  Antoni,..  Tex 12,347 

Duluth,  Minn 6,419 

Erie,  Pa 5,657 

Elizabeth,  N.  J 1,560 

Wilkesbarre,  Pa 2,67  I 

Harrisburg,  Pa 1,126 

Portland,  Me 3,125 

Yonkers,  ff.  T    "  10,178 


Nol  including  data  relating  to  sanitary  district  of  Chit 

including  expenditures  for  hospitals. 

Including  expenditures  for  hospitals,  asylums,  almshouses,  and  other  charities. 
1  including  expenditures  for  garbage  removal. 

Including  expenditures  forstreel  cleaning  and  sprinkling  and  garbage  removal. 
'•  Including  expenditures  for  cleaning  Bewers. 

I lata  for  lo  months. 


822 


MISCELLANEOUS    SANITARY    WORK. 


Norfolk.  Va $32,822 J 

Waterbury,  Conn 2,998 

Holyoke,   Mass 3,245 

Fort  Wayne.  Ind 3,562 

Youngstown,  O 6,695 

Houston,  Tex 24,899 

Covington,  Ky 2,128 

Akron,  () 2.242 

Dallas,  Tex 9,371 

Lancaster,  Pa 2,206 

Lincoln,  Neb 1,275 

Brockton,  Mass 4,988 

Binghaniton,  X.  Y 4.026 

Augusta,  Ga 11,286 

Altoona,  Pa 1,786 

Wheeling,  W.  Va 2,629 

Mobile.  Ala 1,939 

Birmingham,  Ala 3,487 

Little  Rock,  Ark o.SO.j 

Springfield,  O l'.."i22 

Galveston,  Tex 4,626 

Tacoma,  Wash 1.777 

Haverhill,  Mass :i.277 

Spokane,   Wash 8,634 


Terre  Haute,  Ind S2,.">!»4; 

Dubuque,  Iowa 1,521 

Quincy,  111 2,069 

South  Bend,  Ind 42.") 

Salem,  Mass 14,640 

Johnstown,   Pa 1,013 

Allentown,  Pa 3,299 

Davenport,  la 6,654 

McKeesport,  Pa 1,933 

Springfield,  111 1,517 

Chelsea,  Mass 17,321 

Maiden,  Mass 2,041 

Topeka,  Kans ' 8,476 

Sioux  City,  la 3,865 

Knoxville,  Tenn 1.00s 

Chattanooga,  Tenn 2,159 

Superior,  Wis 4,657 

Rockford,  111 1,868 

Taunton,  Mass 2,956 

Joliet,  111 4,500 

Canton,  Ohio 2,012 

Butte,  Mont 9.153 

Auburn,  X.  Y 3,650 


As  illustrating  sanitary  expenditures  in  smaller  communities  refer- 
ence may  be  had  to  the  report  of  the  state  board  of  health  of  ( )hio  for 
1896.  The  figures  refer  to  incorporated  villages  mostly  of  1,000  to 
2,000  inhabitants.  In  two  of  these  the  sanitary  expenditures  were  oyer 
81,000 ;  in  one  between  8500  and  81,000  ;  in  seven  between  8250  and 
8500;  in  twenty-one  between  *100  and  8250,  and  in  159  under  8100. 
In  most  of  them  the  chief  item  of  expense  was  the  salary  of  the  health 
officer. 

Tenement  Hotsks. 

The  housing  of  the  poor  is  one  of  the  most  serious  problems  con- 
fronting large  cities.  The  tenement  house  question  is  a  pressing  one 
with  sanitarians  as  the  death  rate  in  tenement  house  districts  is  usually 
much  higher  than  in  other  parts  of  the  same  city.  It  is  believed  that 
by  improving  the  tenements,  the  conditions  of  life  are  improved  and 
that  the  better  environment  conduces  to  the  physical  and  moral  well  being 
of  the  occupants,  and  increases  the  amount  of  happiness  and  extends  the 
duration  of  life.  Tenement  houses  may  be  defined,  and  are  so  defined 
in  laws  dealing  with  the  subject,  as  dwellings  designed  for  a  certain 
number  of  families.     The  popular  notion  of  a  tenement  is  a  dwelling 

1  Expenditures  for  Brambleton  and  Atlantic  City  wards  included  in  other  expend- 
itures for  maintenance  and  operation. 

2  Including  expenditures  for  street  cleaning  and  sprinkling  and  garbage  removal. 


MIS  <  EL  /,  AXEO I  rS    s.  1  XT T.  IRY    II  rORK.  8  2  3 

hived  by  the  poor  and  usually  cramped  and  dirty.  To  improve  the  con- 
dition of  the  tenement,  both  the  popular  and  the  legal  tenement,  has 
been  one  of  the  chief  aims  of  sanitary  officers. 

All  the.  laws  against  nuisances  and  the  methods  devised  for  their 
abatement,  are  largely  put  in  operation  for  the  benefit  of  dwellers  in 
tenements,  and  the  general  building  and  plumbing  laws,  the  operation 
of  medical  relief,  and  the  care  of  contagious  disease,  have  all  done  much 
to  better  the  condition  of  the  inhabitants  of  tenement  houses. 

Besides  these  general  efforts,  special  attempts  have  been  made  directed 
specifically  to  the  improvement  of  tenements.  The  necessity  for  such 
efforts  varies  greatly  in  different  cities.  It  is  greatest  in  the  cities 
of  the  old  world:  that  is  in  the  older  portions  laid  out  irregularly  with 
narrow  streets  and  alleys.  The  regular  plan  and  generous  thorough- 
fares of  most  American  cities  have  been  of  enormous  advantage.  The 
tenement  question  is  as  a  rule  the  more  important  the  larger  the  city. 
The  smaller  the  city  the  less  valuable  the  land,  and  the  smaller  the 
houses  and  the  greater  the  space  around  them.  Rapid  growth  some- 
times, as  in  Chicago,  has  almost  necessitated  the  occupation  of  many 
unsuitable  buildings  as  dwellings.  Lack  of  freedom  to  expand  in  all 
directions,  as  in  Boston  and  New  York,  will  also  foster  the  tenement 
evil.  In  fine,  crowding  is  what  makes  the  houses  of  the  poor  a  problem. 
In  the  country  there  is  light  and  air  for  all.  no  matter  how  poor  the 
dwelling.  In  the  city,  darkness  and  suffocation  come,  unless  care  is 
taken.  The  greater  the  demand  for  space  the  greater  the  crowding  and 
resulting  harm. 

All  the  conditions  of  the  tenement  house  evil  were  more  actively  in 
Operation  in  New  York  than  in  any  other  city,  and  in  New  York  the 
evil  has  in  the  past   reached  greater  proportions  than  in    any  other  city. 

has  received  more  attention,  and    has   hail   more  done   to  eliminate  it. 

The  labor  of  improving  tenement   houses  is  so  vast   that   it  could    hardly 

lie  expected  that  a  board  of  health  could  accomplish  much  without  out- 
side assistance.  As  a  matter  of  tact  public  opinion  has  been  formed 
and  Legislation  adopted  Largely  by  other  agencies.  Thus  in  New  York 
City  there  have  been  four  independent  commissions  appointed  to  con- 
sider this  tenement  problem,  and  to  their  reports  and  the  public  senti- 
ment created  by  them  has  been  due  much  of  the  improvement  ill  the 
dwellings  of  the  pom- in  that  city.  A  tilth  commission  is  at  present 
<  1900),  considering  the  subject.  The  secretary  of  this  commission,  Mr. 
Lawrence  Veiller,  has  recently  (October,  1900,)  issued  a  report  on 
Housing  Conditions  and  Tenement  Laws  in  Leading  American  Cities, 
and  to  this  reporl  the  writer  is  greatl)  indebted.  The  enforcement  of 
tenement  house  laws  when  the\  are  once  enacted  is  usually  leii   to  the 


824  MISCELLANEOUS   SANITARY   WORK. 

department  of  health  and  can  only  be  secured  by  it  when  backed  by 
strong  public  opinion.  The  most  important  tenement  house  legislation 
is  embodied  in  special  acts  passed  to  affect  certain  large  cities  as  Bos- 
ton,1 Chicago,  Cincinnati,  Cleveland,  New  York,2  and  Philadelphia.3 
There  have  also  been  a  few  acts  conferring  upon  local  government  the 
power  to  regulate  the  construction  of  tenement  houses.  Thus  in  New 
Hampshire4  towns  and  villages,  and  in  New  Jersey  local  boards  of 
health  are  authorized  to  do  this,  and  a  similar  authority  was  given  to 
Baltimore5  though  few  ordinances  have  been  adopted  under  its  pro- 
visions. The  ordinances  governing  the  construction  of  tenements  in 
Buffalo  are  adopted  under  the  provisions  of  the  charter  which  gives  the 
[lower  to  regulate  the  construction  of  buildings.'1 

The  earliest  tenement  house  laws  were  enacted  for  New  York  City 
in  1867  and  these  serve  as  the  basis  of  the  present  statutes.  Various 
modifications  of  these  laws  have  been  made  from  time  to  time.  The 
latest  form  is  that  found  in  the  charter  for  the  greater  city."  The  fol- 
lowing is  a  brief  synopsis  of  the  sections  with  the  exception  of  those 
relating  to  the  vacation  and  destruction  of  houses  unsuitable  for  occu- 
pancy which  have  been  considered  on  page  110 : 

Sec.  1304.     Tenements  must  be  ventilated  as  required  by  the  board   of  health. 

1305.  A  tenement  is  defined  as  a  dwelling  leased  to  three  or  more  families  or 
more  than  two  families  on  a  floor;  a  lodging  house  is  where  persons  for  hire  sleep 
for  less  than  one  week. 

1306.  Roofs  must  not  leak  and  stairs  and  banisters  must  be  kept  in  repair  and 
means  of  escape  from  fire  provided. 

1307.  Sleeping  rooms  if  without  a  window  must  have  a  transom  (of  three 
square  feet  area),  opening  into  a  room  with  a  window,  and  also  a  transom  into  a 
hall  or  room  opening  into  a  hall.     There  must  be  a  ventilator  over  the  stairway. 

1308.  Sewer  connection  must  be  made  when  there  is  a  sewer,  and  vault  or 
water  closet  provided.  The  owner  must  see  that  all  plumbing  is  kept  in  good  order 
and  no  tilth  must  be  put  in  an  improper  place.  When  there  is  no  sewer  there  are 
strict  rules  about  vaults,  and  yards  must  be  drained  into  the  gutter. 

1309.  Cellars  in  buildings  hereafter  erected  are  not  to  be  used  wholly  or  in 
part  as  a  dwelling,  and  in  old  buildings  they  are  not  to  be  used  as  a  dwelling  with- 
out a  permit.  Cellars  so  used  must  be  seven  feet  high,  two  feet  above  street,  sur- 
rounded by  two  and  one-half  feet  open  space  and  drained,  and  have  one  foot  of 
space  below  the  floor.  There  must  also  be  a  window  of  nine  square  feet.  If  there 
is  a  rear  room  in  the  cellar,  it  must  have  a  door  and  transom  into  the  front  room. 
Light  must  not  be  obstructed  by  steps  or  otherwise,  and  a  water  closet  must  be 
provided. 

1  Massachusetts,  Chapters  419  of  1892,  97  of  1895,  and  161  of  1899. 

-  New  York,  Chapter  378  of  1897,  Sees.   1304-25. 

3  Pennsylvania,  Act  of  7  June,  18'.)."). 

1  New  Hampshire,  Public  Statutes  (1891),  Chapter  116. 

5  Maryland,  Public  Local  Laws  (1888),  Vol  I,  p.  415,  Sees.  400-1. 

6  New  York,  Chapter  105  of  1891,  Title  II.,  Chapter  I,  Sec.  17(5). 

7  New  York,  Chapter  378  of  1897,  Title  7. 


MISCELLANMO  Us    SANITA  A*  Y    WORK.  825 

1310.  No  cellar  can  be  used  for  sleeping  without  a  permit.  Wall  paper  must 
be  taken  oft'  before  new  is  put  on.  Owner,  keeper  or  lessee  must  cleanse  house 
whenever  board  of  health  requires. 

1811.  When  part  of  a  tenement  is  used  for  a  bakery  or  bar  room,  transoms 
must  be  tight  to  keep  out  odors,  and  doors  must  be  tire  proof. 

1312.  There  must  be  proper  garbage  and  ash  receptacles,  no  combustibles  or 
hay  or  grain  may  be  stored,  and  no  animals  kept.  There  must  be  no  bakery  unless 
the  building  is  fire  proof. 

1313.  Owners  and  persons  having  control  must  file  name  and  address  and 
description  of  property  with  hoard  of  health.  In  ease  of  change,  new  owner  must 
register  in  thirty  days.  Notices  of  the  health  department  must  be  posted  five  days 
and  mailed. 

1314.  Tenements  are  to  be  inspected  twice  a  year.  Contagious  diseases  must 
be  reported  by  owner  or  occupant. 

1315.  Prescribes  method  of  vacating  tenements  unfit  for  habitation. 

1316.  Provides  for  the  condemnation  and  destruction  of  all  such.11 
The  following  provisions  are  for  new  buildings: 

1318.  Two  tenements  cannol  be  erected  on  one  lot  without  a  permit  from  the 
department  of  buildings.  If  the  buildings  are  one  story  high  there  must  be  a  ten 
foot  space  between  them;  if  two  stories,  fifteen  feet;  if  three  stories,  twenty  feet, 
if  more  than  three  stories,  twenty-live  feet:  hut  if  there  is  through  ventilation,  the 
space  may,  bj  permission,  be  less.  The  building  is  not  to  occupy  more  than  62  per 
cent,  of  the  lot.  except  on  corners,  when  92  per  cent,  is  allowed.  Such  building 
shall  not  come  within  five  feet  of  the  rear  of  the  lot.  and  the  interior  shaft  shall  not 
lie  less  than  two  feel  four  inches  wide.  Xo  shaft  over  ten  feet  square  shall  be 
■  ■  rered  with  a  skylight.  The  cellar  stairs  must  be  fireproof.  There  must  he  an 
area  in  front  from  level  of  cellar.  All  elevator  shafts  must  have  automatic  doors 
unless  there  is  an  attendant.  The  elevator  well  in  cellar  must  be  fireproof.  In 
buildings  of  over  five  stories,  the  stairs  must  he  lire], roof,  and  of  over  three  stories 
of  slow  burning  construction  with  no  wood  wainscot.  <  >ne  flight  niusi  extend  to 
roof.  Every  room  must  have  a  window  into  the  open  air.  The  water  closet  must 
open  outside,  or  if  it  has  its  own  vent  shaft,  may  open  into  shaft  if  twenty-fiv<  feel 
square.     The  floor  of  water  closet   must  Jbe  asphalted  or  otherwise  water  proofed, 

and  it  must  be  water  proofed  sixteen  inches  up  thesides.  The  depart  meiit  of  build- 
ings may  make  further  explanatory  regulations.  Tenements  ma>  noi  be  used  for  a 
private  school,  stable,  or  for  storing  rags,  bul  underwritten  regulations,  the  hoard 
of  health  may  give  permit  for  a scl I.     In  cases  of   violation,  any  court  of  record 

may  alter  notice,  enjoin  further  use  of  building. 

1319.  In  all  new    houses  r is  must  be  eighi   feet  high,  except  in  attic  where 

they  must  be  eight  feel  for  one-half  t  hen-  ana.  livers  room  shall  have  a  window  or 
a  ventilator  over  door  into  a  hall  with  window.     Windows  musl  ha\ le-tentli  ana 

ot  room,  and  extend  to  seven  and  one  half  feet  above  ll ',  and  the  upper  half  must 

open  full  width.  Habitable  rooms  of  less  than  100  feet  floor  space,  if  not  provided 
with  window  or  fireplace,  shall  have  separate  air  shafi    as  prescribed  by   the  board 

of    health. 

1320.  There  must  be  a  chimney  opening  for  stove  for  each  room  and  recep- 
tacles for  rubbish  and  water  on  each    floor.     Cellars  (of  all  houses)  shall  be  made 

water  tiglli   and  ceilings  plastered,  and   in   made  hind   in   wel    pl.i<  es  musl    he  moisture 

proof.     The  hoard  of  health  is  to  compel  these  changes  to  be  made.     Halls  to  have 

windows,    unless    \eiitilated    otherwise    to    I  he    satisfaction    of    the    board  of    health. 

Hall   lights  musl   be  kepi   fr sunset   to  ten  p.  m..  and  in  halls  without  windows 

from  eight   \.  m   to  ten  p.  m. 

1821.     Everj   aduli  occupant  shall   have    100  cubi<    feel  of   space   and  children 

Under  twelve,  300  feet  In  a  house  lor  more  than  eight  families,  there  shall  he  a 
resident   janitor. 


826  MISCELLANEOUS   SANITARY   WORK. 

lo22.  The  penalty  for  violations  of  the  tenement  house  law  is  from  $10  to  §100 
and  310  for  each  day  of  violation,  and  ten  days  imprisonment  for  each  day  of  viola- 
tion.    The  owner  and  lessee  are  responsible. 

1323.  Provides  that  the  department  of  buildings  may  make  other  regulations 
as  to  light  and  ventilation  of  all  new  tenement  or  lodging  houses  consistent  with  the 
foregoing,  when  it  shall  be  satisfied  that  such  regulations  will  secure  equally  well 
the  health  and  safety  of  the  occupants;  likewise  the  board  of  health  shall  have 
authority  to  make  other  regulations  as  to  cellars  and  as  to  ventilation  in  completed 
buildings,  consistent  with  the  foregoing,  when  it  shall  be  satisfied  that  such  regu- 
lations will  secure  equally  well  the  health  of  the  occupants. 

i:»24.     Provides  for  inspection  by  sanitary  police. 

The  New  York  law  has  served  as  the  basis  of  tenement  house  legis- 
lation throughout  the  country.  Several  cities  have  incorporated  more 
or  less  of  it  into  their  sanitary  codes  and  it  has  been  copied  quite  closely 
in  several  acts  of  special  legislation  for  individual  cities.  It  was  em- 
bodied with  few  changes  in  the  act  for  Boston  and  for  Philadelphia,  and 
for  cities  of  the  first  class  in  Ohio,  and  the  most  important  features 
enter  into  the  sanitary  codes  of  Brooklyn,  Buffalo,  Chicago,  Paterson, 
and  the  ordinances  of  St.  Louis.  A  lesser  number  of  its  items  can  be 
traced  in  the  act  for  buildings  in  Providence,  and  in  the  sanitary  regula- 
tions of  Lowell. 

Some  minor  differences  may  be  noticed  in  these  cities. 

In  Milwaukee,  Paterson,  and  Toledo  a  tenement  house  is  one  oc- 
cupied by  two  families,  in  Denver  and  San  Francisco  it  is  a  tenement  if 
occupied  by  two  families  above  the  first  floor,  in  Chicago  if  there  are 
more  than  three  families  or  more  than  two  on  one  floor,  and  a  similar 
definition  is  found  in  St.  Louis,  Boston,  Baltimore,  Providence,  Kansas 
City,  and  Syracuse.  In  Buffalo  four  families,  or  three  above  the  second 
floor  are  necessary  to  constitute  a  tenement.  In  Lowell  and  Bridge- 
port, tenement  house  plans  must  be  approved  by  the  board  of  health, 
but  only  when  the  buildings  are  over  two  stories.  In  New  Haven,  a 
rear  tenement  cannot  be  built  without  the  permission  of  the  board  of 
health. 

The  difficulty  of  fixing  the  responsibility  for  the  care  of  tenements 
is  overcome  in  Buffalo  by  the  following : 

"  Every  owner  or  lessee  of  a  tenement  or  lodging-house,  and  every  person  hav- 
ing control  of  a  tenement  or  lodging-house,  shall,  on  or  before  May  15,  1893,  and  in 
the  month  of  May  in  each  year  thereafter,  tile  in  the  office  of  the  department  of 
health  a  certificate  stating  his  name  and  address,  and  also,  if  he  shall  not  be  a  per- 
manent resident  of  the  city,  the  name  and  address  of  his  resident  agent  for  the  man- 
agement of  said  tenement  or  lodging  house;  and  also  containing  a  description  of  the 
property  by  street  number  or  otherwise,  as  the  case  may  be,  in  such  manner  as  will 
enable  the  department  to  easily  find  the  same,  and  also  the  number  of  apartments 
in  each  house,  the  number  of  rooms  in  each  apartment,  the  number  of  persons  oc- 
cupying each  apartment  and  the  trades  and  occupations  carried  on  therein,  and  said 
facts  shall  be  recorded  in  the  office  of  the  department  of  health.     He  shall  also  file 


MISCELLANEOUS   SANITARY    WORK.  827 

with  the  said  certificate  a  plan  ot  diagram  of  the  lot,  and  each  floor  in  the  building, 
showing  all  dimensions,  and  also  showing  all  doors,  windows,  closets,  water-closets, 
privies,  staircases,  and  means  of  exit,  and  shall  Hie  such  a  plan  or  diagram  annually, 
unless  his  annual  certificate  shall  state  that  no  changes  have  been  made  affecting 

the  previous  plan  or  diagram.""  l 

The  form  of  owner's  certificate  used  in  Buffalo  is  shown  in  Appen- 
dix 127. 

In  Boston  tlic  cellar  ceiling  must  be  one  foot  above  the  ground,  in 
Baltimore  three  feet,  in  Cleveland,  Milwaukee,  Jersey  City,  Toledo,  and 
Columbus  lour  feet,  and  the  rooms  must  be  eight  feet  high,  and  in  Cin- 
cinnati three  and  one-half  feet  above  the  ground  and  seven  and  one-half 
feet  high.  A  concrete  floor  three  inches  thick  is  allowed  in  Phila- 
delphia ami  Pittsburgh,  and  two  inches  in  the  District  of  Columbia  and 
Buffalo. 

The  Buffalo  rules  are  very  strict  in  regard  to  cellars.  Nfo  one  is 
allowed  to  sleep,  lodge,  or  dwell  in  a  cellar. 

•'The  cellar  of  every   tenement  or  lodging-house  shall  be  protected   by  a  two- 
inch  bed  of  concrete  (cement  and  gravel  or  tar  and  grave]  I  or  asphalt,  or  hard  bricks 

laid  in  cement  with  concrete:  asphalt  or  brick  shall  be  laid  on  four  inches  of  broken 
•  s,  Mich  stones  not  being  greater  than  two  inches  in  size."' 

In  Philadelphia  on  corner  lots  uinety  per  cent,  may  be  covered  by 
the  tenement  and  on  the  other  lots  eighty  percent.,  in  Boston  sixty-five 
per  cent,  al  second  story  level  measured  to  the  middle  line  of  the  street 
on  which  it  abuts,  in  Buffalo  on  corner  lots  ninety  per  cent.,  on  others 
Beventy-five  per  cent.,  in  Cincinnati  interior  lots  ninety  per  cent,  above 
the  first  story,  and  for  each  additional  story  two  and  one-half  percent. 
less.  In  Chicago  and  the  District  of  Columbia  a  ten-foot  space  must  be 
left  in  the  rear.  In  Philadelphia  Bpace  between  a  trout  and  rear  ten- 
ement musl  not  In-  less  than  twelve  feet,  in  Baltimore  thirt\  feet. 
Iii  Cleveland  and  Columbus  the  length  of  the  space  must  lie  three- 
fourths  of  the  width  of  the  buildings,  and  in  Cleveland  lor  two-storj 
buildings  the  space  must  he  twenty  feet. 

In  Chicago  if  rooms  open  into  a  shafl  the  latter  must  have  at  leasl 
thirty-six  square  feet  of  area,  in  Denver  forty  square  feet.  In  Phila- 
delphia such  air  shaft  musl  he  eight  feet  wide  and  every  window  must 
be  eight  feel  from  the  opposite  wall  or  lot  line.  In  Baltimore,  Kansas 
City,  Cleveland,  Milwaukee,  Districl  of  Columbia,  and  Providence  the 
law  permits  rooms  i"  open  into  a  room  with  windows  but  it  musl  also 
open  into  the  hall.  Air  -hilts  in  Chicago  must  for  three-stor}  build- 
ings  l»e  thirty-six  feet  square,  for  four  stories  forty-six  feci,  and  for  five 
stories  fifty-six  feet,  and  soon   increasing  ten   feet    for  each   Btory.     In 


Buffalo,  <  Ordinances.  <  lhapter  25,  v>-. .  r_\; 


828  MISCEL  L.  1 NEO Us   SAN11AE  Y    WORK. 

( Ileveland  and  Columbus  the  areas  are  for  three  stories  twelve  square 
feet,  for  four  stories  sixteen  square  feet,  and  for  five  stories  twenty 
square  feet.  In  Denver,  Toledo,  and  Milwaukee  for  three  stories  the 
area  is  forty  square  feet,  and  for  four  stories  fifty  square  feet,  increas- 
ing ten  feet  for  each  story,  and  the  air  space  is  not  to  be  roofed  over. 
In  Boston  two  open  spaces  must  be  left  on  the  lot,  ten  feet  wide  and  of 
an  aggregate  length  of  one  twenty-fifth  of  area  of  building,  also  a  clear 
open  space  at  rear  in  depth  one-half  the  width  of  the  street  in  front  of 
the  building.  In  Buffalo  there  must  be  a  "court"  ten  feet  wide  and  of 
250  square  feet  of  area.  The  width  of  shafts  must  not  be  less  than  two 
feet  in  Chicago  and  three  feet  in  Cleveland.  In  Philadelphia  the  open 
space  at  side  or  rear  must  cover  twenty  per  cent,  of  the  lot  and  the 
minimum  width  of  all  spaces  is  eight  feet,  or  if  between  tenements 
twelve  feet. 

In  Buffalo  every  room  must  have  a  window  opening  into  a  street, 
yard  or  court,  which  window  must  equal  in  area  one-tenth  of  the  area 
of  the  room,  and  must  extend  seven  and  one-half  feet  above  the  floor 
and  both  sashes  must  be  movable.  In  Lowell  every  room  must  have  a 
window  of  twelve  square  feet  area,  and  the  sash  must  be  hung  with 
weights,  and  there  must  be  a  window  in  every  hall  except  with  the  per- 
mission of  the  board  of  health.  In  Philadelphia  there  must  be  a  win- 
dow of  twelve  square  feet  in  every  room,  and  there  must  be  eight  feet 
between  the  window  and  every  dead  wall,  and  the  window  must  extend 
eight  feet  above  the  floor.  Rooms  may  be  seven  feet  high  in  Columbus 
and  Cleveland,  seven  and  one-half  in  Cincinnati,  and  must  be  eight  and 
one-half  in  Jersey  City. 

In  Boston  and  St.  Louis  tenements  must  not  be  over  two  and  one- 
half  times  the  width  of  the  street  in  height,  in  Milwaukee  and  Toledo 
the  height  must  not  be  over  two  and  two-thirds  the  distance  from  the 
face  of  the  building  to  the  middle  of  the  street.  In  the  District  of 
Columbia  no  building  is  to  exceed  in  height  the  width  of  the  street  and 
there  is  a  maximum  of  ninety  feet.  In  Buffalo  on  streets  less  than  twenty 
feet  wide  no  tenement  may  be  more  than  thirty  feet  high,  and  in  Provi- 
dence not  over  thirty-five  feet. 

In  New  York  City  there  must  be  one  water-closet  on  each  floor  for 
every  two  families  and  none  are  allowed  in  the  yard.  In  Chicago  none 
are  allowed  in  cellars.  In  Philadelphia  there  must  be  one  for  every 
suite  of  rooms  and  none  are  allowed  in  sleeping  rooms.  In  Boston, 
Baltimore,  and  Denver  there  must  be  one  water-closet  for  every  twenty 
persons.  In  Buffalo  there  must  be  one  for  every  three  families  or  every 
fifteen  persons,  in  Detroit  one  for  every  two  families,  in  Rochester  one 
for  every  ten  persons.     In  Buffalo,  Hartford,  Pittsburgh,  and  Rochester 


MI&  t  EL  LANJSO  US    &  i XI TAB  J *    WORK.  % 2 9 

no  water-closet  may  be  in  a  cellar.  In  Chicago  and  Denver  a  water- 
closet  must  not  lie  ventilated  by  the  same  shaft  that  ventilates  a  habit- 
able room. 

In  Chicago  tenements  must  have  the  wall  and  ceilings  whitewashed 
in  April  and  <  October  each  year,  and  in  Boston  in  April  or  Maw  and  in 
Buffalo  twice  a  year. 

In  Philadelphia  there  must  be  700  cubic  feet  of  space  in  every  habit- 
able loom.  In  Denver  there  must  be  700  feet  for  each  occupant,  in 
Buffalo  or  Nashville  600  feet,  and  in  the  Districl  of  Columbia  400 
cubic  feet.  In  the  latter  city  the  health  officer  may  affix  a  notice  to  any 
room  stating  the  number  of  occupants  that  may  he  allowed  and  must 
serve  a  similar  notice  on  the  owner.  In  Rochester  there  must  he  500 
cubic  feet  tor  each  occupant  with  a  floor  space  one-twelfth  as  great. 

In  Philadelphia  tenement  houses  of  over  four  stories  must  he  lire- 
proof.  There  must  lie  tower  lire  escapes,  and  the  stairs  must  extend  to 
the  ground  floor.  Stair-  must  he  three  feet  wide  in  a  fifteen  room 
building,  three  and  one-half  feet  in  a  tenement  house  of  from  fifteen  to 
twenty  rooms,  and  four  feet  wide  in  tenements  of  over  twenty  rooms. 
Stairs  shall  have  an  eight  inch  riser  and  nine  inch  tread  without  the 
nosing.  In  Buffalo  no  winders  shall  he  less  than  twelve  inches  wide  at 
tin-  middle  point  of  the  stair.  There  shall  he  a  staircase  leading  to  the 
roof  with  an  opening  three  feet  by  two  feet.     In  Buffalo: 

■•  Every  tenement  or  lodging-house  hereafter  erected  more  than  two  stories  bigh 
shall  bave  at  least  two  independent  means  "f  egress,  each  accessible  from  each 
nt'iit.  either  directly  "i  bj  means  "i  common  halls,  ami  shall  conform  to  exist- 
ing  building  laws,  ordinances,  rules  and  regulations  relating  to  tire  escapes. 

■•  In  every  tenement-house  containing  eight  families  or  more,  ami  of  the  height 
of  three  stories  or  more,  ami  in  every  lodging-house  at  least  one  red  light  shall  be 
kept  burning  at  night  on  every  flight  of  stairs,  ami  one  or  more  u'Ui^s  shall  he 
placed  ami  he  <it'  such  size  ami  number  as  could  give  an  alarm  through  the  house  in 
i  tire.  All  doors  of  exit  or  entrance  shall  open  outward.  The  superintendent 
may  make  such  other  <>r  further  requirements  for  prevention  or  escape  from  fires  as 
may  he  reasonably  necessary  under  the  conditions  of  each  cast 

In  Buffalo,  as  in  New  York,  there  must  be  water  on  each  floor,  ami 
tor  ead,  family,  and  in  Philadelphia  there  is,  the  same  requirement, and 
there  must  he  a   sink    for  each    tenement  and  there  musl  he  no  hydrant 

in   the  yard. 

Buffalo  has  the  following  : 

Ml  receptacles  for  ashes,  waste  ami  other  substances 

liable  by  spun  tan s  combustion  or  otherwise  to  cause  inc.  shall  he  made  of  inc - 

bustible  material,  satisfactory  to  the  superintendent.  Everj  building  used  as  a 
tenement  or  lodging-house  shall  have  outside  ami  appurtenant  to  said  building,  on 
land  "i    the   owner,  a  suitable  space,  satisfactory  to  the  health  commissioner,  ami 


Buffalo,  « Ordinances,  Chaptei  25 


830 


MISCELLANEOUS   SANITARY    WORK. 


approved  by  him  in  writing,  for  the  temporary  deposit  of  garbage  and  other  refuse 
matter.  The  requirement  that  such  deposit  shall  be  made  upon  the  land  of  the 
owner  shall  not  apply  to  any  building  already  erected  where  it  covers  the  whole  lot, 
or  where  there  is  no  direct  exit  from  the  court  of  such  building."1 

In  Illinois,  in  cities  of  over  50,000  inhabitants,  the  plans  of  all  ten- 
ement houses  must  be  approved  by  the  board  of  health. 

The  various  building  and  plumbing  laws  which  are  enforced  in  all 
the  larger  cities  have  done  much  to  improve  the  character  of  tenement 
houses  though  they  may  have  no  special  provisions  relating  to  that  class 
of  buildings. 

Boston,  Buffalo,  Chicago,  New  York,  and  St.  Louis  all  have  syste- 
matic inspection  of  their  tenement  houses,  and  in  New  York  in  1896, 
fifty  sanitary  police  were  detailed  for  this  service,  and  in  Chicago,  ten. 

In  New  York  City  and  Boston  the  law  requires  the  tenement  house 
inspection  to  be  made  twice  a  year.  In  the  latter  city  this  is  perfunc- 
torily made  for  the  apartment  houses,  but  in  the  tenements  of  the  poor 
monthly,  weekly,  and  even  daily  inspections  are  made.  In  New  York 
the  inspectors  are  simply  required  to  look  after  nuisances  and  the  viola- 
tions of  the  law  in  tenements.  They  are  not  required  to  make  a  full 
report  of  the  conditions  of  each  house  for  filing  in  the  office.  This  is 
required  in  St.  Louis  and  Buffalo  and  in  the  latter  city  a  form  is  used 
which  is  shown  in  Appendix  49. 

In  New  York  night  inspections  are  made  to  determine  over-crowding 
and  for  this  work  the  following;  blank  is  used : 


HEALTH    DEPARTMENT. 
Sanitary    Bureau. 

Report  of  Night  Inspection  made  at o'clock  P.  M., 

of  premises  situated 

by  Sanitary  Officers 


ISO 


NAME  OF  TENANT 


Family 


Adults  Child 


Lodgers 


Adults  Child 


Size  of  Rooms 


Length  Width  Height 


Total 
Cubic 

Feet 


Cubic 
Feet  for 
Adults 


Cubic 
Feet  for 
Children 


Simitar//  Officers, 


1  Buffalo,   Ordinances.  Chapter  25,  Sec.  139. 


MISCELLANEOUS   SANITARY    WORK.  83] 

In  New  York  in  1896  there  were  made  190,134  inspections  which 
resulted  in  38,858  complaints  of  nuisances.  There  were  40,461  front 
tenements  and  i\448  rear  tenements.  These  houses  were  occupied  by 
339,237  families  with  1,487,392  persons,  of  whom  180,359  were  under 
live  years  of  age. 

In  order  to  enforce  the  law  requiring  lights  in  tenements  from  sun- 
set till  10  P.  M.,  night  inspections  were  made.  One  hundred  and  fifty 
inspectors  visited  40,000  houses  between  26  and  30  March,  1896;  14,- 
000  violations  of  the  law  were  found  and  orders  issued.  At  a  sul.- 
sequent  inspection  5,630  violations  were  found  and  notices  of  suit  were 
served.  Another  inspection  in  April  showed  that  in  all  cases  the  law 
had  been  complied  with. 

Night  inspections  are  also  made  in  Newton.  .Mass..  and  in  one  in- 
stance thirteen  persons  were  found  in  a  room  of  1,700  cubic  feet.1 

In  St.  Louis  in  1896  there  were  in  1,851  tenemenl  houses  59,621 
persons.  Of  the  occupied  rooms  there  was  an  average  of  1.4  persons 
to  a  room.  The  average  cubic  capacity  of  rooms  was  Loot;  feet  and 
the  ana  unt  of  -pace  per  person  was  1,111  euhic  feet. 

Lodging  Houses. 

The  laws  governing  the  construction  of  tenements  are  usually  made 
applicable  to  lodging  houses  as  well,  hut  there  are  in  some  cities  other 
regulations  prescribed,  either  by  statute  or  ordinance.  The  Boston  act 
ami  the  Pennsylvania  law  have  the  following  requirements  tor  the 
licensing  of  lodging  bouses  : 

v.  such  license  shall  be  granted  until  the  inspector  of  buildings  of  said  city 
has  certified  that  the  said  building  is  provided  with  sufflcienl   means  to  escape  in 

t  tire  ami  that  suitable  appliances  are  provided  for  extinguishing  fires  and  for 

giving  alarm  to  the  inmates  in  case  "t   fire;  and  said  inspoctor  may  Er time  t" 

time  require  such  alterations  to  be  made  or  suoh  additional  appliances  t"  !»<■  pro- 
vided as  may  in  his  judgmenl  he  necessary  for  the  protection  of  lite  and  property  in 

i  ,i-i'  of  lire. 

•  \o  su«  h  license  shall  he  granted  until  the  board  of  health  has  certified  thai  the 
building  is  provided  with  a  sufflcienl  number  of  water-<  L.seis  and  urinals,  ami  with 
good  and  sufficient  means  of  ventilation;  and  said  board  may  from  time  t<.  time  re- 
quire the  licensee  t"  thoroughly  cleanse  and  disinfect  all  parts  of  said  building  and 
the  furniture  therein,  to  the  satisfaction  of  said  board.11 

In  pursuance  of  the  above  statute,  the  board  of  health  of  Boston 
has  adopted  the  following  regulations: 

•  i.  Tin'  means  for  lighi  ami  \ em  i lat inn  must  he  satisfactory  t"  the  board  of 
health  and  beyond  the  control  of  lodgers. 

••■_'.      All    floors    and    stairways    must    he    si.und.  smootll    and    either    painted    or 

shellacked. 

\eu  ton,  Report  oi  Board  '•)  Health  1 1897),  p. 
Massachusetts,  Chapter  n  t  •  •!  1894,  Sees.      I 


832  MISCELLANEOUS   SANITARY    WORK. 

"  3.  There  shall  be  allowed  not  less  than  300  cubic  feet  of  space  to  each  lodger 
in  sleeping  rooms. 

"  4.     Open  and  spacious  dormitories  will  be  preferred. 

"5.  Single  or  small  rooms  will  be  allowed  only  in  exceptional  cases,  and  then 
only  with  fireproof  partitions. 

"6.     No  carpeting  will  be  allowed  on  floors  or  stairways. 

"  7.  There  shall  not  be  less  than  two  horizontal  feet  between  the  sides  of  any 
two  beds. 

"8.     All  bedsteads  must  be  single  and  of  iron. 

"  9.     Blankets  will  be  required  and  "  comforters  "  will  be  prohibited. 
"  10.     Mattresses  must  be  covered  with  a  waterproof  covering. 
"  11.     No  person  will  be  allowed  to  retire  or  sleep  in  his  day  clothing. 
"  12.     No  person  who  is  not  clean  will  be  allowed  to  retire  without  a  bath. 
"13.     Water  closets  (one  to  every  twenty  lodgers),  lavatories  and  shower  bath, 
with  hot  and  cold  water,  all  with  open  plumbing,  must  be  furnished  on  each  floor, 
and  the  floors  to  same  shall  be  of  marble,  slate  or  concrete. 
"14.     All  movable  receptacles  for  excretions  are  prohibited. 
"  15.     Smoking  in  sleeping  rooms  is  prohibited. 

"  16.  All  stairways,  fire  escapes  and  other  means  of  exit  in  case  of  fire  must  be 
in  accordance  with  the  statutes  and  ordinances  on  that  subject  and  to  the  satisfac- 
tion of  the  Building  Commissioner. 

"  17.  Stoves  for  heating  will  be  allowed  only  tinder  the  most  favorable  con- 
ditions for  safety. 

"  18.     The  use  of  portable  kerosene  lamps  is  prohibited. 

"19.  A  reliable  person  or  persons  must  be  in  attendance  at  all  hours  of  the 
night."1 

The  following  is  from  the  Sanitary  Code  of  the  City  of  New  York  : 

"...  The  beds  in  all  [lodging-houses  and  in  every  room  in  which  beds  are 
let  for  lodgers  shall  be  separated  by  a  passageway  of  not  less  than  two  feet,  horizon- 
tally, and  all  the  beds  shall  be  so  arranged  that  under  each  of  them  the  air  shall 
freely  circulate,  and  there  be  adequate  ventilation.  Four  hundred  cubic  feet  of  air 
space  shall  be  provided  and  allowed  for  each  bed  or  lodger,  and  no  more  beds  shall 
be  permitted  than  those  provided  in  this  way,  unless  free  and  adequate  means  of 
ventilation  exist,  approved  by  the  board  of  health,  and  a  special  permit  in  writing 
be  granted  therefor,  specifying  the  number  of  beds  or  the  cubic  air  space  which 
shall  under  special  circumstances  be  allowed."2 

Iii  Fitchburg  500  cubic  feet  of  space  are  required  for  each  lodger, 
and  a  similar  requirement  is  found  in  the  California  law.3  In  Illinois4 
400  cubic  feet  are  required  and  no  more  than  six  persons  may  sleep  in 
one  room. 

In  order  to  secure  the  enforcement  of  these  sanitary  regulations, 
the  licensing  and  inspection  of  lodging  houses  are  necessary.  Lodging- 
houses  are  licensed  in  Boston,  Jersey  City,  New  York  City,  and  Phila- 
delphia.     In   Boston   and    Pennsylvania   cities    it    is    provided  for    by 


1  Boston,  Rules  of  Board  of  Health,  22  March.  1898. 

2  New  York,  Sanitary  Code  (1899),  Sec.  26. 

3  California,  Act  of  3  April,  1876. 

4  Illinois,  Act  of  21  April,  1899. 


Vise  ELL.  I  XKors    SA  XITAE  Y    WO  UK.  s:1,:1, 

statute.  In  Boston1  every  building  not  licensed  as  an  inn,  in  which  ten 
or  more  persons  are  lodged  for  a  single  night  for  a  price  of  twenty-five 
cents  or  less,  is  a  lodging  house.  All  such  must  take  out  an  annual 
license  from  the  board  of  police.  No  fee  is  charged  for  the  license.  In 
Pennsylvania2  the  law  is  applicable  to  all  cities  and  the  mayor  issues 
the  license:  in  other  respects  it  is  like  the  Boston  act.  In  New  York 
City  licenses  are  required  for  lodging  houses  containing  more  than  four 
beds.3 

Both  the  New  York  and  Boston  acts  and  the  Illinois  law  require  the 
proprietors  of  lodging  houses  to  keep  a  register  of  all  lodgers  which  shall 
at  all  times  he  open  to  inspection.  In  New  York4  the  register  is  only  to  he 
kept  hetween  the  1st  of  September  and  the  15th  of  Xovemher,  hut  in 
Boston  it  is  to  he  permanent.  In  New  York  the  hoard  of  health 
furnishes  the  record  hook,  and  the  proprietor  every  fortnight  must  make 
a  sworn  return  of  the  particulars  in  regard  to  each  lodger  for  the  pre- 
ceding twenty-four  hours.  The  following  is  the  heading  of  the  return 
made  in  pursuance  of  this  law: 

Xanie. 

Birthplace. 

Residence. 

lor. 
Approximate  age,  height,  and  weight. 
Peculiarities  of  form. 
Visible  marks  on  face. 
Whether  monthly,  weekly  or  daily  lodger. 
Whether  or  not  he  occupies  a  hed. 

In  Illinois  the  keeper  of  the  lodging  house  must  file  annually  with 
the  county  clerk  such  statements  as  the  state  hoard  of  health  may 
direct. 

In  New  York  nightly  inspections  are  made  of  each  house.      This  not 

only  results  in  a  strid  enforcement  of  the  laws  against  overcrowding  and 

lilthiness,  but   is  the  means  of  getting  control  of  walking  cases  of  coiita- 

Blassachusetts,  <  Chapter  nt  of  1804. 
Pennsylvania,  Chapter  806  "f  1895. 
New  Fork,  Sanitary  Code  (1899),  Sec.  201: 
"Thai  for  all  lodging-houses  in  which  i»eils  are  let  for  lodgers  containing  four 
or  more  heds  in  any  apartment  therein  for  the  use  ..f  lodgers,  a  permit   in  writing 
from  this  department  siiail  !><•  required,  and  no  person  in  the  City  of  New  Fori 

shall  have,  lease,  lei  or  keep  any  Buch  lodging-hous •  the  lodgings  therein,  or 

assist  in  the  keeping,  hire,  or  assisi  in  hiring,  or  conduct  the  business  of  any  such 
lodging-house,  or  the  lodgings  therein,  except  pursuant  t"  the  terms  and  con- 
ditions of  a  permit  in  writing  previously  obtained  therefor  from  this  department, 
an  application  t"i  which  shall  !>••  made  In  accordance  with  the  rules  and  regulations 

of  the  board  of  health  by  the  pers r  persona  who  propose  to  use  the  same. 

1  New  Fork,  Chapter  758  of  1895. 


834 


MISCELLANEOUS    SANITARY   WORK. 


gious  disease.  Many  a  mild  or  incipient  case  of  small-pox  has  thus 
been  discovered,  which  probably  would  otherwise  have  become  the 
starting  point  of  an  outbreak.  The  accompanying  blank  form  of  report 
shows  the  items  to  be  noted  by  the  night  inspectors  in  New  York. 

MEMORANDA. 

Sanitary    Bureau. 
Report  of Class  Lodging    Houses,   Inspected 189 


Report   of  the   Sanitary   Condition. 


Street 

Privies 

Urinals 

Cha  niber 
Utensils 

Sinks 

Bedding 

Walls  and 
Ceilings 


Floors 


Beds  in  Excess 


Respectfully  submitted, 


Sanitary  Officer. 

Of  the  difficulties  of  maintaining  a  high  standard  in  lodging-houses 
the  Boston  board  of  health  speaks  as  follows  :l 

"  One  drawback  to  the  proper  sanitation  of  these  houses  is  the  disinclination  of 
the  patrons  to  avail  themselves  of  such  ventilation  as  is  provided,  as  they  much  pre- 
fer a  heated  atmosphere,  however  foul,  to  fresh  air  of  a  lower  temperature. 

"A  proprietor  of  one  of  these  lodging-houses  has  instituted  a  reform,  which  al- 
though very  unpopular  among  his  customers  could  be  imitated  by  others  in  the 
business  with  beneficial  results,  viz. :  that  of  requiring  every  lodger  to  take  a  bath 
or  going  elsewhere  for  accommodations. " 

In  this  connection  there  may  be  profitably  read  an  article  in  the 
Forum  of  November,  1894,  presenting  the  view  taken  of  lodging  house 
restrictions  by  the  average  lodger. 

Besides  the  cities  above  mentioned,  others,  as  Chicago  and  St.  Louis, 
make  more  or  less  frequent  inspections  of  their  lodging  houses.  In 
Illinois  inspection  of  lodging-houses  in  cities  of  100,000  inhabitants  and 
over  has  by  a  recent  act  been  placed  in  the  hands  of  the  state  board  of 
health. 

In  New  York  City  in  1896  there  were  nine  lodging  houses  with 
300  lodgers  or  over,  thirteen  with  from  200  to  300,  fifty-six  with  from 
100  to  200,  twenty  with  from  50  to  100,  and  twelve  with  less  than 
fifty  lodgers;  in  all  110  lodging  houses  in  the  city. 


1  Boston,  Report  of  Board  of  Health  (1895),  p.  95. 


MIS  <  EL  L .  1 XEO  US    & 1 NI TARY    II rORK.  835 

In  Chicago  in  1898  there  were  128  lodging  houses  which  provided 
on  the  average  for  6,737  lodgers  per  night.  Thirty-nine  of  these  houses 
were  provided  only  with  bunks,  2,703  hunks  in  all,  while  in  the  other 
houses  there  were  6,350  rooms  with  partitions  running  part  way  up 
and  533  entirely  separate  rooms. 

In  Philadelphia  in  1896  the  number  of  lodging  houses  was  eighty- 
three,  and  of  beds  3,037,  and  in  1899  there  were  119  houses,  but  the 
number  of  beds  was  not  given. 

Sweat  Shops. 

The  sweating  system  is  associated  with,  if  it  be  not,  the  direct  cause 
of  the  most  terrible  phase  of  human  life  that  is  found  in  the  United 
States.  A  sweat  shop  is  a  manufactory  in  the  dwellings  of  the  very 
poor.  Very  excellent  accounts  of  the  sweating  system  may  be  found 
in  a  report  on  that  subject  by  the  House  Committee  on  Manufactures, 
52  Congress,  Report  No.  2309,  and  also  in  Bulletin  No.  4  of  the 
department  of  labor  for  May,  1896.  The  writer  of  the  latter  article, 
IIeiii\  White,  general  secretary  of  the  United  Garment  Workers  of 
America,  sums  up  the  conditions  that  produce  the  sweating  system ; 
first,  crowded  population:  second,  high  rent:  third,  contract  work. 
Home  labor  if  the  home  be  healthful,  the  labor  reasonable,  and  the 
wages  fair,  is  by  no  means  to   he    discouraged:    but    the    gradations    are 

gradual  from  tins  ideal  conditi if   labor  to  the   destruction   of  home 

l>\  the  overcrowding  and  intense  application  and  competition,  and 
starvation  wages  of  the  sweat  shop.  As  it  is  a  product  of  high  rent 
and  competition,  it  bee es  acryingevil  in  great  cities. 

The  efforts  that  have  been  made  to  secure  remedies  hy  legislation- 
have  been  both  h\  the  wage  earners  themselves  and  by  others  interested 

in  promoting  the  welfare  of  the  | '.     In  this  movement  the  danger  to 

the    public    from    the    t  ransmissioii    in    the    goods    made,    of   contagious 

diseases  from  the  makers  to  the  buyers   has   figured    largely.     Health 

inspectors  and  visitors  of    the  pOOT    bave    too    often    seen    the    infection 

of  garments  in  process  of  making,  to  doubt  thai  this  danger  is  a  real 
one;  hut  it  has  doubtless  been  much  exaggerated.  The  dut\  of  the 
state  to  help  the  helpless,  and  make  life  more  bearable  for  the  most 
wretched  of  mankind,  is  reason  enough  for  an\  action  which  will 
abolish  or  mitigate  the  sweat  shop,  without  conjuring  up  an  exaggerated 
danger  of  sickness  to  the  well-to-do. 

The     following    states     have     legislation     concerning    sweat     shops: 

Illinois.  Indiana.  Maryland,  Massachusetts,  New  Jersey,  New  York, 
Ohio,  Pennsylvania,  and  Wisconsin.     Thefirsl  law  was  passed  by  New 


836  MISCELLANEOUS   SAKITABY   WORK. 

York  in  1892,1  the  others  have  largely  followed  it.  This  law  was  re- 
vised in  1899.2  It  is  by  this  law  forbidden  to  manufacture  articles  of 
clothing,  cigarettes,  etc.,  in  a  tenement  house  without  a  license,  but 
white  goods  can  be  so  made.  License  is  granted  by  the  factory  in- 
spectors after  inspection.  There  must  be  250  cubic  feet  of  air  space 
for  each  worker  between  6  A.  M.  and  6  P.  M.  and  400  cubic  feet 
between  6  p.  M.  and  6  A.  M.,  but  the  rooms  must  in  all  cases  be  lighted 
by  electricity.  Licenses  must  specify  conditions  and  must  be  posted 
on  the  premises.  Employers  must  keep  a  register  of  all  persons  work- 
ing for  them  in  sweat  shops.  The  factory  inspector  is  to  tag  as  "  tene- 
ment made "  any  articles  which  he  rinds  made  contrary  to  the  pro- 
visions of  the  law.  Sweat  shop  goods  brought  from  another  state  are 
to  be  inspected  and  tagged.  Owners  of  buildings  are  responsible  for 
their  illegal  use  for  sweat  shop  purposes.  The  factory  inspectors  en- 
force the  law  but  the  following  are  the  duties  of  the  board  of  health  : 

"If  the  factory  inspector  finds  evidence  of  disease  present  in  a  workshop  or  in  a 
room  or  apartment  in  a  tenement  or  dwelling  house  or  in  any  room  or  apartment  of 
a  building  in  the  rear  of  a  tenement  or  dwelling  house,  in  which  any  of  the  articles 
named  in  section  one  hundred  of  this  chapter  are  manufactured,  altered,  repaired 
or  finished  or  in  process  thereof  )\e  shall  affix  to  such  articles  the  label  prescribed 
in  the  preceding  section,  and  immediately  report  to  the  local  board  of  health,  who 
shall  disinfect  such  articles,  if  necessary,  and  thereupon  remove  such  label.  If  the 
factory  inspector  finds  that  infectious  or  contagious  diseases  exist  in  a  workshop, 
room  or  apartment  of  a  tenement  or  dwelling  house  or  of  a  building  in  the  rear 
thereof,  in  which  any  of  the  articles  specified  in  section  one  hundred  of  this 
chapter,  are  being  manufactured,  altered,  repaired  or  finished,  or  that  articles 
manufactured  or  in  process  of  manufacture  therein  are  infected,  or  that  goods  used 
therein  are  unfit  for  use,  he  shall  report  to  the  local  board  of  health,  and  such 
board  shall  issue  such  order  as  the  public  health  may  require.  Such  board  may 
condemn  and  destroy  all  such  infected  articles  or  articles  manufactured  or  in  the 
process  of  manufacture  under  unclean  or  unhealthful  conditions.1'' 

The  Massachusetts  law  has  recently  been  amended  as  follows : 

"  No  room  or  apartment  in  any  tenement  or  dwelling  house  shall  be  used  for  the 
purpose  of  making,  altering,  repairing  or  finishing  therein  any  coats,  vests,  trousers 
or  wearing  apparel  of  any  description  whatsoever,  except  by  the  members  of  the 
family  dwelling  therein,  and  any  family  desiring  to  do  the  work  of  making,  altering, 
repairing  or  finishing  any  coats,  vests,  trousers  or  wearing  apparel  of  any  descrip- 
tion whatsoever  in  any  room  or  apartment  in  any  tenement  or  dwelling  house  shall 
first  procure  a  license,  approved  by  the  chief  of  the  district  police,  to  do  such  work 
as  aforesaid.  A  license  may  be  applied  for  by  and  issued  to  any  one  member  of 
any  family  desiring  to  do  such  work.  No  person,  partnership  or  corporation 
shall  hire,  employ  or  contract  with  any  member  of  a  family  not  holding  a  license 
therefor,  to  make,  alter,  repair  or  finish  any  garments  or  articles  of  wearing  apparel 
as  aforesaid  in  any  room  or  apartment  in  any  tenement  or  dwelling  house  as 
aforesaid.      Every  room  or  apartment  in  which  any  garments  or  articles  of  wear- 


1  New  York,  Chapter  655  of  1892. 

2  New  York,  Chapter  191  of  1899. 


MISCELLANEOUS    SANITARY    WORK.  837 

injj  apparel  are  made,  altered,  repaired  or  finished,  shall  be  kept  in  a  cleanly  condi- 
tion and  shall  be  subject  to  the  inspection  and  examination  of  the  inspectors  of  the 
district  police,  for  the  purpose  of  ascertaining  whether  said  garments  or  articles  of 
wcaiing  apparel  or  any  part  or  parts  thereof  are  clean  and  free  from  vermin  and 
every  matter  of  an  infectious  or  contagious  nature.  A  room  or  apartment  in  any 
tenement  or  dwelling  house  which  is  not  used  for  living  or  sleeping  purposes,  and 
which  is  not  connected  with  any  room  or  apartment  used  for  living  or  sleeping  pur- 
5,  and  which  has  a  separate  and  distinct  entrance  from  the  outside,  shall  not  be 
subject  to  the  provisions  of  this  act.  Nor  shall  anything  in  this  act  lie  so  construed 
as  to  prevent  the  employment  of  a  tailor  or  seamstress  by  any  person  or  family  for 
the  making  of  wearing  apparel  for  such  person's  or  family's  use."1 

The  Pennsylvania  law  lias  an   additional  provision  : 

'•  Not  less  than  two  hundred  and  fifty  puhic  feet  of  air  space  shall  be  allowed  for 
each  and  every  person  in  any  workroom  where  persons  are  employed  at  such  labor 
as  i>  hereinbefore  described.  There  shall  be  sufficient  means  of  ventilation  pro- 
vided in  each  workroom  of  every  such  establishment,  and  said  workroom  <>r  rooms 
in  said  establishment  shall  be  kept  thoroughly  clean,  sanitary  and  fit  for  occupancy 
for  such  work  or  business.  The  factory  inspector  and  deputy  factory  inspector, 
under  the  direction  of  the  factory  inspector,  shall  notify  the  owner,  agent  or  lessee 
in  writing  to  provide,  or  cause  to  he  provided,  ample  and  proper  means  for  ventilat- 
ing such  workroom  or  rooms,  and  to  put  said  workroom  or  rooms  in  a  thoroughly 
clean,  sanitary  and  tit  condition  for  occupancy  for  such  work  or  business,  and  shall 
prosecute  such  owner,  agent  or  lessee  if  such  notilication  he  not  complied  with 
within  ten  days  of  the  service  of  such  notice;  and  any  factory  or  shop  under  this 
act  requiring  exits  or  other  safeguards  provided  tor  in  the  fire  escape  law.  the  same 
shall  be  erected  and  located  by  order  of  the  factory  inspector  regardless  of  the 
exemption  granted  by  any  hoard  or  [of]  county  commissioners.  lire  marshals  or 
other  authorities,  and  if  such  alterations  and  additions  are  not  made  within  sixty 
days  from  the  date  of  sucb  notice,  or  within  such  time  as  said  alterations  can  be 
mule  witli  proper  diligence  upon  the  part  of  such  proprietors,  said  proprietors  or 
agents  shall  be  deemed  guilty  of  violating  the  provisions  of  this  act"2 

The  Ohio  law  forbids  cooking  in  a  sweat  shop  and  also  provides  that 
there  shall  In-  do  bed  in  it.  There  must  be  a  stairway  Leading  in  the 
outside  of  tin-  house.  There  must  be  separate  water-closets  for 
thf  two  sexes  and  the  Dumber  «>t'  closets  is  prescribed.  There  must  be 
250  cubic  feet  of  air  space  for  each  person  by  day  and  4<mi  feel  at  aight. 
In  Maryland  there  must  ]»•  tOOcubic  feel  «»t'  air  space  per  person  if  the 
temperature  rises  above  eighty  degrees  hot  worn  <  October  first  and  .May  first 
or  if  artificial  lighl  is  required  between  s  \.  \i.  and  1  v.  m.  In  Indiana 
100  cubic  lo.t  «.f  space  are  required  unless  the  room  is  t>»  ho  Lighted  by 
electricity  and  a  permit  must  be  obtained  from  the  factor]  inspector. 

As  will  ho  soon  from  the   above,   the   pari    played   l>\    the  board  oi 

health  in   these  nlninis,  i^  iml   UAUallj    \ei\    great.      The    w  mk  nut  itially 

comes  within  the  jurisdiction  of  the  factor]  inspector  and  the  results  "i 
the  efforts  made  may  lie  studied  in  their  reports.  A  review  of  this 
work  may  ho  found  in  the  article  by  Mr.  Whiteabove  referred  t". 

Massachusetts,  <  ihaptei  160  of  I : 
Pennsylvania,  Chapter  87  ol  1897,  Sec  2. 


APPENDICES. 


APPENDICES. 


NO.  1. 


ANNUAL  REPORT 

OF    TIIK 

Health  Officeb-ob  Secbetaby  of  the  Board  ok  Bubeau  of  Health 

(>ni"  of  County, 

madetotkt  Stati   Board  of  Health  of  Pennsylvania,  for  the  year,  beginning  January 
J.  189  .  and  ending  December  SI,  189  . 

^£r"( Include  nothing  outside  of  these  dates.) 
I^-The  annual  report  of  the  local  board  of  health  should  be  made  as  early  in 
January  as  possible.— Write  in  the  blank  space  after  each  question,  or,  if  more  room 
is  ii'  eded,  write  on  the  accompanying  blank  sheet  placing  the  appropriate  li^ure  be- 
fore  each  answer. 

1.     Give  the  name  and  address  of  each  member  of  your  board. 


Name. 

Post  Office  Address. 

,    President. 

.    Member. 

it 

It 

.   Secretary. 

.    Health  Officer. 

2.     How  many  meetings  have  been  held  by  the  board  during  the  year".' 
:!.     Have  any  improvements  or  changes  been  made  as  regards  water  supply,  drain- 
age and  sewerage,  <>r  in  the  methods  employed  in  disposing  of  excreta? 
i.     Nuisances.    How  many  have  been  reported  to  your  board? 
How  many  have  been  removed? 

Please  report  the  tacts  in  regard  to  any  nuisances  of  unusual  char- 
acter, or  which  have  given   unusual  trouble  in  respect  to  deci 
sions  regarding  them,  or  in  which  there  has  been  unusual  diffi- 
culty in  securing  abatement. 
.").     Mortality.     What  is  your  population ? 
Total  cumber  of  births '.' 
Total  number  of  deal  lis  ? 
Deatb  rate  per  thousand  of  persons  living? 
8.    Communicable  diseases.     Please  give  the  facts  called  for  in  the  Following  table: 


Nil I  Dii 

No  of 

No.ol 
Deaths 

Nil.  •  1 1 

Outbreaks. 

No   nt    Houses 
Inspected. 

No.  nt  i  Outbreaks  Confined 

i"  in  -t  Kouse. 

Smallpox. 

Diphtheria    (in- 
cluding Croup). 

Measles. 

Scarlel   Fever. 

( lonsumpi  ion. 

Typhoid  Fever. 

842  APPENDICES. 

7.  Are  these  diseases  reported  to  your  board  by  the  physicians  in  attendance  in 

accordance  with  the  law,  ordinance  or  regulation  requiring  such  reports? 

8.  What  action  has  been  taken  by  your  board  when  cases  of  the  communicable 

diseases  have  been  reported  to  it '? 

9.  Were   houses  in  which   cases  of  smallpox,  diphtheria  or  scarlet  fever  occurred 

placarded '? 

10.  What  other  epidemic  diseases  were  more  than  usually  prevalent  during  the 

year?  (Influenza,  whooping  cough,  German  measles,  pneumonia,  cerebro- 
spinal meningitis,  dysentery,  diarrheal  diseases  of  children,  etc.) 

11.  Please  communicate  the  facts  regarding  any  cases  of  disease  which  were  inter- 

esting from  a  sanitary  point  of  view.  (Unusual  course  of  epidemic  pre- 
valence, unusual  symptoms  or  want  of  certain  symptoms,  observations  as 
regards  period  of  incubation,  communication  of  diseases  by  contagion,  spread 
of  contagious  diseases  by  public  funerals,  long  periods  of  vitality  of  infec- 
tion, concurrent  or  consecutive  prevalence  of  diseases,  etc.) 

12.  .Schools.     Have  any  special  cases   come  under  your  observation  in  which  un- 

healthy conditions  existed  ?  Have  contagious  diseases  entered  any  of  the 
schools  ?     If  so,  what  action  was   taken  ? 

13.  Have  you  any  particularly  unhealthy  localities  ?    If  so,  what  appears  to  be  the 

cause  of  such  unhealthfulness  ? 

14.  What  methods  can  you  suggest  for  improving  your  sanitary  conditions  ? 

15.  Accidents.     Has  sickness  or  death  resulted  from  accidental  causes;  drowning, 

fires,  and  kerosene  accidents  ?  If  accidents  have  occurred  from  the  last 
cause,  please  report  in  full  to  this  Board. 

16.  Please  communicate  the  facts  regarding  any  cases  of  disease  which  appeared  to 

have  been  caused  by  polluted  water,  cess-pool  or  sewer  gas,  defective  venti- 
lation, lead,  arsenical,  or  other  forms  of  poisoning. 
IT.     Have  any  instances  of  food  adulteration,  or  injurious  effects  from  it,  come  to 
your  knowledge  ? 

18.  Diseases  of  animals.     Please  report  any  cases  of  diseases  of  animals  which  have 

occurred,  and  any  cases  of  relation  or  apparent  relation  between  such  dis- 
eases and  human  diseases. 

19.  Were  any  by-laws  adopted  by  your  board  during  the  year  ?     If  so,  please  for- 

ward copies  of  all  such  to  the  office  of  the  State  Board. 

20.  Please  give  an  account  of  any  other  work  of  interest  which  has  been  done  by 

your  board  during  the  year. 

21.  Has  the  experience  of  your  board   suggested  any  changes  which  ought  to  be 

made  in  the  health  laws  of  the  State  ?     If  so,  please  report  them. 

22.  Registration.     Do  you  enforce  registration  of  births? 

Do  you  enforce  registration  of  still-births  ? 
Do  you  enforce  registration  of  marriages  ? 
Do  you  enforce  registration  of  plumbers  ? 
Do  you  enforce  registration  of  undertakers  ? 
Do  you  enforce  registration  of  nurses  and  midwives  ? 
Do  you  enforce  registration  of  vaccination  of  school  children  ? 
2:;.     What  compensation  has  been  received  by  the  secretary  and  health  officer  of 
your  board  ?     If  payment  has  not  been  received,  for  what  reason  ? 

Signed 

Dai'-  ,  189  . 


APPENDICES.  843 


NO.  2. 


WMTAIiV    REGULATIONS. 

Recommended  by  the  State  Boabd  of  Health  of  New  Yobb   for  Adoption 
1sy   loc  \  i    bo  lrd8  of  ii  i.  \  i. 111. 

Nuisances  Section    1.      Whatever   is  dangerous  to    human   lift-   or  health; 

defined.  whatever  building,  or  part  or  cellar  thereof,  is   overcrowded  or  nut 

provided  with  adequate  means  of  ingress  and  egress,  or  is  not  suffi- 
ciently supported,  ventilated,  sewered,  drained,  lighted  or  cleaned:  and  whatever 
renders  soil,  air,  water  or  food  impure  <>r  anwbolesonie,  are  declared  to  be  nuisances 
and  to  be  illegal;  and  every  person  having  aided  in  creating  or  contributing  to  the 
same,  or  who  may  support,  continue  or  retain  any  <>f  them,  shall  be  deemed  guilty 
of  a  violation  of  this  ordinance,  and  shall  also  be  liable  for  the  expense  of  the  abate- 
ment or  remedy  required. 

S   2.      No    privy-pit,    cess-pool    or   reservoir   into   which    any  privy, 
/'/'Vox.  watcr-dosct.  stable,  sink  or  other   receptacle    of  refuse    or   sewage    is 

cess-pools,  drained,  shall  be  constructed  or  maintained  in  any  situation  or  in  any 

etc.  manner  whereby,  through  leakage  or  overflow  of  its  contents,  it  may 

cause  pollution  of  the  soil  near  or  about  habitations,  or  of  any  well, 
spring  or  other  source  of  water  used  for  drinking  or  culinary  purposes;  nor  shall 
the  overflow  from  any  such  reservoir  or  receptacle  be  permitted  to  discharge  into 
any  public  place  or  in  anywise  whereby  danger  to  health  may  be  caused.  And 
every  such  pit,  reservoir  or  receptacle  shall  be  cleaned  and  the  contents  thereof 
removed  at  such  times  and  under  such  precautions  as  the  Hoard  of  Health  may 
prescribe.     Violation  of  any  of  the   provisions  of    this  ordinance  shall  subject    the 

offending  party  to  a  penalty  of   for  each  day's  continuance   of   the 

nuisance  after  due  notice  to  abate  it  from  an  authorized  officer. 

§   :!.      All  house-sewers  or  drains  for  the  conveyance  of  deleterious 

Sewers,  or  offensive  matters  shall  be  water-tight,  and  the  plans  and  methods 

drains,  ■  tc.        of  their  consl  ruction  shall  be  subject  to  the  approval  of  the  Board  of 

Health.      In    streets   or    avenues   where    public   sewers   are  or  shall  be 

constructed,  the   Board  of  Health  may  order  house-connections  to  be  made  there- 
with. 

S  4.  No  house-refuse,  offal,  garbage,  dead  animals,  decaying 
Houst  refuse,  vegetable  matter,  or  organic  waste  substance  of  any  kind,  shall  be 
garbayi ,  etc.  thrown  upon  any  street,  road  or  public  place,  and  no  putrid  or  decay- 
ing animal  or  vegetable  matter  shall  be  kept  in  anj  house,  cellar  or 
adjoining  outbuilding  for  more  than  twenty-four  hours.  Violation  of  any  of  the 
provisions  of  this  ordinance  shall  subject  the  offending  party  to  a  penalty  of 


Filled-in 


§  :>.    No  sunken  places  shall  be  filled,  nor  made  land  constructed, 

with  any  materials  containing  an  admixture  of  putrescible  animal  or 

mad(  land.        vegetable  matter,   under  penalty  of for  each  cartload, 

pari   thereof,  of  such   materials  deposited. 

!j  6.     No  person  or  company  shall  erect  or  maintain  any  manufac- 
Voxlous  tory  or  place  of  business  dangerous   to  life  or  detrimental  to  health. 

trades.  or  where  unwholesome,  offensive  or  deleterious  odors,  gas,  smoke, 

deposit  or  exhalations  are  generated,  without  the  permit  of  the  Board 
of  Health,  and  all  such  establishments  shall  !>•■  kept  dean  and  wholesome  so  as  not 
to  be  offensive  or  prejudicial  to  public  health;  nor  shall  anj  offensive  or  deleterious 
waste-substance,  gas-tar,  sludge,  refuse  or  injurious  matter  be  allowed  to  accumu- 
late upon  the  premises  oi  be  thrown  or  allowed  to  run  into  anj  public  waters, 
stream  watei  course,  street  or  public  place.  \ n< I  everj  person  or  company  con 
ducting  such  manufacture  or  business  shall  use  the  best  approved  ami  all  reasonable 
means  to  prevent  the  escape  of  smoke,  gases  and  odors,   and   tt  the  health 

and  ill  operatives  employed  therein.     A.nj    violation  of  any  of  th< 

visions  of  this  ordinance  shall  subject  tl Sending  partj   to  a   penaltj   of   not   less 

t hau   nor  more  t ban  foi  each  offense. 


844  APPENDICES. 

§  7.  Xo  meat,  fish,  bird,  fruit,  or  vegetables,  milk,  or  anything 
Unwholesome  for  human  food  or  drink,  not  being  then  fresh  or  properly  preserved, 
food.  sound,  wholesome  and  safe  for  such  use;  nor  any  flesh  of  any 
animal  which  died  by  disease,  or  which  was  at  the  time  of  its  death 
in  a  sickly  or  unwholesome  condition;  nor  the  carcass  or  meat  of  any  calf  which 
was  at  the  date  of  its  death  less  than  four  weeks  old,  or  of  any  lamb  which  was  at 
the  date  of  its  death  less  than  eight  weeks  old,  or  of  any  pig  which  was  at  the  date 
of  its  death  less  than  five  weeks  old  shall  be  brought  within  the  limits  of  this 
municipality,  nor  offered  or  held  for  sale  as  food  therein.  Any  violation  of  any  of 
the  provisions  of  this  ordinance  shall  subject  the  offending  party  to  a  penalty  of  not 
less  than and  by  the  seizure  and  destruction  of  such  unsound,  un- 
wholesome, immature  food  substances. 

§  8.  Xo  person  or  persons,  without  the  consent  of  the  Board  of 
Slaughter-  Health,  shall  build  or  use  any  slaughter-house  within  the  limits  of 
houses,  this  municipality  and  the  keeping  and  slaughtering  of  all  cattle, 
markets,  etc.  sheep  and  swine,  and  the  preparation  and  keeping  of  all  meat,  fish, 
birds,  or  other  animal  food,  shall  be  in  the  manner  best  adapted  to 
secure  and  continue  their  wholesomeness  as  food ;  and  every  butcher  or  other  per- 
son owning,  leasing  or  occupying  any  place,  room  or  building  wherein  any  cattle, 
sheep  or  swine  have  been  or  are  killed  or  dressed,  and  every  person  being  the  owner, 
lessee  or  occupant  of  any  room  or  stable  wherein  any  animals  are  kept,  or  of  any 
market,  public  or  private,  shall  cause  such  place,  room,  building,  stable  or  market, 
and  their  yards  and  appurtenances,  to  be  thoroughly  cleansed  and  purified,  and  all 
offal,  blood,  fat,  garbage,  refuse  and  unwholesome  and  offensive  matter  to  be  re- 
moved therefrom  at  least  once  in  every  twenty-four  hours  after  the  use  thereof  for 
any  of  the  purposes  herein  referred  to,  and  shall  also  at  all  times  keep  all  wood- 
work, save  floors  and  counters,  in  any  building,  place  or  premises  aforesaid 
thoroughly  painted  or  whitewashed;  and  the  floors  of  such  building,  place  or 
premises  shall  be  so  constructed  as  to  prevent  blood  or  foul  liquids  or  washings  from 
settling  in  the  earth  beneath.  Any  violation  of  any  of  the  provisions  of  this  ordi- 
nance shall  subject  the  offending  party  to  a  penalty  of for  each  day's 

continuance  or  repetition  of  the  offense. 

§  9.  Every  householder  or  head  of  family  in  a  house  wherein  any 
Notification  case  of  infectious  disease  may  occur  shall  report  the  same  to  the 
of  infectious  Board  of  Health  or  to  the  Health  Officer  within  twelve  hours  from  the 
disease.  time  of  his  or  her  first  knowledge  of  the  nature  of  such  disease;  and, 

until  instructions  are  received  from  the  said  board  or  the  Health 
Officer,  shall  not  permit  any  clothing  or  other  article  which  may  have  been  exposed 
to  infection  to  be  removed  from  the  house;  nor  shall  any  occupant  change  his 
residence  elsewhere  without  the  consent  of  the  said  Board  or  Health  Officer. 

Every  physician  who  may  be  called  to  attend  a  case  of  infectious  disease  shall, 
as  soon  as  he  discovers  the  nature  thereof,  make  a  written  report  specifying  the 
name  and  residence  of  the  patient,  the  nature  of  the  disease,  and  any  other  facts 
relating  thereto  which  he  may  deem  important  to  the  public  health,  and  affix  the 
date  and  sign  his  name  thereto,  and  he  shall  transmit  the  same  to  the  Board  of 
Health  within  twelve  hours  as  above  provided.  The  diseases  to  be  thus  promptly 
reported  are:  Asiatic  cholera,  yellow  fever,  typhus  and  typhoid  fevers,  small-pox, 
scarlet  fever,  measles,  diphtheria  and  membranous  croup.  Any  violation  of  any 
of  the  provisions   of  this  ordinance  shall  subject  the  offending  party  to  a  penalty 

of 

§  10.  Xo  person  or  article  liable  to  propagate  a  dangerous  disease 
Importation  shall  be  brought  within  the  limits  of  this  municipality  unless  by  the 
of  infect cil  special  permit  and  direction  of  the  Board  of  Health;  and  any  one 
persons  or  having  knowledge  that  such  person  or  article  has  been  brought 
things.  within  such  limits  shall  immediately  notify  the  said  board  thereof. 

Any  violation  of  any  of  the  provisions  of  this  ordinance  shall  subject 
the  offending  party  to  a  penalty  of  not  less  than nor  more  than 


§  11.  Xo  person  shall,  within  the  limits  of  this  municipality, 
^Exposure  of  unless  by  permit  of  the  Board  of  Health,  carry  or  remove  from  one 
infected  per-  building  to  another  any  patient  affected  with  any  contagious  or 
•s""s'  or  infectious  disease.     Xor   shall   any   person,  by   any   exposure  of   any 

things.  individual  so  affected,  or  of  the  body  of  such  individual,  or  of  any 

article  capable  of  conveying  contagion   or  infection,  or  by  any  negli- 
gent act  connected  with  the  care  or  custody  thereof,  or  by  a  needless  exposure  of 


APPENDICES.  845 

himself  or  herself,  cause  or  contribute  to  the  spread  of  disease  from  any  such  indi- 
vidual or  dead  body.  Any  violation  of  any  of  the  provisions  of  this  ordinance  shall 
subject  tin-  i .ft'ending  party  to  a  penalty  of  Dot  less  than 

§  12.  There  shall  not  be  a  public  or  church  funeral  of  any  person 
Funerals  who  lias  died  of  Asiatic  cholera,  small  pox.  typhus  fever,  diphtheria. 
after  infec-  membranous  croup,  scarlet  fever  or  measles,  without  the  permit  of 
/inns  r/;.s-  the  Hoard  of  Health  therefor;  and  the  family  of  the  deceased  shall  in 
eases.  all  such  cases  limit  the  attendance  to  as  few  as  possible,  and  take  all 
precautions  possible  t..  prevent  the  exposure  ..f  other  persons  to  con- 
tagion or  infection.  Any  violation  of  any  of  the  provisions  of  this  ordinance  shall 
subject  the  offending  party  to  a  penalty  of  not  less  than 

§  13.  No  animal  affected  with  an  infectious  or  contagious  disease 
Infectious  shall  be  brought  or  kept  within  the  limits  of  this  municipality,  except 
diseases  of  by  the  permission  of  the  Board  of  Health;  and  the  bodies  of  animals 
animals.  dead  of  such  disease  or  killed  on  account  thereof,  shall  not  be  buried 
within  five  hundred  feet  of  any  residence,  nor  disposed  of  otherwise 
than  as  the  said  hoard  or  its  Health  Officer  shall  direct.  Any  violation  of  any  of 
the  provisions  of  this  ordinance  shall  subject  the  offending  party  to  a  penalty  of  not 
less  than 

>j   14.     It  shall  be  the  duty  of  the  groom  in  every  marriage,  or  the 

Reports  of        clergyman  «.r  magistrate  performing  the  ceremony,  and  of  the  parents 

marriages        or  custodian  of  every  child  born,  and   the   physician  or  midwife  who 

and  births.        attended  at  the  birth  of  such   child   to  make  sure  that  the  prescribed 

report  of  such  marriage   or  birth  is  presented  to  the  Hoard  of   Health 

or  its  registering  officer  within  thirty  days,  under  a  penalty  of for  failure  to 

do  so;  and  for  each  ten  days  of  continued  neglect  to  present  such  report,  after  the 
expiration  of  the  first  thirty  days,  an  additional  penalty  of shall  be  incurred. 

S  15.  It  shall  be  the  duty  of  the  physician  or  midwife  in  attendance  at  every 
birth  to  write  out  and  sign,  upon  the  form  prescribed  by  the  Mate  Hoard  of  Health. 
the  certificate  of  such  birth,  and  make  sure  that  said  certificate  is  returned  to  the 
local  hoard  of  health,  or  person  designated  by  it  to  receive  it,  within  thirty  days  of 
such  birth.  Any  violation  of  the  provisions  of  this  ordinance  shall  subject  the 
offending  party  to  a  penalty  of 

s'  16.  Every  undertaker  or  other  person  who  may  have  charge  of 
Certificates  the  funeral  of  any  dead  person,  shall  procure  a  properly  filled-oul  cer- 
of  death  tiflcate  of  the  death  and  its  probable  cause,  in  accordance  with  the 

andburial  form  prescribed  by  the  state  Hoard  of  Health,  and  shall  present  the 
permits.  same  to  the  designated  officer  or  member  of  the  Hoard  of  Health,  and 

obtain  a  burial  or  transit  permit  thereupon,  at  least  twenty-four 
hours  before  the  time  appointed  for  such  funeral ;  and  he  shall  not  remove  any  dead 
body  until  such  burial  or  transit  permit  shall  have  been  procured.  Any  violation  of 
any  oi  the  provisions  of  this  ordinance  shall  subject  the  offending  party  to  a  penalty 

Of  not  less   than 

S  17.     It  shall  he  t he  duty  of   the  physician  last   in  attendance  upon  any  person 

who  may  die  within  t  he  limits  of  the  jurisdiction  of  this  Hoard  of  Health,  to  write 
OUt  and  sign  without  delay,  upon  the  form    prescribed  by  the  State  Board  of    Health 

the  professional  certificate  of  the  death  and  send  it  to  or  leave  it  with  the  familj  of 
the  deceased,  or  hand  or  -end  it  to  the  undertaker  in  charge  of  the  remains.  Incase 
an  inquest  has  been  required  by  law,  the  coroner  shall  till   out  the  said  certificate, 

and   if  no  inquest  has  been  required  by  law   and  DO  physician  has    been  in  attendance. 

the  certificate  shall  be  filled  out,  setting  forth  the  probable  or  believed  cause  of 
death,  l>y  some  reputable  person  known  to  the  officer  issuing  the  burial  or  transit 

burial  permit,  and  the  said   person  shall  also    make   atlida\it    to  the    facts  sel   forth  in 

the  certificate,  which  affidavit  must  be  attached  to  said  certificate.'  Any  violation 
of  the  provisions  of   this  ordinance  shall  subject    tl Sending  party  to  a  penaltj 

of 

S  18.     Everj  person  who  acts  as  a  Bexton,  or  undertaker,  or  cemeterj 
,.>•.  keeper,  within  the  limits  of  this   municipality,  or   has   the  charge  oi 

cemetery  careofanj  tomb,  vault,  burying  ground  or  other  place  for  the  recep 

keepers,  etc.  tionof  the  dead,  or  where  the  bodies  of  anj  human  beings  are  deposited, 
shall  so  conduct  his  business  and  so  care  for  any  such  place  above 
named,  as  to  avoid  detriment  or  daoger  to  public  health;  and  every  person  under- 
taking pre | .a rat  ions  for  the  burial  of  a  bodj  dead  from  contagious  or  infectious  dis- 
ease as  hereinbefore  enumerated  shall  adopt  such  precautions  as  the  Board  of  Health 


846 


APPENDICES. 


may  prescribe  to  prevent  the  spread  of  such  disease.     Any   violation   of  any  of   the 
provisions  of  this  ordinance  shall  subject  the  offending  party  to  a  penalty  of  not  less 

than 

§  19.  The  Health  Officer  is  directed  and  empowered  to  execute  and 
Duties  and  enforce  all  sanitary  regulations  of  general  obligation  now  or  hereafter  to 
powers  of  be  published  by  this  board;  also  to  enter  upon  or  within  any  premises 
health  offi-  where  conditions  dangerous  to  the  public  health  are  known  or  believed 
cer.  to  exist,  and  to  examine  into  the  nature  of  complaints  made  by  any  of 

the  inhabitants  concerning  sources  of  danger  or  injury  to  health;  and 
he  shall  preserve  accurate  records  of  his  official  actions  and  report  the  same  to  the 
Hoard  of  Health  at  its  next  meeting.  And  whenever  in  his  judgment  danger  to  pub- 
lic health  shall  arise  requiring  special  regulation  not  of  general  application,  he  shall 
forthwith  notify  the  president  of  the  Board  of  Health,  who  shall  thereupon  convene 
the  board  to  take  such  action  as  may  be  necessary  and  proper. 

§  20.     Every  person  who  willfully  violates  pr  refuses  to  comply 

Penalties.  with,  or  who  resists  any  ordinance,  order,  regulation  or  resolution  of 

the  Board  of  Health  of  this  municipality  will  be  liable  to  the  arrest, 

action,  penalty,  fine  and  punishment  provided  and  declared  in  the  Public   Health 

Law,  chapter  25  of  the  General  Laws,  1893,  of  which  notice  mtist  be  taken. 


NO.  3. 

Size  84  in.  x  11  in. 

REPORT 

Of Undertaker  in  the  City  of  Milwaukee,  for  the  month  of 189 

to  the   Commissioner  of  Health,    in  pursuance   of   Chapter  4,   of   City  Ordinances. 
Reports  are  to  be  made  on  the  first  of  every  month. 

Section  85  of  Chapter  IV,  of  General  Ordinances  of  the  City  of  Milwaukee,  relat- 
ing to  Burials,  reads  as  follows:  Upon  the  death  of  any  person  within  the  corporate 
limits  of  the  City  of  Milwaukee,  it  shall  be  the  duty  of  every  undertaker  or  other 
person,  who  inters  such  deceased  person,  and  before  the  removal  of  such  deceased 
person  for  interment,  and  within  thirty-six  hours  after  the  death. of  such  person,  to 
apply  to  the  Health  Office  for  a  permit  for  interment  from  said  Commissioner  of 
Health  or  Secretary;  (Permits  will  only  be  issued  upon  Certificates  of  Physician,  of 
Commissioner  of  Health  or  one  of  his  Medical  Assistants.) 


When 
Interred 


NAME  OF 
DECEASED. 


WHERE 
INTERRED, 


Date  of 
Burial    Permit. 


No. 


Name  of 
Person  who 

signed 
Certificate. 


Date 
of  Death 

on 
Certificate. 


STATE  OF  WISCONSIN,  J 

County  of    Milwaukee.  >  I, Undertaker,  residing  at 

Street Ward,  City  of  Milwaukee,  do  solemnly  swear 

that  the  above  report  for  the  month  of 189  ,  is  correct  in  all  respects.— 

.So  Help   Me  God. 

Subscribed  and  sworn  to  before  me,  this day  of 189 

Votary  Public,  Milwaukee  Co.,  Wis. 


APPENDIt  ES. 
NO.   4. 


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APPENDICES. 


NO.  7. 

Size  \\  is.  x  13  i\. 
These  permits  are  bound  in  books  with  stubs  for  record. 


When  a  body  from  another  State  or 
city  is  in  transit  for  burial,  besidt  tin 
transport  coupon  some  eities.  like  New 
York,  require  that  the  ferry  or  transport 
agent  should  tear  off  and' return  a  cou- 
pon to  their  health  department,  in  order 
that  it  may  have  record.  This  special 
coupon  is  in  such  cases  to  be  given  to 
the  ferry  or  bridge  master  or  transport 
agent.  We  therefore  add  to  the  usual 
coupons  1  and  2,  this  special  No.  3,  for 
such  use  when  required.  When  nor 
needed,  this  coupon  should  not  lie  given 
out  or  should  not  be  signed  by  the  officer 
issuing  the  permit. 


(See  back  of  this  Coupon. | 

SPECIAL  COUPON  FOR  CITY  TRANSIT  WHEN  REQUIRED. 

Special  Coupon  A7».  Thm  to  Transit  Permit  2V».. 

of  tin  in, ii  1/  of 

who  died  at'. N.J.,  and  is  to  be 

bur  led  at 

Perm  it  issnrit Is!) 

i  Kate.) 

nt .-. 

for  transit  lliiiimili  tin   vittiof..'. 

Sii/iiiil '...' 

Official  Title.. 

Before  this  body  leaves  the  city  of through 

which  it  is  in  transit,  the  ferry  or  bridge  master  or 
transport  agent  will  tear  oif  this  coupon  and  send  it 
to  the  Heatlh  Department  of  the  citv,  as  its  regula- 
tions may  require. 


TRANSIT  PERMIT. 


'■    7= 


|"  5  1 
I  I  - 


Second  ( Taken   at, 
(  lotipon  I  By 


First    f  Taken    at 

(  011)1011  /  ]{y 


This  Permit  must  in  all  eases  accompany  the 
body  to  its  destination  and  be  retained  by  the 
Superintendent  of  the  Cemetery. 


r 

_ 

n 

- 

7T 

- 

/ 

ft 

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= 

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" 

> 

— 

a 

- 

— 

s. 

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pu 

_: 

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A 

hS 

•£ 

—. 

— 

- 

Coupon  No.  Two  to  'transit  Permit  No of 

who  died  at 

This  Coupon  will  be  detached  by  Train  Baggage- 
man of  terminal  line  and  sent  to  General  Baggage 
Agent.  SEE   BACK. 


( loupon  No.  ( ine  to  Transit  Permit  No of 

who  died  at 

This  Coupon  will  be  detached  by  Train  Baggage- 
man at  starting  point  and  sent  to  General  Agent. 

SEE    HACK. 


APPENDICES.  85] 


NO.  8. 

Size  ::}  in.  >;  5±  in. 
STAT]    OF   \I.\V   HAMPSHIRE.  CERTIFICATE  OF  DEATH. 

■ . .  

Place  and  date  of  Death .  

Single, 
Marriei 
I  Hvorced,  or 


1  I     \'<  .ii  -. 

.,  ,  Married. 

1  "1"1" ....    ..    ,  Age,    '     Months, 


Widowed.  I     "a> 


pation Place  of  Birtli 

Disease  or  Cause  of  Death,  

Name  of  Fal  liei .     

Maiden  Same  of  Mother 

Birthplace  of  Fal  her,..  Mother 

■'•.it  ion  ••!  Fal  lier,  . .  

\l.    I». 

of  Burial.  I-'.'      . 

Place  "i'  Burial.  <  lemetery,  .    Undertaker. 


S52  APPENDICES. 

NO.  9. 

Size  8  in.   x  10  IN. 

The  following  form  of  return  is  suggested  for  general  adoption  by  the  Director  of 

the  12th  Census. 

RETURN    OF    A    DEATH. 


County.. 
Town.  .  . 
Village,. 

City 


NO 

.  OF  RECORD. 

No.  OF 

K I' RIAL  PERMIT. 

NO    INCOMPLETE    RETURN    WILL    BE    ACCEPTED. 

1.  Name,  in  full, 

■i.  Color:  3.  Sex:  4.  Conjugal  Condition: 

White.  Malt-.  Single. 

Black  (Negro  or  mixed).         Female.  Married. 

Indian.  Widowed. 

Chinese.  Divorced. 

Japanese. 

vote.—  Vox  questions  '-'.  :'•.  and  4.  strike  <>ut  words  not  applicable. 


T  ,  (  Year (  Year (  Years,  . . 

•     ,;  J,)     ■    Month. '>•   OfBirth.JMonth 7.  Age.-    Months,. 

(  Day. (  Day, (  Days...  . 


Death 
i.   Occupation, 


Return  occupation  lor  all  persons  10  years  of  age  and  over.) 


9.  Place  of  Birth, ) 

10.  Birthplace  of  Father, state  or  Country. 

11.  Birthplace  of  Mother ) 

,_  ,     T  ,  Id    UATION. 

12.  Disease  or  Cause  of   Death:  

Chief   Cause __ 

Contributing  Cause 


Place  where  Disease  was  Contracted,  if  other  than  place  of  death, 

13.  Place  of  Death,  Xo Street,  Ward. 

If  death  occurred  in  an  institution,  give  the  name  of  same 

Length  of  time  deceased  was  an  inmate and 

previous   residence 

14.  Late  residence,. .' 

Length  of  residence  (in  city  or  town), 

Undertaker 

Place  of   Intern icnt 

Signature 

Of  physician  or  informant.) 
Date  of  Certificate ,  19 


APPENDICES. 

NO.    lO. 

Size  TA  in.   x   12  in. 


853 


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8  54  APPENDIt  'E& 

NO.  11. 

Size  H  in.  x  10$  in. 

RETURN  OF  A  DEATH. 
City  of  Providence. 

1.  Date  of  Death 

2.  Name  in  Full 

3.  Date  of  Birth Age? yrs .......  mos dys. 

4.  Place  of  Death,  Street 

and  Number 


5.  Usual  Residence 

*'».  Sex T.     Color 

S.  Single,  Married,  Wid.  | 
owed,  or  Divorced      S 

'.».  Name  of  Husband  or  Wife 

10.  <  >ccupation  of  Decedent 

11.  Birthplace,  State  or  Country City . 

12.  Father's  Name 

13.  Mother's  Name 

14.  Parents1  Birthplaces     Fa Mo 

15.  Where  to  be  Buried 


Name  of  Informant  and  Relationship  to  Deceased. 


PHYSICIAN'S    CERTIFICATE. 

Please  state  different  causes  of  death  in  order  of  occurrence. as  FULLY  as  possible,  particularly 

in   DOIBTFUL  cases. 

Date  of  Death Hour M. 

Name 

Causes  of  Deatli 


I  Miration  of   Diseases 

Physician. 

/  certify  that  the  above  is  a  true  reurn  to  thebest  of  my  knowledge  and  belief. 

Undertaker. 

TO  THE   PHYSICIAN.     If  more  than  one  cause  of  death  is  given,  please  under- 
line that  which  you  consider  the  most  important. 


A  PPENDIl  'JS& 


855 


NO.   12. 


Size  7.1  ix  x  8  in. 


MICHIGAN 

DEPARTS!  KM'  I  >1    SI   \  I  i: 

Lansing 

1  "'ii'i'.i' Vital  Statistics  Division 

'  ''" Certificate  and  Record  of  Death 


^    ,-  i  outuy... 
a    1    Townsh  i/i 


The  Registrar  should 
Dumber  each  certificate 
received  at  ona .  in 
space  below,  beginning 
with  •■  No.  l "  for  each 
year. 

REGISTER]  D    SO. 


i  Location  i 

i  in  City      I  Ward:  No St. 

/■-„//                                                                      DaU  of 
Vanu Death 


Month. 

Day. 

\  ear. 

190 

y.  :l 


s  g 


Arjt 


Single,  married,  widowed  or  divorced Sex 

^  If  married,  age  at   first'  marriage years. 

'  Parent  of children,  of  whom-     -are  living. 

Occupation 

f    Note — Th scupationshould.be stated  /.,,,,  ,,,■ 

for  all  persons  aged  i<>  years  and  over. 
Be  precise  and  definite,  and  whenever 
necessary  give  the  kind  of  industry,  trade 
or  employment,  as  well  as  the  special  oc- 
cupation. 

i  Birthplace  of ) 
lather  (State' 

(or  country i     )  . . 

i  Birthplace  ol  \ 
]  mother  (State 
/mother    1  (or  country)      ) 


Color- 


Years.         Months. 

Hays. 

birth 


Year  of 
Birth 

Month. 

Hay. 

l 

i    Name  of  l 
i  Father     i 


i  Maiden 

;  name  of 


\  Date  of  burial  i 

I      or  removal      ( 

j  Signature  of  i 


i  Place  of  burial  i 
i  or  removal  i 
i  Address  of  I 


i  undertaker  \  (undertaker! 


i  Birthplace  i 

State  or 

'  country)     )  

Certificate  of  Reporter. 
The  personal  and  family  partic- 
ulars herein  given  relative  to  de- 
ceased are  true  to  the  best  Of  my 
knowledge  and  belief 

i  Signed) 

(Address) 


MEDICAL  CERTIFICATE  OF  (  A.USE  OF  DEATH. 

I  berebj  cerl ify  thai  [attended  deceased  from   190. ...to L90 

that  l  las t  saw  h alive  on 190 that died  <>n 190 

about o'clock M.,  and  that  to  the  best  ol  my  knowledge  and 

belief  the  ('a usi   of  Death  was  as  hereunder  written  : 

Disease  causing  death* 

Immediate  cause  of  death* 

Contributor)  causes  or  complications,  it  any* 

i  Place  where  Disease  Causing  Death  was  I 
Post-mortem    . ...'  contracted,  if  other  than  place  of  death   '■ 


I  Mi  rat  ion  of  each  Cause. 


z  - 

—  v 
7  / 


Witness  my  h I  this  .daj  ol 190. 


•  /■//  j/« Iciitns  are  requested  to 
note  the  "  Suggest  Ions  to  Phj  bJ 
clans  Relative  to  Statemenl  ol 
i  ;ui-i'-  of  i  >eath  "  on  the  back  of 
t hi>  cert iflcate. 

In  Vlolenl    Deaths, a  different 
form  of  statement   i-  necessary,     >    Signature  ol  physician    / 
a-  follows  i  health  offloei  "i  coroner  i    . 

1  Mi, ih  hi  injury  and  w  let  In  i 
iiiiiilinhrl,      -11  iriilnl      or       limn  i 

I  Ida  I 

Vature of Injury  ii ullate  \ > !■  1 1  <  — 

■  i  deal  h  . 
<  < .  1 1 1 1 1 1  ■  1 1 1 . .  i  •.  cause* 


856 


APPENDICES. 


NO.  13. 

Size  4|  in.  x  7|  in. 
RETURN  OF  A    BIRTH. 


City  of  Providence. 


1.     Date  «.f  Birth? 189. 

'J.     Full  name  of  Child? 


t'». 

7. 

8. 

!). 
10. 
11. 
12. 
13. 
14. 
1.-.. 
Hi. 
17. 


Sex  ° 

S      No.  of  Child  of 

/  Mother  ?  

Plate  of  Birth  '.' 

Present  Residence '.' .... 

Father's  Name  '.' 

Father's  Age  '.' 

Father's  Occupation  ?. . 
Father's  Birthplace  ?. . . 

Mother's  Name'? 

Mother's  Maiden  Name ' 

Mother's  Age  ? 

Mother's  Birthplace '.'... 
Color  of  Parents  ?  Fa  . . 
*Remarks  ? 


Color 


Mi 


Physici  \  \. 


\.  1>. — At  No.  2,  give  the  full  name  of  the  child,  and  be  particular  to  get  the  mid- 
dle name  in  full.  At  No.  4,  state  whether  the  child  is  white,  black  or  mulatto.  At 
No.  5,  state  whether  it  is  the  1st,  2d,  3d,  etc.,  child  of  the  mother.  At  No.  0.  give 
the  street  and  number  if  in  a  city,  the  name  of  the  town  and  village  if  in  a  village, 
and  State  if  elsewhere  in  this  country.  At  No.  7,  give  the  present  home  of  Mother, 
Street  and  No.  At  Nos.  9  and  14,  give  the  age  at  last  birthday.  At  Nos.  11  and  15, 
give  the  town  and  State,  if  in  this  country,  if  not,  then  the  name  of  the  foreign 
country. 

*If  the  child  was  still-born,  or  has  died  since  its  birth,  or  tens  illegitimate,  state 
the  facts  a(    No.  17,  with  any  other  facts  of  interest. 

In  case  of  twins  or  triplets,  a  separate  blank  is  to  be  filled  for  each  child. 

The  above  blanks  bound  in  book  form  with  stubs  are  furnished  to  the  physicians 
and  midwives.  In  Massachusetts  the  physicians  report  all  their  births  monthly  on 
one  sheet. 


NO.  14. 


Size  4  in.  n  14  in. 


COMMONWEALTH  OF    MASSACHUSETTS. 


Lisl  of  Births  occurring  in  the  practice  of  the  undersigned  during  the  month  of. 


Date  of  s 
Birth.    *<x- 

Color,  if 

other  than 

white. 

Name 
i  it  named. 

Place  of 
Birth. 

Names  of  Parents. 

(Maiden  name  of 

mother.} 

Resi- 
dence of 

Parents. 

Occupa-      Birth- 
tion  of     place  of 
Father.      Father. 

Birth- 
place of 
Mother. 

• 

Signed, 


Postals  arc  used  for  reports  in  Florida  and  in  Denver,  Omaha,  Chicago  and  other  cities. 


APPENDICES. 


v-">, 


>0.   15. 

Size  34  vs.  x  T:   in. 

189 

To  Mr 

I'.  <>.  Address 

'I'm  enable  me  to  complete  the  record  <>f  the  birth  of  your  child  which  occurred 

189     .  please  enter  it^   name   in  the  first    line 

in  the  blank  on  the  other  side  of   this  >Iij>.  together  with  the  facts  called  for  in  any 
other  lines  indicated  l>y  a  cross  (X)  made  with  pen  or  pencil. 

The  law  requires,  under  penalty  for  neglect,  parents  to  report  the  births  of  their 
children;  but,  irrespective  of  this,  a  permanent  and  accurate  record  <>f  all  births  is 
a  matter  of  great  importance  to  parents,  to  children,  and  to  society. 

Respectfully, 


Clerk  of. 


I  Kl.\  ERSE.  | 


s     - 


_=    '/ '—    i    -' 


X     X     >      -      - 


-    - 

r 

- 


-      - 


|      § 


In  Providence  the  items  required  are  left  blank,  the  others  being  tilled   in  as 
they  appear  "ii  the  records.     Opportunity  i^  thus  given  for  corrections. 


858 


APPENDICES. 


NO.  16. 


Size  ~i  in.  x  8-J  in. 


STATE  OF  NEW  JERSEY 


S  I' ATI:   OF    XEW   JERSEY". 


RETURN  OF  STILL-BIRTH. 


RETURN  OF  STILL-BIRTH. 


SEE    PENALTY  FOB  SON-REPORT. 

Place  of  Birth 


(If  in  city,  give  name,  street  and  number;  if  not, 
give  township  and  county.) 

Date 18!) 

Sex Color 

Name  of  Father 

Name  of  Mather 


SEE    PENALTY    FOB    NON-REPORT. 

Place  of  Birth 


(If  in  city, give  name,  street  and  number:  if  not, 
give  township  and  county.) 


Datt 

Sex 

Namt  of  Fathe 
Xante  of  Mothe 


•r. 


Residence  of  Mother Residence  of  Mothi 


I  If  inf city, give  name,  street  and  number;  if  not, 
give  township  and  county. i 


(If  in  city,  give  name,  street  and  number;  if  not.. 
give  township  and  county.) 


Agi 


Age 


Period  of  Utero- Gestation ■ Period  of  Ultero  Gestatioi 


How  many  previous  children....     No.  Living. 

Country  of  Motht  r's  Birth 

Country  of  Father's 

Cause  of  Dead-Birth  i  if  known) 


How  many  previous  children. .  .     No.  Living. 

i  'ountry  or  Mother's  Birth 

<  'ountry  of  Father's 

const  of  Dead-Birth  i  if  known.) 


I,  as  Ho   attendant   in  eharge.  certify  Uiat  the       I,  as  the  attendant  in  charge,  certify  that  the 


Child  was  dead  befori  birth. 


child  was  dead  before  birth 


Mtt  ndant. 
P.  o.  Address. 
Undertaker. 
Plate  of  Burial. 


Attendant, 
P.  O.  Address. 
Undertaker. 
p/oee  of  Burial. 


APPENDICES.  859 

>0.    17. 

Sl/.K     11     IN.     X    .V.     IN. 

MARRIAGE    LICENSE. 

DECLARATION    OF    [NTENTION    OF     MARRIAGE. 

State    of    Rhode    Island. 


( Expectant.  > 
i .     Pi  i.i.  name  of  G  room  '.' 


•_'.     Place  of  Residence  ? 

8.     Age  in  years? Color? 

4.     <  Occupation? 

■">.     1  'lace  of  birtli  ? 

6.  Father's  Name  '.' 

7.  Mother's  Maiden  Name  ? 

Parents'  Birthplace?    Father        Mother 

l'a rents'  Occupat ion?    Father Mother  

8.  No.  oi  Marriage  '.' Divorced  ? 

18 

/.  ih<   expectant  yroom  named  in  the  foregoing  declaration,  hereby  certify  that   the 
information  given  is  correct  to  the  best  of  my  knowledge  and  belief. 
Signed   in   the  presence  of        


Expectant  Groom.) 


■  ctunt.) 
1.     Fc  i.i.  name  of  Bride  ? 


(Maiden  Name  if  a  Widow.) 

i.     Place  of  Residence  ? 

:).     Age  in  years  ? Color  ? 

4.     Place  of  Birtli  ? 

.">.     l'a i  her's  Name? 

6.  Mother's  Maiden  Name? 

Parents' Birthplace  ?    Father  Mother 

Parents'  Occupation  '.'    Fathei     Mother 

7.  No.  of  the  Marriage? Divorced  ? 

is 


/.  /A-    expectant  bridi    named  in  tin    foregoing  declaration,  hereby  certify  that   the 

information  yiren  is  correct  to  the  best  m'  my  knowledge  and  belief. 

ined  in   tin  nrescner  of         

pertant  RrUl>  .  > 


N.B.     State  whether  the  marriage  is  the  1st,  2d,  kl,  &c,  marriage  ol  each.    State  whether  white 
black,  or  mulatto,    Olve Idle  names  In  full. 

Re  ei  Be  on  succeeding  pa 


860 


APPENDICES. 


(  REVERSE.) 

OFFICE  OF  CITY  REGISTRAR. 
Proyi  dence,  K.  I. 


No. 


,189. 


I  hereby  certify  that  the  within  license  and  declaration  of  intention  of  marriage, 
is  duly  recorded  in  this  office. 


City   Ueyixtrar 


1    3.  H    ~ 

~     CD  _, 

CO     S"   c       ~ 


2   -■  i5 


*J      CD      75        3 

CD      «      3        ~ 

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v.        — 


APPENDICES.  861 

NO.   18. 

Size  8^  in.  x  81  in. 

These  lilank-;  siv  furnished  in  books  with  stul»s  containing  the  same  items. 
State    of    New    Jersey. 


MARRIAGE     RETURN. 


Set-  Penalty  for  Non-Report  Within  :'.(>  Days. 
I  "he  ink  and  write  plainly,  especially  names. 

1 .     F  r  i.i.  Name  ok  Hush  and 


i  r  colored,  so  state. 

Place  of  ll<  suit  no 

It  in  city, give  name,  street  and  number:  it  not,  give  township  and  county.) 

■_'.  .1'/' years months.     Number  of  his  marriage 

:;  Occupation ■ ( 'ountry  of  Birth 

4.  Name  of  Father <  'ountry  of  Hirth 

5.  Maiden  Name  of  Mother Country  of  Birth 


1.  I'i  i.i.  Maiden  N  ami:  ok  Wife, 

t 'ountry  of  Hirth 

1 1  colored,  so  state. 

2.  Plact   of  llesidenct 

'It  in  city,  (rive  name,  81  reel  and  number;  it  not,  give  township  and  county.) 


8  l./r    nean  */  birthdau                                        !  "  '"  :|"-V  tradeor  • 

...     .1./' .  neai   si  nu  inaay j  business, so  Mate  j 

4.      Last  name,  if  <<  widow Viimher  of  Bride's  Mai  riage 

.*).     Name  -;/'  i'ntlii  )• <  'ountry  of  Hirth 

6.     Maiden  Nairn  •■(  Motht  r '  ountry  of  Birth 


1.     Dati   {in  full) 18         Plaei      

Citj  <>!■  t"«  nship  and  count] . 


2,      //'  nresenct    oj  Be  sure  to  have  witness 


:;.      Signature   of    Minister    i 

i  what  ( liurch  Pastor  of)      

'//•  person  officiating.        > 

\o  1 1  .      \  II  the  facts  called  for  in  this  blank  are  important  and  should  be  accur- 
ately given. 

\ir\  erse  on  succeeding  pa  g 


862 


APPENDK  Es. 


(reverse.  ) 


Above  space  to  be  left  blank. 


3 1:  ~  i-~' c 

S  jj  ai  r.  ,2  a; 

~  £  a>  -H>  j;~ 

v.  o  aj'd.c". 

—  *^    ^    C    *    0^ 

h  h'5  X  ^  h 

—  s  —  -  ci  aj 

«~2  £££ 

-  -  °  i,  z  : 

S  *h  .c  c  £  !3 
>°  =  I-=o 

•-    JJ    T    T    z,    V. 


2  5 


!  53  £  SS 


RETURN  OF  MARRIAGE. 


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Parties  Married. 


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Note.— Blanks  for  the  Return  of  Marriages 
■are  to  be  obtained  from  the  local  Registrarof  Vital 
Statistics,  or  in  some  Cities  from  the  Citj  Clerk. 
In  Townships  such  Blanks  are  to  be  obtained 
from  Assessors.  When  Blanks  have  been  tilled 
out  they  are  to  be  returned  to  the  local  Registrar, 
City  Clerk  or  Assessor,  as  the  case  may  require. 


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APPENDICES. 
NO.   19. 


863 


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APPENDICES. 


NO.  20. 


NO.  21, 


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APPENDICES. 
NO.    2>. 

SlZK    8J     IN.     X    121     IN. 


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866 


APPENDICES. 
NO.    23. 

Size  4  in.  x  0  in. 


State  of  Connecticut,  Town  op 


189 

Marriage  License 


I ,  one  «>f  the  persons  named  in  the 

Marriage   License  to  which  this   is  attached,  do   solemnly  swear  thaf  the  statements 
therein  made  are  true. 

Signed 

Sworn  to  before  me 

this day  of p 189  Attest 

lieyistrar. 


T   Hereby  Certify  That  Mr and 

M the  above-named  parties,  were  legally 

joined  in  marriage  by  me  at this 

day  of L89  (Signed) 

<  official  Capacity 


Received  for  record  on  the                day  of 

189 

This  copy  of  Marriage  License  is  correct. 

Attest  : 

Write  Legibly                                    (~) 

R 

Registrar 


(reverse.) 


This  Certifies,  that  the  within  named  parties  have  declared  their  intention  of 
marriage,  and  have  complied  with  the  provisions  of  the  laws  of  the  State  of  Con- 
necticut, relating  to  the  issuing  of  a  marriage  license  as  indicated  by  attached 
affidavit. 

Attest: , Registrar. 


Groom 


Residence 
of  <  >  room 


Bride 


.Maiden  name 
if  widow 


Age                        ('(dor 

Residence 
of  Bride 

<  Occupation 

Age                       Color 

Birt  liplace 
of  Groom 

Birthplace 
of  Bride 

1st,  2d,  3d  marriage   Widowed 
Name  of  Father 
Maiden  name  of  Mother 

>r  Divorced 

1st,  2d,  3d  marriage  Widow  or  Divorced 

Name  of  Father 

Maiden  name  of  Mother 

Nationality  of  Father 

Nationality  of  Father 

Nationality  of  Mother 

O 

Nationality  of  Mother 

. 

APPENDICES. 

NO.    >4. 

Width   of  Sheet   14   in. 

Return  of  I>i-atli~  Registered  in  the  Town  of during  the  Month  of. 


86' 


Causes  of  Death 


Sex 


I'aicnt- 


Ages  <>f  Decedents. 


Primary  Secondary  •£ 


Under 


s.    v .      ■- 


2  3 
to  to 

3  5 


5  10 
to  to 
10  15 


1.-.  20 
to  to 
•JO  .'30 


30  40  50 
to  tn  tn 
4i)  50  60 


so        90  \_' 

tn     and         not       Total. 

'.•ii     over,     stated. 


NO.  25  (a). 

Size  7  \   in.  n  >s  in. 

State  of  Iowa  —  Ueaeth   Department. 

APPLICATION     FOR    DISINTERMENT    PERMIT. 

TO   THE  STATE  IK  >  All  I  >  OF  HEALTH: 

Application  is   lierebj    made   for  a    per  mil   for  the  disinterment  of  the  bodj  of 

Give  full  hi  i  in'  here,  whether  it  be two  or  three;   use  no  initials. 

now  lying  in <  lemetery  in  the 

State  whether  city,  town  or  township, 

of       Count)  of State  of  Iowa, 

and  wIki  died  mi  the  day  of 18 aged years 

tin mt  lis days,  the  cause  of  death  being 

and  n<  1 1  directly  or  indirectly  by  Diphtheria, 

Membranous  Croup,  Scarlel  Fever,  (Scarlatina,   Scarlet    Rash),  Small  Pox,  Leprosy, 

Asiatic   Cholera,  Typhus  Fever,  or  Yellow    Fever  or  other  contagious  disease,  as 

shown  by  the  certificate  oi  attending  physician. 

Give  lull  name  of  ph> ulcl  m  liei e 

The  bodj  is  to  be  removed  bj    

State  whether  1>)  railroad  or  hj  private  conveyance. 

Cometerj  in  the   

state  whether  oity,  town  or  towntdiip. 

,,i  County  of  State  of 

f  for  interment. 

A  pplicaut. 

This        .  <  1 : i >   ..I  I 

Postottlce  Address     County  ol  Iowa. 

Send  [.limit  bo  P<  »stoffl<  e 

c, units  ..I  Iowa. 


868  APPENDIt  b S. 

NO.  25  (b). 

Size  8  in.  x  14  in. 

State  of  Iowa. 

embaemer's  department. 

DISINTERMENT    PERMIT. 


Application  having   been  made  for  the  disinterment  of  the  body  of. 
now  lying  buried   in - 


Cemetery,  in  the of County  of 

(City,  Town  or  Township) 

State  of  Iowa,  who  died  on  the day  <  >f 

1 aged years months days,  the  cause  <>f 

death  being 

and  not  directly  or  indirectly  by  diphtheria;   (membraneous  croup;)  scarlet  fever: 

smallpox;  leprosy;  Asiatic  cholera;  typhus  fever;  or   yellow   fever;   as   shown   by 

the  certificate  of  death  of  said  deceased,  given  by attending  physician, 

this  is  to  certify  that  permission  is  hereby  given  for  such  disinterment  and  removal 

by to 

Cemetery,  in  the of 

(I  ity.  Town  or  Township) 

County  of State  of to  take 

effect  upon  approval  by  the  local  board  of  health  of  the 

of it  being  understood  and  provided  that  nothing  herein  shall  be 

deemed  as  contravening  or  in  anywise  modifying  or  releasing  the  Regulations  of  the 
State  Board  of  Health  governing  the  Transportation  of  Corpses  or  the  requirements 
for  a  Transportation  Permit,  and  all  Transportation  Companies  and  Common  Car- 
riers will  be  governed  accordingly ;  and  provided  further,  that  where  the  disinter- 
ment is  for  the  purpose  of  reinterment  in  another  part  of  the  same  cemetery,  or  in  a 
contiguous  cemetery,  the  removal  shall  not  be  made  by  any  public  conveyance. 
Given  under  my  hand  and  seal  of  the  State  Board  of  Health  at 

Des  Moines,  this day  of 

A.  D.  1 


Secretary. 
By 


The  foregoing  application  for  disinterment  and  removal  is  hereby  approved  by  the 

local  board  of  Health  of  the of 

(City,  Town  or  Township) 

Mate  of  Iowa,  this day  of 1  r. 


President  Lorn]  Board  of  Health. 

r   If  a  City  or  Town    "I 

[_affix  corporate  seal.  J  Attest 

Clerk  Loral  Board  of  Health. 


APPENDICES.  869 

NO.  26. 

OHIO  ANNOTATED  STATUTES,   1900. 

Se<  .  6921.  Whoever  erects,  continues,  uses,  or  maintains,  any  building,  structure 
or  place  for  the  exercise  <>f  any  trade,  employment,  or  business,  or  for  the  keeping 
or  feeding-  of  any  animal,  which  by  occasioning  noxious  exhalations,  or  noisome  or 
offensive  smells,  becomes  injurious  to  the  health,  comfort  or  property  of  individuals. 
or  the  public,  or  causes  or  suffers  any  offal,  filth,  or  noisome  substance  to  be  col- 
lected, or  to  remain,  in  any  place,  to  the  damage  or  prejudice  of  others,  or  the  pub- 
lic, or  obstructs  or  impedes,  without  legal  authority,  the  passage  of  any  navigable 
river,  harbor,  or  collection  of  water,  or  corrupts,  or  renders  unwholesome  or  im- 
pure, any  water-course,  stream,  or  water,  or  unlawfully  diverts  any  such  water- 
course from  its  natural  course  or  state,  to  the  injury  or  prejudice  of  others,  or 
obstructs  or  incumbers,  by  femes,  buildings,  structures,  or  otherwise,  any  public 
ground  or  highway,  or  any  street  or  alley  of  any  municipal  corporation,  shall  be  lined 
noi  more  than  live  hundred  dollars. 

Si  '  •  6922.  Whoever  builds,  erects,  continues,  or  keeps  up,  any  dam  or  other 
obstruction,  in  any  river  or  stream  of  water,  and  thereby  raises  an  artificial  pond, 
or  produces  stagnant  water,  which  is  manifestly  injurious  to  the  public  health  and 
safety,  shall  he  lined  not  more  than  live  hundred  dollars. 

SEC.  <;'.»•_'•'!.  Whosoever  puts  the  carcass  of  any  dead  animal,  or  the  offal  from  any 
slaughter-house,  or  butcher's  establishment,  packing-house,  or  fish-house,  or  any 
Spoiled  meat,  or  spoiled  fish,  or  any  putrid  substance,  or  the  contents  of  any  privy 
vaults,  upon  or  into  any  lake,  river,  bay,  creek,  pond,  canal,  road,  street,  alley,  lot, 
field,  meadow,  public  ground,  market  space  or  common,  and  whoever  being  the 
owner  or  occupant  of  any  such  place,  knowingly  permits  any  such  thing  to  remain 
therein,  to  the  annoyance  of  any  of  the  citizens  of  this  state,  neglects  or  refuses  to 
remove  or  abate  t  he  nuisance  occasioned  thereby,  within  twenty-four  hours  after 
knowledge  of  the  existence  of  such  nuisance  upon  any  of  the  above  described 
premises,  owned  or  occupied  by  him,  or  after  notice  thereof  in  writing,  from  any 
supervisor,  constable,  trustee,  or  health  officer  of  any  municipal  corporation  or 
township  in  which  such  nuisance  exists,  or  from  a  county  commissioner  of  such 
county,  shall  lie  lined  not  more  than  fifty  dollars  nor  less  than  ten  dollars,  and  pa\ 
the  cost  of  prosecution,  and  in  default  of  the  payment  of  said  tine  and  costs,  be  im- 
prisoned not   more  than    thirty  da\  s. 

Sec.  6925.  Whoever  intentionally  throws  or  deposits  or  permits  to  be  thrown  or 
deposited,  anj  coal  dirt,  coal  slack,  coal  screenings,  or  coal  refuse  from  coal  mines, 

or  any  refuse  or  filth  from  any  coal  oil    refinery  or  gas   works,  or  any  w  hey   or  filthy 

drainage   from   a   cheese   factory,  upon   or  into  any  of   the   rivers,  lakes,  ponds,  or 

streams  of  this  state,  or  upon  or  into  any  place  from    which  the  same  will  wash  into 

any  such  river,  lake,  pond, or  stream;  or  \\  I vex  shall,  by  himself,  agent  or  em- 
ploye, cause,  suffer  or  permit  anj  petroleum  or  crude  oil,  or  refined  oil  or  refuse 

mailer  or  filth  from  an\  oil  well,  or  .,il  tank,  or  oil  vat.  or  place  of  deposit  of  crude, 
or    refined  oil.  to    run    into,  or  he  poured,  or    emptied,  or    thrown  into    any    ri\cr.  or 

ditch,  or  drain,  or  water-course,  or  into  anj    place  from   which  said  petroleum,  or 

crude  oil.  or  refuse    matter,  or   filth  or   refined   oil  may  run  or  wash,  or   does    run   or 

wash  into  any  such  river,  or  ditch,  or  drain,  or  watercourse  shall  be  lined  in  anj 

sum  not   more  than  one  thousand   dollars  nor  less  llian  fiftj  dollars. 

^1  <  .  6927.      Wl \er   maliciously  puts   an\   dead    animal,  carcass,  or  pari   thereof. 

or  anj   other  putrid,  nauseous,  noisome,  bl  offensive   substance,   into,  or  in  any   man 

ner  befouls,  any  well,  spring,  brook,  or  branch  "i  running  water,  or  any  reservoir 
of  water- works,  of  which  use  i^  or  may  in'  made  for  domestic  purposes,  shall  be 
lined   not   more  than  fifty  nor  less  than  five  dollars,  or  imprisoned   not   more  than 

Sixtj   days,  or  hot  h. 


S  7 1 )  A  P  FEND  ICES. 

NO.    27. 

ATLANTA   SANITARY    EULES. 

Rules   for  the   District  Inspectors. 

7th.  The  Inspectors  shall  devote  their  whole  time  and  attention  to  the  business 
of  the  .Sanitary  Department,  and  to  the  performance  of  the  duties  already  prescribed, 
or  that  may  be  hereafter  prescribed,  by  the  Board  of  Health;  and  although  certai.i 
hours  are  allotted  to  the  performance  of  ordinary  duties,  each  Inspector  must,  at  all 
times,  be  prepared  to  act  immediately  on  notice  that  his  services  are  required. 

8th.  The  Inspectors  shall  be  quiet,  orderly  and  civil  in  their  conduct  and  de- 
portment. They  shall  at  all  times  refrain  from  boisterous  manner  and  from  violent 
or  profane  language,  and  in  the  performance  of  duty  they  shall  maintain  full  com- 
mand <>f  their  temper. 

Oth.  The  Inspectors  are  strictly  forbidden  to  drink  intoxicating  liquors  while  on 
duty,  or  to  enter  any  bar-room  or  drinking  saloon,  or  house  of  ill-fame  in  their  uni- 
forms, except  upon  official  business.  No  gaming,  playing  of  cards  or  games  of 
chance  will  be  allowed.     Smoking  while  on  duty  is  prohibited. 

10th.  The  Inspectors  shall  not  leave  the  city  without  the  consent  of  the  Board 
of  Health.  Applications  for  leave  of  absence,  when  desired  by  the  District  Inspec- 
tors, shall  be  made  to  the  Board  through  the  Chief  Inspector. 

11th.  The  Inspectors  shall  not  wilfully  maltreat  or  use  unnecessary  violence  to 
a  prisoner  or  to  a  citizen.  They  shall  not  use  their  canes  or  pistols  except  in  urgent 
cases  and  in  self-defense. 

12th.  The  Inspectors  shall  be  punctual  and  prompt  in  reporting  for  duty.  They 
shall  be  neat  in  person,  with  clothes  and  shoes  clean  and  brushed.  Their  uniforms, 
including  overcoats,  shall  be  worn  buttoned.  An  umbrella  may  be  carried  during 
rain  only. 

13th.  The  Inspectors  shall  carefully  inspect  every  part  of  their  respective  dis- 
tricts. They  shall  keep  so  informed  that  they  can  give  particular  information,  when 
requested,  respecting  the  state  of  the  district,  including  the  condition  of  the  streets, 
alleys,  lots,  cellars,  areas,  privies,  etc.  They  shall  report  in  writing  to  the  Chief 
Inspector,  at  the  time  fixed,  before  every  regular  meeting  of  the  Board  of  Health. 
They  shall  make  out  a  weekly  pay-roll,  showing  the  amount  due  each  laboror  under 
their  control,  and  submit  the  same  at  the  approved  time  to  the  Chief  Inspector. 

14th.  The  Inspectors  shall  promptly  pay  over  to  the  Chief  Inspector  any  money 
that  may  come  into  their  hands  on  account  of  the  city,  and  he  shall  immediately 
deposit  the  same  with  the  City  Treasurer.  Each  Inspector  shall  make  an  acceptable 
bond,  to  insure  the  faithful  performance  of  duty,  in  the  sum  of  five  hundred  dollars. 
All  purchases  made  by  Inspectors  on  account  of  the  city  shall  be  made  by  orders  of 
prescribed  and  printed  form,  which  shall  be  returned  with  the  bills  as  vouchers. 
Any  abuse  of  this  privilege  on  the  part  of  the  Inspectors  shall  subject  the  offender 
to  dismissal  from  service. 

15th.  The  Inspectors  shall  not  leave  their  respective  districts  while  on  duty 
without  the  permission  of  the  Chief  Inspector,  except  upon  strictly  official  business, 
or  in  going  to  dinner, for  which  one  hour  daily  will  be  allowed. 

10th.  The  Inspectors  shall  walk  their  districts  while  on  duty.  No  lounging  or 
loitering  on  street  corners  or  at  any  other  places  will  be  tolerated.  Conversation 
with  each  other  or  with  any  other  person,  except  on  official  business,  is  prohibited. 

17th.  Failure  of  the  Inspectors  to  be  present  at  roll-call  for  two  consecutive 
occasions,  without  a  good  and  valid  excuse,  shall  subject  the  offender  to  trial  and 
dismissal. 

lstli.  The  Inspectors  shall  strictly  and  promptly  obey  all  orders  issued  by  or 
through  the  Chief  Inspector,  or,  officially,  by  the  Board  of  Health.  If  any  order 
issued  by  the  Chief  Inspector  should  appear  to  the  District  Inspectors  unlawful  and 
improper,  formal  complaint  in  writing  maybe  made  directly  to  the  Board  of  Health. 
But  no  refusal  to  obey  an  order  will  be  tolerated,  nor  will  unnecessary  delay  or  any 
inattention  be  permitted. 

10th.  The  Inspectors  shall  not  use  their  office  with  malice,  to  oppress,  persecute 
or  annoy  any  person.  Any  Inspector  violating  this  rule  shall  be  dismissed  from 
service. 

20th.  Neither  the  Chief  Inspector  nor  any  of  the  District  Inspectors  shall  ad- 
vocate the  claims  of  any  candidate  for  municipal  office.  The  Inspectors  are  the 
servants  of  all  the  people,  and  any  partizanship  manifested  in  any  political  contest, 
or  in  any  election  held  within  the  city,  whether  for  State,  county  or  municipal 
officers,  will  not  be  tolerated. 


APPENDICES. 
NO.  £8. 

Sl/.K    7    IN.    X  8    IN. 

DEPARTMENT    OF    HEALTH. 


Office    Health    Commissioner. 


i:i   RE  M      SAXIT  VTIOX. 

{'i-i'iiiixi  s  No 

Tenant  ■ 
Otcner,   A<jt  nl 


Buffalo,  .V.   T. 


No. 
No. 


871 


189 

>/,■■  i  / . 


COMPLAINT. 


(I  iMl'l.  AIN  \  N  I 

NO.    >». 

Size  3^    IN.    n   B   in. 

BOARD  OF  HEALTH,  CITY   OF 

SEW   HAVEN   SANITARY    [NSPECTION. 

Mo   Street. 

.     The  Premises  No Street  of  which 

[nspected  189  .      yon  are  owner,  agent,  tenant,  is  in  an  unsanitary 

Notice  Is'-1  .      condition  "ii  account  of. 

( 'ondit  ion         .  

Unless  i  In   nuisance  is  abated  in days,  '•> 


.\il\  ised 


Time 


ii  will  be  reported  i"  the  Board  "i   Health  i"i  in 
diate  acl  ion. 

To 
Days, 
.Inspector.      1  >ate     


1 80  -      'tary  lnnpt  ctor. 


(S7:>  APPENDICES. 

NO.    30. 

The  following  blank  is  in  use  in  Asbury  Park,  N.  J.  These  blanks  are  bound  into 
books,  one  book  for  each  street  and  one  blank  for  each  lot  or  separate  premises. 
Each  blank  has  four  pages  and  the  books  measure  seven  inches  by  eight  and  one- 
half  inches.  The  printing  and  binding  (twenty-seven  books)  of  these  blanks  cost 
880  per  1,000: 

RECORD    OF    SANITARY    INSPECTION. 


No Street,  Avenue. 

Owner Address '. 

Agent 

SITE    OF    HOUSE. 

1.     .Size  of  lot feet  x feet.     Area  of  lot square  feet. 

Area  covered  by  buildings square  feet. 

•J.      Has  lot  been  tilled  in  ? 

3.  Elevation  of  house  sill  above  curb feet. 

4.  Ground-water  level  below  curb feet. 

5.  Height  of  buildings  on  adjoining  lots ' 

6.  Yard 

T.     Privy-vault:  size x ;  distance  from  privy-vault  to  dwelling 

feet;    distance  from    privy-vault  to  wTell feet;  construction   of  privy- 
vault 

8.  Catch-basin:  size x x ;    size  of  grating x 

how  covered ;  is  ventilation  adequate  ? 

9.  Cesspool :  size,  constuction,  location  and  ventilation 

10.      Water  supply :  analysis  of  well-water 


1 1 .  Stable :   ;  number  of  stalls ;  how  floored 

disposal  of  fluid  excrement 

storage  of  solid  excrement 

manure  receptacle ;    size .  . . 

cover 

12.  Chickens  kept  on  premises? 

13.  Oarbage :  how  stored? 


HOUSE. 


14.  House  erected 

15.  House  used  for  boarders?      ;  for  other  business? 

1G.  House  faces ;  sun  exposure 

IT.  Number  of  sleeping-rooms 

18.  Rooms  without  windows 

19.  Heating ;  has  furnace  an  air-tight  fresh  air  box?. 

20.  Lighting 

21.  Number  of  stories  high 

~1'1.  Material  of  construction 


sheathed  and  covered  with  building  paper?. 
'!'■'>.     Eire  escape 


APPENDICES. 


24.      Roof. 


26. 


34. 


Hack  dwelling  on  lot 

Ki  mndation  :  thickness ;  damp  ? ;  cause 

Cellar:   how  floored :   under  all  of  house? :  outside  entrance  .' 

:   number  and  size  of  windows ;  is  cellar  dry  <>r 

damp?  :  is  ground-water  level  below  cellar  bottom  ? 

•liar  well   ventilated  '.' 

PLUMBING. 

Water-.!,  isets:     number ;  located 

style   :  condition 

windows  in  water-closel  apartment :  is  apartment  used  for 

sleeping-room  ? 

House  drain  :   material 

size :   fall 

Trap  on  main  drain 

1  nlei  for  fresh  air 

An-  all  fixtures  trapped  ? ;   t raj >s  vented  '.' 

Premises  connected  with   street  sewer.' 

VITAL    STATISTICS. 


1'ojiulat  ion  of  house 

N  Limber  of  families 

Diseases  reported  during  |>ast  year 


Diseases  reported  during  pasl  ten  years 


:;s.     Deaths  during  past  year 

39.      Deaths  during  pasl  ten  years. 


PLAN     <>F     PREMISES. 


1,1  S I II    ill 


Scale.     <  >ue    inch,  25    feet;    one-fifth    inch.    ~>    feet.     Each  square  represents  5 
square  feet. 

I.I   Mil:-    INDICATE     IS  FOLLOWS:     W,  well;    ('.cistern;      I".    privy-vault;    D.    drain 

(dotted    line   shows   course  of  drain);     L,    leaching   cesspool;     I!,    brick    cesspool; 
(    li.  catch-basin. 


_|_  |__ 

. : ' L 

, : !_ 

' I 

J i L. 

i I 

_i_  

: I 

_'  l_ 

!  i      i 


S7-L 


APPENDICES. 


NO.  31. 

Form  proposed  by  the  Minnesota  State  Board  of  Health. 

The  following  model  plat  for  recording  facts  of  inspection  can  be  drawn  with 
pencil  on  a  half  sheet  of  letter  paper  making  a  convenient  record  which  can  be 
changed  as  occasion  requires. 

To  be  used  in  making  and  recording  a  sanitary  survey  of  a  farm,  lot  or  block  (as 
the  case  may  be),  as  parts  of  a  township,  village  or  city  survey.  (The  signs  illus- 
trated and  described  below  enable  the  record  to  be  made  with  the  minimum  of 
notes.) 

No.  of  Plat 


1.  House:  Roman  numeral  (e.g., 
II)  indicates  adult  population.  Arabic 
(c  g.,  4),  child  population.  Number  in 
parenthesis  (e.  </.,  1),  reference  number 
of  house. 

2.  Well;  if  used  for  drinking  pur- 
poses, mark  u.  f.  d. 

3.  Water  or  earth  closet. 

4.  Privy,  with  ordinary  vault;  see 
23  helow. 

5.  Cistern;  if  used  for  drinking  pur- 
poses, mark  u.  f.  d. 

6.  Cesspool  and  drain  from  house. 
T.     Garbage  heap. 

8.  Barn;  marks  on  diagonal  indicate 
horses  and  number  of  same. 

9.  Shed;  marks  indicate  cattle  and 
number  of  same. 

10.     Manure  heap. 


11.  Pig  pen;  numeral    {<■.  ;/.,  9)    indi- 
cates number  of  occupants. 

12.  Plank  sidewalk. 

13.  Stone,  brick  or  concrete  sidewalk. 

14.  Water  main  and   connection  with 
house;  arrow  indicates  direction  of  how. 

15.  Sewer  and  connection  with  house; 
arrow  indicates  direction  of  flow. 

16.  Swamps  or  wet  ground. 

17.  Flowing  stream. 
IS.     Stagnant  pool. 

19.  Trees. 

20.  Arrow   indicates  direction  of  sur- 
face drainage. 

21.  U.  F.  D.,  used  for  drinking    pur- 
poses. 

22.  Ft.  D.,  followed  by  numeral,  indi- 
cates number  of  feet  deep. 

23.  W.  T.,  means  water  tight. 


1-    cc     r.     - 


APPENDICES. 


•>i  •» 


NO.  32. 

This  form  is  used  in  North  Carolina  ami  also  in  Brunswick,  <.a. 
SAMPLE   PAGE  OF  INSPECTION    BOOK. 


1893-'n4. 


1  .2    3 


April 

1 

124  Wolf  Street, 

b 

a 

a 

May 

.-; 

a 

a    a 

.1  line 

2 

a 

a 

a 

July 

- 

I. 

a 

a 

Aug. 

1 

a 

a 

a 

Sept. 

2 

b 

a 

a 

Oct. 

1 

a 

a 

a 

Jan. 

... 

a 

a 

a 

April 

1 

T.  II.  Jones, 

<• 

c 

May 

■> 

b 

b 

.1  une 

2 

Ami    so    on  down. 

a 

a 

4    :> 


1,    c 


a 

a 

a   a 

a    a 

x 


a  a 
a  a 
a    a 


KKMARKj 


1.     Too    mucli     litter    ami     trash. 

5.   Very  foul. 
.">.     Improved  hut  not  clean  yet. 

l.     Rank   weeds,    •">.   Not    enough 
dry  earth  used. 


Land  3.   Dim  pig-pen  too  near  well. 

5.   Very  foul,  never  cleaned. 
1.      Pig-pen  improved,  door  raised. 
N.,  thai  ean  lie  raked  under. 


NOTE.  -  Bj  allowing  nine  lines  to  each  lot  there  will  be  a  line  for  each  one  of  the 
inspections  required  bj  the  ordinance  —  monthly  from  April  to  October,  inclusive. 
•■  124  Wolf  Streel  "  represents  a  complete  establishment,  "  T.  II.  .lones"'  an  humbler 
one  with  no  stable  or  other  out-building  and  no  sink. 

The  inspector  should  carry  this  hook  with  him  when  making  his  rounds  and  make 
his  notes  on  I  he  spot. 
I'  IB.M    No.  2. 

I      he  printed  or  written  on  tirst  fly-leaf  of  Inspection  Book). 

Column  No.  i  indicates  condition  of  Premises    other  than  below]. 

..    .z  ..  ..  stable. 

:;  »  •■  Well  or  Pump. 

••    4  ■•  ••  ^ink. 

■•    :,  ■■  Privy. 

■    6  ••  Out-building. 

•-    T  ••  ••  Residence. 


A    indicates    Good.      B    indicates    Fair.      C    indicates    Bad.       X    indicates  a   serious 
menace  to  heall  h. 

no.  :;:;. 

Size  s  in.  t  10  in. 

Boakd  of  Mi  \i  in.   l_'  Beacon   Sthei  i 

Boston 189 


T 


of   Boston,    in  the  Countj  of  Suffolk,  ami   C monwealth  of   Massachusetts: 

The  Board  ol  Health  ol  said  city  of  Boston  hereby  order  you  to  remove,  at  your 

Own  expense,   within days  from  service  Of  this  notice.  ;i 

nuisance,  source  of  tilth  and  cause  of  sickness,  found  on  certain  private  property, 
of  which  you  are  the  owner  and  occupant,  to  wit : 

situated  on  and  appurtenant  to  the  premises  numbered. 


in  s;iiil    Boston  :   and  which  sai'l 


sanl  Board  of  Health  have  adjudged  to  be  a  nuisance. 

Bj  ordei  of  the  Board  ■■<  Heath 


I  Reverse  has  blanks  for  record  oi  service.  ] 


"••  i  rptan  ■ 


876 


APPENDICES. 
NO.    34. 


Size  84  in.   x  14  in. 
The  following  is  the  form  used  in  Providence  under  the  Rhode  Island  law 

[FORM    A.] 

THE     CITY     OF     PROVIDENCE. 


No. 


In  Hoard  ok  Aldermen 


189 


ordered,   that. 


being  the  owner  or  occupant  of  premises  situated. 


in  tlie  City  of  Providence,  Rhode  Island,  remove  at own  expense  a 

certain  nuisance,  source  of  filth,  filth,  or  cause  of  sickness,  to  wit  : 


found  on  said  premises,  within  twenty-four  hours. 
after  service  of  this  notice  of  said  order. 


Clerk  of  the  Board  of  Aldermen. 

[reverse.] 
State  of  Rhode   Island. 

Providence,  sc, 
City  of  Providence. 

I  have  made  service  of  the  within  notice  and  order 

by  leaving  a  copy  thereof  personally  with  the  said 

at  the  last  and  usual  place  of  abode  of  said 

within  this  state,  by  reading  the  same  in  the  presence  and  hearing'  of  said 

of 

the  authorized  agent  of  said 

on  the day  of A.  D.  ISO     at 

<>"clock, M. 

Constable. 


<    9 


H  — 


APPENDICES. 


877 


NO.  35. 

The  Ohio  nuisance  law  appears  to  be  a  very  effectual  one  and  the  state  board  of 
health  has  prepared  a  blank  form  of  order  for  the  use  of   local  boards  in  that  state 

in  abating  nuisances. 

Size  4  in.  x  91  in. 


2 


£      « 


— 
r. 

?. 


/. 


878 


APPENDICES. 
NO.  36. 

Size  T  in.   x  84  in. 


t— i       43        O 


5fe 


No 
Nuisance 


Ward. 


S; 

M 

•fc3 

•y. 

g 

~ 

;_; 

G 

05 

** 

— 

0) 

CS 

>= 

s*      ®       °       — 


c 

p 

tf3 

® 

£ 

- 

O 

Inspector  —  District  N< 


18 

By  order  of  the  Board  of 

Health,  the  Health  Officer 
is  directed  to  have  the 
within-described  nuisance 
abated  or  removed. 

Chief  Clerk. 


(  REVERSE. 


Ward, 


A  LIST  OF  LICENSED  CLEANERS  CAN  BE  SEEN  ON  APPLICATION  AT  THE  HEALTH  OFFICE. 


HEALTH       OFFICE.       Philadelphia, 

To    

owner,  agent,  or  occupier  of  premises  situated.. 


is 


You  are  hereby  notified  and   required  to  have  removed  within  days 

from  the  date  of  the  service  hereof,  a  certain  Nuisance  on  the  above-described  prop- 
erty,  arising   from 


which  Nuisance  has  been  declared  to  have  a  tendency  to  endanger  and  be  prejudicial 
to  the  public  health.  On  failure  to  do  and  perform  which,  the  said  Nuisance  will 
be  removed  at  your  expense,  and  a  lien  entered  agreeably  to  the  provisions  of  the 
Act  of  Assembly. 

By  order  of  the  Board  of  Health. 

Attest:  Chief  Clerk. 

Clerk. 

Extract  from  Act  of  Assembly. 


APPENDICES.  879 

NO.    37. 

Size  8  in.  x  10.1  in. 

I  x  Board  of  Health, 

Boston 189 

Whereas,  upon  due  examination  ii  is  adjudged  by  this   Board  that  a  nuisance 
exists  on  premises 

consisting  of 


rendering  the  same  unlit  for  occupation  as  a  dwelling  place  therefore 

hat    the   tenants  of    sa 
days  from  service 

A  true  copy.      Attest. 


Ordered,   That    the   tenants  of   said    premises    lie    notified  to   vacate   the  same 
within days  from  service  of  not  ice  lierei  >f. 


Secretary. 


tenants  of  premises  No 

In  compliance  with  the  above  adjudication  and  order  you   are    hereby  ordered  to 
vacate  said  premises  within days  from  service  hereof. 


A  true  copy.      Attest . 


Secretary. 

Constable. 


NO.    38. 

Size  8     i\.  \  1 1   i\. 

Cm   of  Camhridg  k. 

OFFICE    OK 

L.  S.   I  BOARD      OF      H  E  A  I.  Til. 

I'm    II  \  i  i  . 

ISO 


M 

Sib  : 

In  the  oj.iii ,f  this  Hoard  the  privy  vault   maintained  upon  your  premises 

situated  on in  said  Cambridge,  and 

numbered t hereon,  said  street  being 

a  public  street  wherein  t  here  is  a  public  sewer  opposite  your  said  premises     

is  injurious  to  t he  public  health. 

In  accordance  with  the  provisions  of  Chapter  74  of  the   Legislative   Acts  of  the 
year  1890,  said  privj  vaull  is  hereby  declared  to  be  a  nuisance,  and  the  further  con 

tiliualice   thereof   is   f  >>l  I » i(  h  len.        Veil   ale   then  >foP 

Ordf.ued, 

To  remove  the  aforesaid  nuisance  al  your  own  expense  within 

afiei  sen  ice  oi  nol  ice  of  this  ordi  i , 

Bj  order  of  the  Board  of  Health. 

Clerk. 

Middlesex,  --.  Cambridge,        .  L89 

I  have  this  daj  served  the  foregoing  notice  bj  delivering  in  hand  to  the  said ... . 
bj  leaving  al  the  l:t -. t  and  usual  place  of  abode  in  said 
( laiubridge,  oi  i  lie  said 


a  i  rue  and  attested  copj  oi   tin   same 


880 


APPEXDK  'JUS. 


NO.    3<>. 

SlZF.    8    IX.     X    1(1    IX. 

APPLICATION     FOR    DRAINAGE    PLUMBING     PERMIT. 


No. 


No.  of  Building  Permit Denver,  Colo., 180 

Application*  is  hereby  made  for  Permit  fob  Drainage  Plumbing: 

Class  of  Buildings,  stores, 

No.  Street,  Avenue, 

Lot.  Block.  Addition, 

owner,  Address, 

Plumber.  Address, 


Number. 

Ilaseluent. 

Yard 

1st  floor..  . 
•.'.1  floor.... 
3d  floor.... 
4th  floor.. 
5th  floor.. . 
0th  floor.. . 
7th  flour..  . 
Stli  floor... 


Wash  j    Bath 
Howls.     Talis. 


Sinks. 


Wash 
Tubs. 


Urinals. 


Stop 
Hoppers. 


Grease    < 'ess- 
Traps,    pools. 


Sewer. 


All  work,  mat   rials,  and  construction  to  lie  strictly  in  accordance  with  the  Rules,  Regulations, 
ami  city  ordinances  pertaining  to  Plumbing  and  House  Drainage  of  the  City  of  Denver, 


APPENDICES. 
No.  40. 

Si/.k  si   in.  x  14  In.     (Four  pag<  s. 
PLAN  No 


881 


Street  No 


CITY   OF    PROVIDENCE. 


I'd  tin   Inspector  <>(  Plumbing  : 

As  required  by  Chapter  061  of  the  Ordinances,  the  following  Plan  is  this  day, 

189. .  .submitted  for  approval;  and  we,  the  undersigned,  do  hereby 

agree  to  do  all  drainage  and  plumbing  in  the  building  specified  herein  according  to 
this  PLAN  and  iii  accordance  with  the  ordinance  in  relation  to  plumbing. 

Location Street. 

Owner Address Street. 

Master  Plumber ,  Address Street. 

Architect ,    Address Street. 

Estimated  Cost  "t   Plumbing 


Class  of  Building Old  or  New, Number  of  Stories 

How  is  building  t.i  be  occupied  '.' 

Where  does  the  I  >rain   Pipe  Discharge? 

Js  the  Drain  Pipe  above  or  below  the  basement  floor? 

Size  "i'  Drain  Pipe  in  cellar, inches;  size  of  Snii  <.r  Waste  Pipe inches. 

Where  dues  t  lie  Air  Inlet  Pi] pen?     Iii  Court-Yard  or  at  Sidewalk  ? 

Is  there  Underdrainage  ? I  low  dues  it   connect  with  Sewer  ? 


u  \  1  i.i:    I  LOS1   rs 

\   LRD. 

B  181 

Ml\  1 '. 

lsl 

1    LOOR. 

2d 
Floor. 

3d 
Floor. 

■nil           5th 

R.       Ii. :. 

6th 
1   LOOR. 

Pal  tei Name  of 

l|.iu  Supplied  with 
w  atei . 

[a  tpai  tnnni  Venti- 
lated '.'    n  bo,  state 

it  ii  is  i.\  \n  Shaft 

.  r  \\  niilow. 

lli.u    i.o    are    I  rapi 
from  \  ertical  Pipe? 

How  are  Tank  « »\  er- 
Howe  Trapped  1 

882 


APPENDICES, 


\ 

< 

■f. 

1    '- 

- 

.-  ~  '- 

£  5 

• 

el 

*5 

< 

- 

a) 

:. 
X 

[s  there 

a 
separate 

one '.' 

• 

e 

K 
O 

M 

o 

CO 

Connected 

with 
Sewer  or 

Cesspool. 

G3 

i  -  — 

&c<h  £, 

'S  =  r 

i 

Size  of 
Soil  in- 
Waste 
Pipe. 

KIND  OF  TRAP. 

4- 

0 
Q 

— 

c 
c 

c 

c 
c 

c 
c 

-r 

c 

c 

'- 

s 

a 
■/ 

e 
X 

| 

3 

c 
c 

c5 

4- 

[* 

a 

-t 

-_ 

SX5 

sor 

10 

:r.i. 

\  . 

A 

"Sh 

IS> 

a 

HS1 

AV 

•s 

an 

L    i 

i  i  \ 

a 

APPENDICES. 


883 


ti 

j 

— 

z 

■~ 

93 

s. 

-r 
Z 

> 

— 

0) 

— 

-. 

-  \  \ 

3  r  S  l  -  z 

■_  -  -  -  — 

■      —  —  j-  ~ 


'-    z    :     -     :     : 

1   I  ~  ~  a  1 


■-  i   I  |    n~\   \\ 

I"   -  I    IV 


1 

- 

- 

1 

— 

- 

— 
< 

1 1 

\ 

1 

g  I  s  i  §  l 

_    •  r  E  fc 



-  — —  — 

- 


•»:i  I.I.IOH    ■!< 


—  -  — 
-  a  - 

—  i  ■  •  i  uo)onp 

ri.nil|..:|  <!•  .    (  Ml  1JI 


884 


APPENDICES. 


INSPECTOR  OF  PLUMBING 


City  of  Providence. 


Plan  of    Plumbing   and  Drainage. 


Plan  No 

No Street. 

Filed 

Inspected 189 


.189.. 


Final  Inspection  shows  that  all  work 
lias  been  done  in  accordance  with  this 
Plan  and  the  Rules  and  Regulations. 


Inspector  of  Plumbing. 


APPENDICES. 


885 


Bureau  of  Health. 


No.    41. 

Size  4  VS..   x  5$   in. 

ORIGIN  AX. 
PLUMBING    CERTIFICATE. 


No. 


D<  river,  <  'olo 189. .  . . 

I  hereby  certify  that  lhave  on  this  day  examined  the  plumbing  of  house  oioned 

by Lot 

Block Add Street 

b(  '"■'  en 

and  find  that  the  work  has  been  dont  according  to  requirements  of  tin  City  Ordinance  in 
relation  to  plumbing. 


Health  (  omnusstom  i 


Plumbing  Lisj»  ctor, 


[JJ8P K    "I      l'K"\  ISIONS. 

So 
Proridt  nee,  18U 

Quant  it  a. 

Kind 

i  Qutu  i  . 
[Address, 
i  i 'onsiffiu  ■  .. 
I  Addn  is,. 
Privatt  mark  . 

hull   o)  mrii  "/. 


NO.  42. 

Size  \\  in.  \  8  in. 
city  of  providence    health  departmen1 

[NBPEI    riOK    01    l"l:n\  ISIONS. 

No. 

18 


l  i,  reby  i  -  rtl/y  thai  mi  Via day 

,.188  ,  I  seized  and  coiulemnril  at 


i hi  jn  ii/n  1 1 a  "i 


,i ,,,i  cotislf/neil  in 
U  ,■■•  .  R.  I 


aropi  1 1  ii  '"  \ng 

,n„l    hi, III   fo 


I ,,*i„  ,  tor  ni  l'i  ■■•  i  *ian». 


886 


APPENDICES. 


NO.    43. 

Size  7  in.  x  8  in. 

APPLICATION    FOE    LICENSE    TO    SELL    MILK. 

City  of  Minneapolis,  Minnesota. 


Application  of to  the  City  Council  of  the  City  of 

Minneapolis,  for  a  License  to  sell  milk  in  said  city. 
1st.     Name  of  Applicant  and  residence 


2d.      Location  of  dairy  from  which  applicant  obtains  his  milk 

3d.      Name  of  owner  of  such  dairy 

4th.  Number  of  cows  in  dairy  from  which  applicant  obtains  his  milk. 

5th.    Manner  of  disposing  of  milk 


Date 

No.  of  Application. 

(OVER.  ■ 


189..  Signed 


(BEVEBSE.) 


O 


1     '-=     - z 

.2     ►.    =3     £ 

-t-=       cs       =      — 


£     2 


c3       <s 


o 

CD        r- 


•fl 

r/i 

£ 

? 

o 

O 

o 

y 

«*-( 

o 

° 

o 

o 

fc 

K 

X         X        00 


U       ~       s 


i.        CD        cS 

9h      3h       — 


APPENDICES.  887 

NO.  44. 

Size  T  in.  x  14  ix. 

APPLICATION    FOR    LICENSE   TO   SELL  MILK  IX  THE  CITY  OF   BOSTON 
DURING  THE  YEAR  ENDING  MAY  :ilst,  1900. 


Xanie  of  applicant 

Residein-e  (street  and  number,  town) 

Place  of  business 

Number  of  wagons  used  in  delivery  of  milk. 
Number  of  drivers  employed 


NAMES   OK    DKIVEBS. 


RESIDENCES. 


'  If  any.  lill  out   Form  3. 


1'.  M. 


Section  supplied 

Amount  of  Milk  raised,  (quarts) 

Number  of  cows  kept 

Amount  of  milk  bought  (quarts) 

of  whom  bought 

Where  delivered  by  him 

Sour  delivered A.  M 

Where  stored  and  handled  after  delivery 

Whether  mixed,  handled,  or  stored  where  cows,  horses,  or  other  animals  are  kept, 

or  where  manure  is  stored 

Whether  mixed,  handled,  or  stored  iu  rooms  used  for  domesl  ie  purposes  or  sleeping 

rooms 

Location  of  milk   room 

How  drained 

Whether  walls  are  tight  and  easily  cleaned 

Whether  floor   is  tight  and  easily  cleaned 

Whether  appliances  are  at  band  for  washing  or  sterilizing  all  utensils 


Whether  any  water-closet,  urinal  01   privj    is  located  in  the  room. 
Whether  ice-box  or  refrigerator  drained,  and  how 


The  above  is  a  c<  irrect  statement. 

Signal  ure. 

Witness.  

Host,  ,11 

License  Issued. 
Number  of   License. 


888  A  PPEXU1 C  'JUS. 

NO.    45. 

Size  T   in.   x  10}  in. 

APPLICATION   FOE    REGISTRATION    AS   A    DEALER    IN  MILK   AND  FOR 
LICENSE  TO  SELL  MILK  IN  A  STORE    IN  THE  CITY  OF  BOSTON. 


Name  of  applicant  (if  a  partnership,  the  name  and  address  of  each  member  must  be 
given). 

Residence 

Residence : 

Kind  of  store  (bakery,  provisions,  groceries,  etc.) 

Place  of  business,  N< Street. 

District Amount  sold  per  day  (quarts) 

From  whom  purchased 

Time  received 

Whether  kept  in  a  separate  covered  cooler  or  refrigerator 

Whether  cooler  or  refrigerator  is  drained  and  how 


Where  and  how  the  measures  are  washed. 


Whether  there  is  a  urinal  or  water-closet  in  the  store 

Whether  any   part  of  the   store  is   used  for  domestic  purposes  or  as  a  sleeping- 
room 


The  above  is  a  correct  statement. 
Signature 


Witness 

Boston 

License  issued 

Number  of  License. 


NO.    46. 

Health  Department  of  the  City  of  New  York,  \ 

Criminal  Court  Building,  v 

New  York, 189..  ) 

Permit  No 

is  hereby  authorized  to  sell  Milk,  Fresh  and  Condensed, 

at  No under  the  laws,  rules  and  regulations  of  the  Board 

of  Health  of  the  Health  Department  of  the  City  and  County  of  New  York. 

This  permit  is  not  transferable  to  any  person  or  location  other  than  above,  and 
must  be  kept  posted  at  all  times  in  a  conspicuous  place  in  this  store,  and  is  revoc- 
able at  the  pleasure  of  the  Board. 

By  order  of  the  Board  of  Health, 

CHARLES    (i.    WILSON. 

President. 
Emmons  Clark, 

Secretary. 

Countersigned.  EDWARD   W.    MARTIN, 

Chief  Inspector,  Fooil  Division,  etc. 


APPENDICES. 

for  Wagons: 

Health  Department  of  the  City  of  New  York,  ) 
Criminal  Court   Building, 

New  York 189..  ) 

Permit  No 

resid  i  ng  a  i 

is  hereby  authorized  to  sell  Fresh  and  Condensed  Milk 

from  Wagon  No ,  in  the  City  and  County  of  New  York,  under  the  laws,  rules 

ami  regulations  of  the  Board  of  Health  of  the  Health  Department  of  said  City  and 
County.     This  permit  is  revocable  at  the  pleasure  of  the  Board. 
By  order  of  the  Hoard  of  Health, 
Emmons  Clark,  CHARLES  G.  WILSON, 

Si  cretary.  President. 

Countersigned,  Edward  W.  Martin, 

Chief  Inspector,  Food  Division,  etc. 
This  permit  is  void  if  used  for  any  cart  except  the  One  designated  on  the  face. 

Driver"  s  name 

Residence 

Not  transfi  ruble. 


NO.  47. 

Size  4  in.  \  Q{  in. 
Ins.  Date  Time  Lab.    X". 

Name 
Address 
Attendant 

Marks  on  Can  Size  of  Can  Approx.  Ami.  in  Can 

Tag.'     Yes     No.  Duplicate  Given ?     Yes     No.  Milk  Cream 

No.  of  Wagon  License  No.  Ward 

Where    Taken 

Remarks 

Specific  Gravity  Butter  Fal  Total  Solids 


(  Kl.\  RBSE.  I 

The  Milk  Ordinance  requires  Milk  to  contain  at  hast  three  per  cent,  of 

butter  fat  :    this  means  three  pounds  of  butter  fat  in  one  hundred   pounds  <'!'  milk. 

"Skim1'  milk   may  lie  sold   if  1  lie  can.  jar.  ^lass  or  ressel    in  which  the  milk  is 
kepi    is  marked  with  a     •  skim  "  milk  tag  in    plain  sighl   where  customers  may  see  it. 

mi  must  contain  at  least  twelve  per  cent,  of  butter  fat ;  this  means  twelve 
pounds  of  butter  fal  in  ever]  one  hundred  pounds  of  cream. 

v     •  whole  milk,11  -skim  milk11  or  cream  may  he  sold  which  coin  a  ins  water, 
color,  preservative,  soda,  salt  or  any  other  adulteration. 


This  blip  is    \   beceip' t  tour  saupu    and  you   cannot  gel    youi    t<  -: 

without  it.  unless  it  has  been  destroyed  or  lost,  when  satisfactory  evidence  of  tin- 
fact  must  be  given.  No  results  of  tests  will  he  given  by  telephone ;  either  presenl 
this  slip  for  your  test  or  mail  with  it  a  two  cent  stamp  enclosed,  to  Room  111,  Cit} 

Hall,  and   result  of  test   will  he  sent  you. 

Samples  of  milk  "i  cream  will  he  received  for  i>  sting  between  nine  o'clock  in 
the  morning  and  four  o'clock  in  the  afternoon.  A  half  pint  of  milk  or  cream  is  re- 
quired for  a  test.      Ml  testing  is  done  free  of  ,  harge. 

For  furt  her  informal  ion.  ado  ■ 

E.   B.  ST1    \KT. 

Slipt  ri  ill'  /ill'  ill     Mill,     I  iisjii  ,  I 

Room   II  I.  City  Hall 


890 


APPENDICES. 
NO.  48, 

Size  3i  in.  x  10  in. 


Warning   Notice    to  Sellers  of 
Illegal  Milk 


No. 


DEPARTMENT    OF    HEALTH. 
City   of   Minneapolis. 

Minneapolis,  Minn.,. 


. . .  189 . 


You  are  hereby  notified  that  <i  sample  of  m  ilk  recently 
obtained, from  you  has  been  found  mi  analysis  to  be  of  a 

Address ■  character  declared  bylawto  beillegaT.  )'<>"  are  respect- 
fully notified  that  the  sale  of  such  m  ilk,  «</•  the  offering  or 

( "haracter  of  m  ilk  sold exposing  <>r  delivering  of  such  m  ilkfor  sale  or  consumption 

renders  you  liable  to  the  penalties  provided  /></  the  Ordi- 
nances of  the  City  of  Minneapolis. 

Further  information  will  be  furnished  you  <m  personal 
Date 180. .       application  to  I  his  office. 

Respectfully, 
No.  of  Notice 

To 

Commission*  r  of  Health. 


NO.  49. 

SANITARY    INSPECTION    OF    TENEMENT    OR    LODGING    HOUSE. 

Date  of  inspection 189  .... 

1.     Street No 

•_'.     Owner,  Agent Address 

3.  Condition  of  Street.     Paved  or  Unpaved. 

4.  Condition  of  yards  and  courts:     Clean,  Unclean;  rubbish,  ashes,  garbage,  wet, 

damp,  dry. 

5.  Barn:     Clean,  unclean,  wet,  damp,  dry,  sewered.  Manure  Box:  Clean,  unclean, 

covered,  or  uncovered. 

6.  Outhouses:  Clean,  unclean,  whitewashed,  not  whitewashed. 

7.  Animals :     No Nature 

8.  Basement  or  Cellar:     Cemented,  uncemented,  wet,  damp,  dry,  clean,  rubbish, 

ashes,  filth,  lighted,  ventilated. 

'.'.     Apartment  No.  1.     Living  rooms ;  Sleeping  rooms ;  Ventilated ; 

No.  of  occupants ;  Color . .  ;    Nationality 

Air  space 

29.  Apartment  No.  21.     Living  rooms ;  Sleeping  rooms ;  Ven- 

tilated; No.    of   occupants ;  Color ;  Nationality ; 

Air  space 

30.  Sickness  in  house ;  what  diseases 

31.  Sickness  during  12  months;  what  diseases 

32.  Deaths  during  past  12  months ;  what  diseases 

33.  Water  supply ;  Source  of  contamination 

34.  Janitor.     Night  lights.     Gong.     Metal  receptacles  for  refuse,  etc. 

35.  Plumbing :  Yard 

Basement 

1st  floor 

2d  floor 

3d  floor 

4th  floor 

5th  floor 

Conductors  discharge 

36.  Sanitary  needs ;  observations 


APPENDICES.  891 

NO.    50. 

Size  8-J  in.  x  14  in. 

REPORT    OF    INSPECTION    OF    DAIRY    FARM. 

Health  Department,  Distbict  <>f  Columbia. 


Washington, 

To  thi  Health  Officer: 
Sib:— 

1  respectfully  submit  the  following  report  upon  an  inspection  of  the  dairy 

farm  of ,  located 

BUILDING. 

Brick Frame Stories  high. 

Condition 

Is  any  part  of  it  used  for  any  other  than  dairy  purposes  ".' 

If  so.  specify,  in  the  space  for  remarks,  what  parts  of  it   are  so  used,  and  the  pur- 
poses for  which  used. 
Room  for  <  'attle. 

Mz.- long wide high 

Floor.      Kind 

Condition 

Is  it  properly  sloped  and  guttered  ? '. 

What  disposition  is  made  of  the  drainage  .' 


Ventilation  and  lighting.    How  accomplished?. 


Windows.     1  low  man]  ? 

Location 


Size. 


Are  window  s   glazed  '.' 

Ventilators.    How  many  .' 

Kind 


I.,  ical  ion . 

Size 


I  toors.      How  many  ? 
Local  ion 


Mall>.     Where  located  ? 


How  man]  ?   

Size  of  each  ? wide long  . 

wide long 

Lre  animals  of  any  kind  other  than  cattle  kepi  in  i  Ins  room? 

[f  so,  specif]  ho\\  many,  and  what  kind 

/•"<  ediny  trouyhs  or  boxen.     I  low  many  ? 

Kind 

Local  ion 

(  ondit  ion 

Water  trouy ha.     ll"W  many? 

K  ind 

Local  ion 

( '•  'iid  ition 

it  water  troughs  are  nol  used,  how  are  cattle  watered 


892  APPENDICES. 


Source  of  water  supply. 

If  from  well,  state  location 

Approximate  depth feet,  and  construction . 


Location  of  well  with  reference  to  nearest  privy.  State  distance  and  slope 
of  ground 

Location  of  well  with  reference  to  place  where  dung  is  deposited.  State 
distance  and  slope  of  ground 

lias  water  any  perceptible  odor,  color  or  taste  ? 

If  so,  describe 

Receptacles  for  dung  and  other  refuse.     How  many? 

Kind 

Location 

Condition 

Receptacles  for  milk.     How  many  ? „ 

Kind 

Condition 

What  provision  is  made  for  cleaning  ? 

Is  milk  cooled  immediately  after  milking  ? 

If  so,  how  ? 

BARN-YARD. 

.Size long wide 

Is  it  properly  graded  ? and  drained  ? 

Is  it  paved 

What  disposition  is  made  of  the  drainage  ? 


What  is  its  condition  as  to  cleanliness,  at  time  of  inspection? 

PASTURE. 


Size  of 

Location  of . . 
Condition  of . 


Is  it  supplied  with  drinking  water  for  cattle  '.' . 
If  so,  from  what  source  ? 


CATTLE. 

How  many  milk  cows  are  usually  kept  ? 

How  many  other  cattle,  if  any,  are  kept  in  the  same  stable  ?. 

Kind  of  milch  cows  used 

Condition  of  cows  at  time  of  inspection.     General  condition. 


Cleanliness,  etc 

Character  of  feed 

PRIVY  ACCOMMODATIONS. 
How  is  human  excreta  from  the  premises  disposed  of  ?. . . 


Location  of  privy,  if  any. 
Construction  of  privy. . . 


SEWER  AND  WATER. 

Is  a  public  sewer  available  for  premises  ? 

If  so,  have  sewer  connections  been  made  ? 

Is  a  public  water  main  available  for  premises  ? 

If  so,  are  the  premises  connected  therewith? 


1!  KM  ARKS. 


Inspector, 


APPENDICES. 


89a 


NO.  51. 

Size  \\  in.   x  11  ix. 


y. 

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r: 

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894 


APPEXDK  7-:s. 


NO.  52. 

Postal  Card. 


Diseases  to  be  Reported  :;ip?er^MehasHescMernbwrhanous  cioup;Puerpera 

wiwuuvuw   iu   m«   nufjunuu  ■  Smallpox .  Typhoid  Fever,  Whooping  Cough 


Fever,  Scarlet  Fever, 
Optional  —  Tuberculosis. 


NOTE. —  Where  the  Attending  Physician  will  undertake  to  enforce  necessary  measures 
against  the  spread  of  contagion  in  a  case  of  any  of  the  above-named  diseases,  tlie  intention 
should  be  indicated  by  writing  in  the  word  assume  in  Entry  No.  8.  If  this  be  done  the  De- 
paetmest  will  not  placard  the  premises — except  in  Smallpox.  If  it  is  proven  that  efficient 
precautions  are  not  being  enforced,  the  premises  will  be  taken  in  charge  of,  placarded  and 
quarantined  by  the  Department  —  Tuberculosis  excepted. 

If  the  Physician  does  not  see  fit  to  assume  this  responsibility,  the  word  decline  should  be 
written  in  the  blank  space,  when  the  Department  will  placard  and  quarantine  as  may  be 
necessary  fur  the  protection  of  the  neighborhood.  Absence  of  any  indication  will  be  construed 
as  declining'  the  responsibility  and  the  DEPARTMENT  will  take  action  accordingly. 

Where  the  responsibility  is  assumed,  the  Physician  must  cause  neighboring  families  to  be 
fully  warned  against  the  disease  and  must  prohibit  members  of  the  infected  family  from  ex- 
posing others  to  the  risk  of  infection. 

1     Chicago 1 Case  of 

•1     Xo Ward 

Avenue,  Boulevard,  Court.  Place,  Street. 

3  Case connected  with  Milk  .Shop  or  Depot,  Laundry,  Shop,  other  business 

place.  If  n"r  so  connected  write  in  blank  space  the  word  not. 

4  Name  of  patient 

5  Age years months.  Color Sex 

(If  the  Patient  had  lived  outside  Chicago  within  the  last  .30  days,  state  below  where 
and  date  of  return.) 

0     Returned  from on  the 

Name  of  place  and  State.  Date  of  return. 

7      

In  Puerperal  Eever  — where  Midwife  had  been  in  attendance,  give  her  name  and  address  on 

above  line. 

8  See  note  above. —  I the  responsibility  of  preventing  spread  of  contagion 

from  this  case. 

M.  I). 

Address 


NO.  53. 

Postal  Card. 


Physicians  are  required  by  Utn-  to  report  within  twenty-four  hours  all  cases  of 
contagious  or  pestilential  diseases,namely:  Smallpox,  Epidemic  Cholera,  Epidemic 
Dysentery,  Scarlet  Fever,  Diphtheria,  Typhoid  Fever,  Puerperal  Fever,  Measles, 
Erysipelas,  AVhooping  Cough,  Hydrophobia,  giving  name,  age  and  residence. 

See  Revised  Ordinances,  Sec.  69. 

To  Health 
Division.              Age. 
Name. 

Kesidence 

Street  and 

Number. 

3 

-f.— 

73       . 

2  S 

■s  > 

ft  o 

02 
QD 

o 

00 

S3 

QD 

6J3 

£  3 

Miscellaneous 
Diseases. 

Cleveland,  Ohio, 

18QZ.  \                                                     ^r    it 

APPENDICES.  895 

NO.    54. 

Postal    Card. 


San  Francisco, 1893. 

Tht    Board  of  Health   is  hereby   notified  thai 

agt  . . . .//'  ars,  living 


ill  No. . . . 
is  ill  with 


.  M.  It. 


Order  No.  2313 — Sec.  6.  It  shall  Bs  the  duty  of  each  physician  in  this  city  and 
county  to  report  to  the  Eealth  Office  in  writing,  every  patient  heshall  have  laboring 
under  Small  Pox,  Asiatic  Cholera,  Diphtheria,  Scarlet  Fever,  or  other  contagious 
disease,  immediately  after  he  shall  be  satisfied  of  the  nature  of  the  disease.  lie 
shall  also  reporl  to  the  .^ame  officer  every  ease  of  death  from  such  disease. 

Any  person  who  shall  violate  any  of  the  provisions  of  this  <  )rder  shall  be  deemed 
guilty  of  a  misdemeanor,  and  upon  conviction  thereof  shall  he  punished  by  a  line  of 
not  more  than  five  hundred  dollars,  or  by  imprisonment  in  the  County  Jail  for  not 
more  than  six  months,  or  by  both  such   tine  and  imprisonment. 

This  law  will  be  strictly  enforced. 


Health  Officer. 


NO.    55. 

Size   :,\    IN.    X  8   IN. 

Fob  Typhoid  Feveb.] 

Evebett,  M  .\>>.  189 

TO    THE    BOABD    01     III    \  I   ill   : 

In   the  case  of 


Disease 

I  >;ile  of    first    s\  mptoms  : 

lias  the  person  been  oul   of  town  within  three  weeks.'    (Visit  or  at   work.) 


Has  the  person  drunk  anj  w  eii  or  spring  water  within  three  weeks! 


I" i . . 1 1 •  w  bom  is  milt  bought  " 

Is  t  his  1 1 ii I >  milk  used? 

It  ;it  work  out  oi  town  where  are  dinners  obtained 
Has  the  person  risited  any  one  sick  with  fevei 


896  APPENDICES. 

NO.   56. 

SlZE    8    IX.     X     11    IX. 

Mobile,  Ala., 187 

Dr.  T.  S.  Scales,  Health  Officer. 

Dear  Sir  :     I  most  respectfully  report  a  case  of  Yellow  Fever  in  the  person  of 

Sex.  ;     Color,  ;    Age,  ; 

Street 

Contracted  when. 

Contracted  where 


remarks. 


Very  Respectfully, 

M.  D., 

Attending  Physician. 

Office  of  the  Board  of  Health, 

Mobile,  Ala.,  Sept.  20th,  1878. 
Dear  Doctor:     Please  All  out  a  blank  similiar  to  the  above  for  each  case  that 
you  may  meet  with,   and  return  them  to  this  office  by  12  m.  of  each  day.     Please 
give  all  the  history  known  to  you  of  each  case  under  the  head  of  Remarks. 

Yours  Very  Respectfully, 

T.  S.  SCALES,  M.  D.,  Health  Officer. 


NO.  57. 

Size  5  ix.  x  8  in. 
REPORT    OF     OUTBREAK    OF    A    COMMUNICABLE    DISEASE. 

To  be  mailed  to  the  Secretary  of  the  State  Board  of    Health,  Concord,  N".  H., 
immediately  on  the  occurrence  of   a  first  case  of  cholera,  smallpox,  typhus  fever, 
yellow  fever,    diphtheria,    membranous   croup,    scarlet   fever,   typhoid   fever,   and 
measles. 
To  the  Secretary  of  the  State  Board  of  Health  : 

Sir  : — There  has  come  to  my  knowledge  a  case  of 

(Name  of  disease.) 


(Town,  city  or  village.) 

The  hrst  person  sick  is 

a , about old,  who  was  taken  sick  with 

(Male  or  female.)  (Age.) 

this  disease  on  the day  of ,189  .     The 

(Month.) 

number  of  cases  which  have  already  occurred  is 

The  danger  of  the  spreading  of  the  disease  is 

(Great,  not  great,  etc.) 
for  the  reason  that 

Precautionary  measures 

(Will  be  taken,  have  been  taken,  or  are  suggested  to  the 

as  follows, 

state  Board  of  Health,  as  the  case  may  be.) 


Signature, 


(Whether  Health  Officer,  or  Secretary  of  Local  Board  ofHealth.) 

189  .. 

(Postoffice  Address.)  (Date.) 

Please  fill  the  blank  spaces  in  this  notice  if  possible,  but  having  learned  the 
name  of  the  disease,  do  not  delay  sending  the  report  in  order  to  learn  other  facts 
provided  for  in  this  blank. — Sec.  State  Board  of  Health. 


APPENDICES. 


897 


NO.   58. 

Size  :>',   in.   x  8i   in. 
THE    STATE    OF    NEW     HAMPSHIRE, 


Weekly  Report  During  the  Prevalence  of  a  Communicable  Disease.* 


'/'.«  the  Secretary  of  the  State  Board  of  Health,  Concord,   N.   II.: 

Sir:-  The  following  is  a  report  of  all  known  cases  of  the  diseases  named  below, 

in ,  X.  II.,  during  and  at  the 

if  the  week  ending  Saturday 189 

,  (Date.) 


X  mkes  of  Diseases.  1 

Number       In  ring   ihi:  Week,  Ni  mbek. 
of  sick 

Number  sick 

at  Close  lit' 
week. 

Number 
of 

at  last 

Report.     Taken  sick  Recovered.       Died. 

infected 
bouses. 

DIPHTHERIA       

MEMBR  VXni  s  croup..  .. 

BC  LRLET  FEVER 

. 

TYPHOID  FEVER          

Mi:  \^i  i ■•>                 



What  action  lias  your  Hoard  taken'.' 


-  Signature, 

(Health  officer  or  secretary  Local  Board  of  Health. 


PobI  office  \  ■  i  •  1 1  ■  — . 


1 1. ite  of  making  this  Report.) 


■  The  i  lea  i iii  officer  or  secretary  "i  each  local  board  ol  health  in  New  Hampshire  is  respectfullj 
requested  i"  forward  a  report  on  this  blank  in  the  State  Board  "i  Health,  Concord,  V  n..  promptlv 
alter  the  close  ol  each  week,  during  any  portion  "t   which  a  caseol   the  diseases  named  in  thft 

report  has  been  present  within  the  jurisdici "i  In-  board. 

\,iii  to  iiii-  n-i  the  names  "i  such  diseases  a-  smallpox,  cholera,  yellow  fever,  typhus  fi 
etc..  » benevei  it sure. 

ii  this  i-  tin-  lasl  blank  (F 3  that  you  have,  make  a  cross  against  this  sentence  and  more 

U  ill    lie  -enl    Mill. 


898 


APPENDICES. 


NO.  59. 

Size  9  in.  x  18  in. 


SMALLPOX. 

A  Contagious  and  Infectious  Disease. 

All  persons  are  forbidden  to  go  into  or  out  of  these  premises,  or  to  carry  into 
or  out  of  them  any  material  whereby  Small-Pox  may  be  conveyed  except  by 
permission  of  the  Board  of  Health,  under  penalty  of  not  less  than  rive  dollars 
($5.00)  nor  more  than  twenty-five  dollars  ($25.00)  for  any  violation  of  this  order. 

The  Burgess  or  Health  Officer  will  give  to  all  who  ask  printed  instructions 
how  to  prevent  Small-Pox  and  all  infectious  diseases. 

Clerk  of  Council. 

Chairman  Board  of  Health  or  Sanitary  Com. 

Date 18.... 

Benjamin  Lee,  M.  D.,  Secretary  State  Board  of  Health. 


NO.  6(). 

Size  61  in.  x  9  in. 


Health  Department,  City  ok  New  York. 


DIPHTHERIA. 

All  persons  not  occupants  of  this  apartment  are  advised  of  the 
presence  of  Diphtheria  in  it,  and  are  warned  not  to  enter. 

The  person  having  Diphtheria  must  not  leave  the  apartment 
until  the  removal  of  this  notice  by  the  Health  Department. 

By  order  of  the  Board  of  Health, 

CHARLES  G.  WILSON,  President. 

Emmons  Clark,  Secretary. 

Date 


Chief  Inspector. 


APPENDICES.  899 

NO.  61. 

Size  si  in.  x  11   in. 


City  of  Seattle  —  Department  of  Sanitation. 
KEEP   OUT. 

Whereas^  There  is  a  person  affected  with  an  infections  disease  in  this  house, 
it  is  hereby  ordered  that  no  person  enter  or  leave  this  house  without  the  written 
permission  of  the  Health  officer  of  the  City  of  Seattle. 

Any  person  violating  this  order  will  he  subject  to  prosecution,  and  liable 
upon  conviction  to  a  penalty  of  line  and  imprisonment  as  provided  by  Ordinance 
No.  2406  as  amended. 

F.  S.  PALMER,  M.  I).,  Health  Officer. 


NO.  <>2. 

l'-K!>    IN    XEWAliK. 

Size  :'>'.  in.  x  .V,  in. 


Notice. 

This  house  contains  a  case  i 

f 

SCARLET    FEVER. 

When 

the 

danger 

rom  contagion  has  passed,  this 
Per 

card  will  he 
irder, 
BOARD  OF 

removed. 
HEALTH. 

Any  person  removing,  defacing  or  obscuring  this 
Liable  to  a  tine  of  Fifty  I  dollars. 

card  withou 

L  authority, 

is 

NO.  63. 

Postal    C  led. 


HEALTH     DEPARTMENT. 

l'i:o\  inisci ... 

on  account  of  contagious  disease  in  the  In. use.  the  following  named,  said  to 
be  employed  by  you,  should  not  be  permitted  i"  return  i"  work  without  a  permit 
from  t  he  Medical  I  nspector: 

i  i  ..  i  m    P.   K  is...  M<  dical  Inapt  ctor. 


900  A  PP END  ICES. 

NO.  64. 

Size  3  in.   x  5|  in.} 


BOARD  OF  HEALTH. 

Ref.  No. 
PASS 
To  Quarantine  Inspector,  and  others  whom  it  may  concern: 

This  is  to  Certify,  That 

has  permission  to  leave  and  enter  the  premises  No 

now  under  quarantine  for 


The  isolation  of  the  patient  in  a  remote  part  of  the  house,  and  the  non-inter- 
course of  the  person  to  whom  this  pass  is  granted  witli  the  patient,  or  those  in 
attendance  upon  the  same,  is  the  basis  upon  which  this  privilege  is  granted. 

Any  violation  of  the  above  conditions  will  operate  as  a  forfeiture  of  this  Pass. 

M.  D. , 

Health  Officer. 

Detroit, 189  •  • 

Incase  of  any  difficulty  show  this  pass  to  the  Quarantine  Inspector. 


NO.  65. 

Size  3-i-  in.  x  5 -J-  in. 
BUSINESS    PERMIT. 


Health  Department,   City  Hall, 
Providence. 


residence  

is  hereby  given  permission  to  attend  business. 


Medical  Inspector, 


NO.  66. 

Size  Si  in.  x  51  in.     (Yellow  Paper.) 
BUSINESS    PERMIT. 


Health  Department,  City  Hall, 
Providence. 


residence 

is  hereby  given  permission  to  attend  business  while  he  lives  away  from  home. 

Medical  Inspector, 


NO.  67. 

Size  5+  in.  x  8  in. 

Pro 
BOARD  OF  HEALTH. 


Detroit,  Mich.,  189 

Reference  No 

Permission  is  herewith  given ■■ 

to  continue  work,  provided  that  remains  perfectly  isolated 

from  the patient 

at 

and  lias  no  contact  with  any  one  attendant  upon  the  same,  until  the  above  house 
has  been  disinfected  and  placard  removed  by  an  officer  of  this  department. 

Per 

Any  violation  of  the  terms  of  the  above  agreement,  will  result  in  a  forfeiture 
of  the  privilege  granted. 


APPENDICES.  901 

NO.*  08. 

Size  :ii  ix.  x  .VI  ix.     (Yellow  Papeb.) 
SCHOOL  PERMIT. 


HEALTH     DEPABTMENT,    CITY    HALL, 

Providence. 


residence  

is  hereby  given  permission  to  attend  school  while     he  lives  away  from  home. 

M.  dical  Inspector. 
NO.  (>9. 

S  I  /.  I       4     l  .V  .    X    I  i  '.     IN. 


Office  of  the  IJoAlU)  <)F  HEALTH. 


Minneapolis,  Minn., 189 

This  is  to  Certify,  That  the  children  of- 


living  at  No St.  A.ve.  X.  E. 


an-  hereby  permitted  to  return  to  school,  all  the  rules  and  regulations  of  the  said 
board  pertaining  to  the  public  health  in  which  the  above  family  was  interested, 
having  heen  complied  with. 

Commissioner  of  Health. 

Per Clerk. 


NO.   70. 

Size  B{  in.  \  5  \  in. 
scilool.    PERMIT. 


UK  a  I   ill     DEP  \  RTMENT,    city     II  \  I.I.. 

Providence. 


residence 

is  hereby  given  permission  to  attend  scl 1. 


Mi  dical  Tnspi  <\,,,-. 


NO.  71. 

Si  xi    •".     in.  \  8  IN. 
OFFICE    <>K   THE 

HEALTH   DEP  \  i;tm  i-.vi  . 
\...  19  Oily  Hall. 


Rochester,  V  Y..  L89 

To  the  Principal  of  Scl I  No. 

I   do  herebj    <  lerl  if)    thai    the  Children  of 

M 

,,,     \,,  Street,    ill    whose    familj  eases 

0j  have  recentlj  existed,  are 

in  a  safe  condition  to  attend  school,  there  being  no  further  danger  of  contagion  or 

infection.  i  Signed) 

M.  I>. 

\ pproi eii  i.\  i he  Boabd  oi   Health. 

//.„///,    <  >tlir,r. 


902  APPENDICES. 

NO.    12. 

Pennsylvania  Laws,  Chapteb  124  of  1895. 

Section  4.  In  the  care  and  burial  of  the  bodies  of  persons  who  have  died  of 
cholera,  small-pox,  yellow  fever,  typhus  fever,  scarlet  fever,  relapsing  fever,  diph- 
theria, diphtheritic  croup,  membranous  croup,  or  leprosy,  in  any  of  the  municipal- 
ities of  this  commonwealth,  it  shall  be  the  duty  of  the  undertaker  or  other  person 
or  persons  having  the  body  in  charge,  to  thoroughly  disinfect  and  place  every  such 
body  within  the  coffin  or  casket  in  which  it  is  to  be  buried  within  six  hours  after 
first  being  called  upon  to  take  charge  of  the  same  :  Provided,  Said  call  is  made 
between  the  hours  of  five  ante  meridiem  and  eleven  'post  meridiem  ;  otherwise  such 
body  shall  be  placed  in  such  coffin  or  casket  within  twelve  hours,  the  coffin  or 
casket  then  to  be  closed  tightly,  and  not  again  opened,  unless  permission  be  granted 
by  the  health  authorities  for  special  and  satisfactory  cause  shown  :  Provided,  That 
the  health  authorities  in  any  municipality  may  adopt  more  stringent  rules  and  regu- 
lations than  are  herein  provided  for  the  disinfection,  preparation,  and  burial  of  the 
bodies  of  persons  who  have  died  of  any  of  the  diseases  named  in  this  section,  which 
rules  and  regulations  they  may  from  time  to  time  alter  or  amend. 

Section  5.  The  body  of  a  person  who  has  died  of  any  of  the  diseases  mentioned 
in  section  four  of  this  act,  shall  not  remain  unburied  for  a  longer  period  of  time 
than  thirty-six  hours  after  death,  unless  special  permission  be  granted  by  the  health 
authorities  extending  the  time  during  which  said  body  may  remain  unburied  for 
special  and  satisfactory  cause  shown.  The  head  of  the  family  and  the  person  or 
persons  having  charge  of  the  funeral  of  such  body  shall  be  responsible  for  any  vio- 
lation of  the  provisions  of  this  section. 

Section  6.  All  services  held  in  connection  with  the  funeral  of  the  body  of  a 
person  who  has  died  of  any  of  the  diseases  mentioned  in  section  four  of  this  act 
must  be  private,  and  the  attendance  thereat  shall  include  only  the  immediate  adult 
relatives  of  the  deceased  and  the  necessary  number  of  adult  pall-bearers,  and  any 
advertisement  of  such  funeral  shall  state  the  cause  of  death.  The  head  of  the 
family  and  the  person  or  persons  having  charge  of  said  funeral  services  shall  be 
responsible  for  any  violation  of  the  provisions  of  this  section. 

Section  7.  The  body  of  a  person  who  has  died  of  any  of  the  diseases  mentioned 
in  section  four  of  this  act,  shall  in  no  instance  be  taken  into  any  church,  chapel, 
public  hall  or  public  building  for  the  holding  of  funeral  services.  The  head  of  the 
family,  and  the  person  or  persons  having  charge  of  said  funeral  services,  and  the 
sexton,  janitor,  or  other  person  or  persons  having  charge  or  control  of  such  church, 
chapel,  public  hall  or  public  building,  shall  be  responsible  for  any  violation  of  the 
provisions  of  this  section. 

Section  8.  No  undertaker,  or  other  person  or  persons  having  charge  of  the 
funeral  or  burial  of  the  body  of  a  person  who  has  died  of  any  of  the  diseases  men- 
tioned in  section  four  of  this  act,  shall  in  any  case  furnish  or  provide  for  such 
funeral  more  than  the  necessary  number  of  conveyances  for  said  adult  relatives  and 
pall-bearers,  and  all  such  conveyances  which  may  have  been  used  or  occupied  by 
any  person  or  persons  who  have  been  residing  in  the  same  family  or  house  with  the 
deceased,  shall  be  fumigated  and  disinfected  at  such  time  and  in  such  manner  as 
may  be  directed  and  required  by  the  health  authorities. 

Section  9.  The  body  of  a  person  who  has  died  of  any  of  the  diseases  mentioned 
in  section  four  of  this  act,  shall  not  be  conveyed  to  or  from  any  dwelling,  or  other 
building  or  place,  to  any  cemetery  or  other  point  except  in  a  hearse  or  other  vehicle 
used  for  the  purpose  of  conveying  corpses  only,  or  in  such  vehicle  as  shall  be  satis- 
factory to  the  health  authorities,  and  under  such  regulations  as  they  may  in  any 
case  adopt.  The  undertaker  and  the  person  or  persons  having  charge  of  the  funeral 
or  transportation  of  such  body,  shall  be  responsible  for  any  violation  of  the  pro- 
visions of  this  section. 


APPENDICES.  003 

NO.  7.J. 

Kile  1.  The  transportation  of  bodies  dead  of  Small-pox,  Asiatic  Cholera, 
Yellow  Fever.  Typhus  Fever  or  Bubonic  Plague  is  absolutely  forbidden. 

RvLE  2.  The  bodies  of  those  who  have  died  of  Diphtheria  (Membranous 
Croup),  Scarlet  Fever  (Scarlatina,  Scarlet  Rash),  Glanders,  Anthrax  or  Leprosy, 
shall  not  be  accepted  for  transportation  unless  prepared  for  shipment  by  being 
thoroughly  disinfected  by  arterial  and  cavity  injection  with  a  proved  disinfectant 
fluid  (b)  disinfecting  and  stopping  of  all  oriftcies  with  absorbent  cotton,  and  (c)  wash- 
ing the  body  with  disinfectant,  all  of  which  must  be  done  by  anembalnier  holding  a 
certificate  as  such  approved  by  the  State  Board  of  Health.  After  being  disinfected 
as  above,  such  body  shall  be  enveloped  in  a  layer  of  cotton  not  less  than  one  inch 
thick,  completely  wrapped  in  a  sheet  and  bandaged,  and  encased  in  an  air-tight 
zinc,  tin,  copper,  or  lead  lined  coffin,  of  iron  casket,  all  joints  and  seams  hermeti- 
cally soldered,  and  all  enclosed  in  a  strong,  tight  wooden  box.  Or,  the  body  being 
prepared  for  shipment  by  disinfecting  and  wrapping  as  above,  may  be  placed  in  a 
stron»'  coffin  or  casket,  and  said  coffin  or  casket  encased  in  an  air-tight  zinc,  copper. 
or  tin  case,  all  joints  and  seams  hermetically  soldered,  and  all  enclosed  in  a  strong 
outside  wooden  box. 

Ki  ii  3.  The  bodies  of  those  dead  from  Typhoid  Fever,  Puerperal  Fever,  Ery- 
sipelas, Tuberculosis,  Measles,  or  other  dangerous  communicable  diseases,  other 
than  those  specified  in  rules  l  and  2,  may  be  received  for  transportation  when  pre- 
pared for  shipment  by  filling  cavities  with  an  improved  disinfectant,  washing  the 
exterior  of  the  body  with  the  same,  stopping  all  orifices  with  absorbent  cotton  and 
enveloping  the  entire  body  with  a  layer  of  cotton  not  less  than  one  inch  thick,  and 
all  wrapped  in  a  sheet  and  bandaged  and  encased  in  an  air-tight  coffin  or  casket. 
provided  that  this  shall  apply  only  to  bodies  that  can  reach  their  destination  within 
forty-eight  hours  from  time  of  death.  In  all  other  cases  such  bodies  shall  be  pre- 
pared for  transportation  in  conformity  with  rule  2.  But  when  the  body  has  been 
prepared  for  shipment  by  being  thoroughly  disinfected  by  an  embalmer  holding  a 
certificate  as  in  rule  2,  issued  by  the  State  health  authorities,  the  air-tight  sealing 
may  be  dispensed  with. 

Rule  4.  The  bodies  of  those  dead  from  diseases  that  are  not  contagious,  infec- 
tious or  communicable  max  he  received  for  transportation  when  encased  in  a  sound 
coffin  or  casket  and  enclosed  in  a  strong  outside  wooden  box,  provided  they  reach 

their  destination  within  thirty  hours  from  time  of  death.  If  the  body  cannot 
reacb  its  destination  within  thirty  hours  from  time  of  death  it  must  lie  prepared  for 
shipment  by  filling  the  cavities  witli  an  approved  disinfectant,  washing  i he  exterior 
of  i  lie  body  with  tlie  same,  stopping  all  orifices  with  absorbent  cotton  and  enveloping 
the  entire  body  with  a  layer  of  cotton  not  less  than  one  inch  i  hick,  and  all  wrapped 
in  a  bandage  and  encased  in  an  air-tight  coffin  or  casket.  But  when  the  body  has 
been  prepared  for  shipment  by  being  thoroughly  disinfected  by  an  embalmer  hold- 
ing  a  Certificate  :ts    in    rule    J.  issued    bj    the    Mate    health    authorities,  the   airtight 

Bealing  may  he  dispensed  w  it  b. 

Ri  i  i;  :,.  [n  case  of  contagious,  infectious  or  communicable  diseases  the  body 
must  not  be  accompanied  by  persons  or  articles  which  have  been  exposed  to  the 
infection  of  the  deceased,  unless  certified  by  the  health  officer  as  having  been 
properly  disinfected;  and  before  Belling  passage  tickets  agents  shall  carefully 
examine  the  transit  permit  and  note  the  name  of  the  passenger  in  charge,  and  of 
anj  others  proposing  to  accompany  the'  body,  and  see  that  all  necessary  precautions 
have  been  taken  to  prevent  the  .spread  of  the  disease.    The  transit   permit   in  such 

cases    shall    Specifically     slate    who    is    authorized    by      the     health     authorities     to 

accompany  the  remains.  In  all  cases  where  bodies  are  forwarded  under  rule  •! 
notice  must  he  sent  bj  telegraph  to  the  health  officer  at  destination,  advising  the 
date  and  train  on  which  the  bodj   maj   be  expected.    This  notice  must  be  sent  by 


904  APPENDICES. 

or  in  the  name  of  the  officer  at  the  initial  point,  and  to  enable  the  health  officer  at 
destination  to  take  all  necessary  precautions  at  that  point. 

Kile  6.  Every  dead  body  must  be  accompanied  by  a  person  in  charge,  who 
must  be  provided  with  a  passage  ticket  and  also  present  a  full  first-class  ticket 
marked  "corpse11  for  the  transportation  of  the  body,  and  a  transit  permit  showing 
the  physician's  or  coroner's  certificate,  name  of  deceased,  date  and  hour  of  death, 
age,  place  of  death,  cause  of  death,  and,  if  of  a  contagious,  infectious  or  communi- 
cable nature,  the  point  to  which  the  body  is  to  be  shipped,  and  when  death  is  caused 
by  any  of  the  diseases  specified  in  rule  No.  2,  the  name  of  those  authorized  by  the 
health  authorities  to  accompany  the  body.  The  transit  permit  must  be  made  in 
duplicate,  and  the  signatures  of  the  physician  or  coroner,  health  officer  and  under- 
taker must  be  on  the  original  and  duplicate  copies.  The  undertaker's  certificate 
and  paster  of  the  original  shall  be  detached  from  the  transit  permit  and  pasted  on 
the  coffin  box.  The  physician's  certificate  and  transit  permit  shall  be  handed  to 
the  passenger.  The  whole  duplicate  copy  shall  be  sent  to  the  official  in  charge  of 
the  baggage  department  of  the  initial  line,  and  by  him  to  the  Secretary  of  the  State,  or 
Provincial  Board  of  Health  of  the  State  or  Province  from  which  said  shipment  was 
made. 

Rule  7.  When  the  dead  bodies  are  shipped  by  express  the  whole  original  tran- 
sit permit  shall  be  placed  upon  the  outside  of  the  box  and  the  duplicate  forwarded 
by  the  express  agent  to  the  express  agent  and  secretary  of  the  State  or  Provincial 
Board  of  Health  of  the  State  or  Province  from  which  said  shipment  was  made. 

Rule  8.  Every  disinterred  body  dead  from  any  disease  or  cause  shall  be  treated 
as  infectious  or  dangerous  to  the  public  health,  and  must  not  be  accepted  for  trans- 
portation unless  said  removal  has  been  approved  by  the  State  or  Provincial  Health. 
Authorities  having  jurisdiction  where  such  body  is  to  be  disinterred,  and  the  consent 
of  the  health  authorities  of  the  locality  to  which  the  body  is  consigned  has  first 
been  obtained;  and  all  such  disinterred  remains  must  be  enclosed  in  a  hermetically 
sealed  (soldered),  zinc,  tin  or  copper  lined  coffin  or  box. 


NO.   74. 

FOR     THE 

Notification  of  Persons   Haying  Charge 

of 

CONTAGIOUS  DISEASE. 


1.  The  patient  must  be  kept  in  a  room  by  himself. 

2.  All  children  in  the  house  must  be  kept  from  school. 

3.  No  visitors  should  be  admitted. 

4.  Other  members  of  the  family  must  be  kept  away  from  the  patient. 

5.  The  one  who  nurses  the  patient  must  keep  away  from  other  people. 

6.  It  is  best  to  have  some  disinfectant  always  in  the  vessel  in  which  discharges 
are  received.  In  case  of  diphtheria  or  scarlet  fever,  all  discharges  from  mouth  and 
nose  should  be  received  in  old  cloths  which  can  be  burned.  If  received  into  a  mug 
or  dish,  these.should  be  thoroughly  scalded. 

7.  In  the  room  where  patient  is,  the  carpets  should  be  taken  up,  all  stuff, 
hangings,  rugs,  mats  and  chairs  having  stuff  covers  taken  out,  and  the  attendant 
should  wear  calico  dresses. 

8.  Upon  recovery  of  the  patient,  notice  should  be  sent  to  the  Office  of  the  Health 
Board,  City  Building. 

9.  In  case  of  death,  the  body  should  be  immediately  coffined,  the  coffin  not 
again  opened,  the  funeral  must  be  within  twenty^four  hours  after  death.  The 
funeral  must  be  strictly  "  private,11  the  body  being  carried  in  a  hearse  and  not  in  a 
carriage.  No  wake  can  be  allowed.  All  bed  clothes,  clothes  of  patient,  and  articles 
in  the  room,  must  remain  in  room  until  fumigated. 

By  order  of  the  Board. 


Health  Officer. 


APPENDICES.  905 


NO.    75. 

Health  Department  Cieci  lab 

concerning 

SCARLET  FEVER 


-  cagion.     Scarlet  Fever  is  a  contagious  disease.     It  spreads  from  one  person 

to  another.     The  contagion   is  probably  present  front  the  lirst  days  of   the  disease  . 
until    about    live    wirk.v   from  that    time.      Person-,   exposed    to  the  disease  do   not 
always  catch    it.  but   we  do   not   know  any  way  of  telling   whether  a   person   is  sus- 
ceptible or  not.     Therefore  the  patient  should   he  isolated;  that   is.  separated  as 
much  as  possible  from  all  well  people. 

ISOLATION.  When  a  room  is  <  hosen  for  isolation,  lirst.  all  useless  articles  should 
he  removed,  since  everything  in  the  room  is  liable  to  become  infected  with  the 
disease.     Then  keep  the  patient   in  the  one  room  until  complete  recovery.     Nio  one 

but   the   physician,  nurse  or  mother  should  be  allowed   in  the  1 i.     No  articles 

should  be  taken  from  tin-  room  until  they  have  been  disinfected. 

No  visitors,  especially  children,  should  be  allowed  in  the  house. 

Soiled  linen,  sheets,  underwear,  towels,  and  similar  articles,  should  beat  once 
placed  in  a  tub  or  pail  standing  in  the  room  and  containing  a  disinfecting  solution, 
and  after  standing  awhile  should  be  thoroughly  boiled  and  washed  apart  from  the 
rest  of  the  washing.  The  Circular  on  Disinfection  shows  what  to  use  as  a  disin- 
fectant. It  is  best  not  to  use  handkerchiefs  at  all.  but  pieces  of  old.  soft  cloth 
which  should  be  burned  at  once. 

All  dishes  used  by  the  patient  should  be  put  in  a  disinfecting  solution  in  the 
To.. m.  and  scalded  and  washed  by  themselves. 

I)n  ,,,,/  lit  the  child  wear  school  clothes  while  sick,  for  they  should  not  be  worn  to 
school  until  they  have  been  disinfected.  All  school  and  library  books  must  be  given 
to  the  Superintendent  of  Health  for  disinfection. 

When  possible  it  is  a  good  plan  to  send  away  from  the  house  any  children  that 
may  not  have  been  exposed  to  the  fever.  Such  children  should  of  course  be  care- 
fully watched  for  any  symptoms  of  the  disease,  and  if  m»  such  symtoms  appear  the 

children  should  remain  away  until  after  the  removal  of  the  placards.  As  soon  as  it 
seems  certain  that  such  children  thus  living  away  are  not  likely  to  have  the  disease, 
this  Department  will  issue  to  them  a  permit  to  attend  scl 1.  if  desired. 

The  law  requires  that  under  no  circumstances  shall  the  sick  person  leavi  H"  housi 
without  "  permit  from  the  Superintendent  "I  Health. 

It  is  also  againsl  the  law  lor  other  children  in  the  family  of  the  sick  one  to 
attend  school.  Sunday  school,  of  t<.  visit  the  public  library  or  any  other  public 
place,  or  to  tide  in  the  cars,  and  they  should  not  play  in  the  street  with  other 
children. 

About  two  or  three  weeks  aftei  the  beginning  oi  the  sickness  some  of  the 
patient's  skin  usually  becomes  tike  "dead  skin,"  and  rubs  off  or  peels  off.  This 
peeling  usually  continues  longest  on  the  hands  and  feet.  Sometimes  it  is  so  slight 
that  it  is  not  noticed.  When  five  weeks  have  passed  since  the  beginning  of  the 
disease,  and  when  the  patient   is  through  u  peeling,"  it    is  proper  to  disinfect   the 

patient    and    the  rooms    in  which    he    has    been  si.k.       \ticr   satisfactory   disinfection 

the  cards  will  be  removed  from  the  house,  and  school  and  work  permits  will  be 
given  when  required. 

./'//  this  Department  when  ready/or  disinfection. 
Please   read    the    Rules  of    the    board   of   Aldermen  in    regard   to   Contagious 
I  diseases. 

All  these  precautions  must   be  taken  in  the  mildest  as  well  as  in  the  most  sev<  re 
cases. 
pi:o\  i  in  \.  i .   Februarj .  i  B99. 

An  excellent  and  much  more-  extended  cin  ular  was  issued  by  the  New  Hampshire 

board  of  health  in  It 


906  APPENDICES. 

ISO.    76. 

What  You  Ought  to  Know  About 
DIPHTHERIA. 


Diphtheria,  one  of  the  gravest  of  infectious  diseases,  is  due  to  a  bacillus  which' 
invades,  by  preference,  the  mouth,  nose  and  throat.  Of  the  many  persons  whose 
throats  and  noses  harbor  these  little  organisms  only  some  develop  diphtheria,  and 
they  are  the  ones  whose  mucous  surface  the  bacillus  is  able  to  penetrate.  Neither  age 
nor  robust  health  exempts  any  one  from  infection,  but  children,  whose  tissues  are 
less  resistant,  suffer  far  more  from  diphtheria  than  do  adults.  Any  person,  therefore, 
who  has  been  in  intimate  contact  with  a  case  of  diphtheria  may  curry  the  infect  ion 
about  with  him  and  yet  remain  well.  In  the  presence  of  an  epidemic  of  diphtheria 
every  sore  throat,  however  mild,  every  running  at  the  nose,  in  child  or  adidt,  should 
be  treated  with  the  respect  due  to  a  formidable  enemy.  Every  individual  who  has 
been  in  personal  contact  with  a  case  of  diphtheria  should  be  regarded  as  infected 
until  the  contrary  is  proved. 

But  a  man  whose  nose  is  infested  with  these  malignant  organisms,  carries  in  his 
pocket  a  thing  more  deadly.  His  handkerchief  contains  the  dried  virus  in  a  condition 
to  be  preserved  indelinitely.  It  may  go  with  his  own  or  other  people's  clothing  to 
the  unsuspecting  laundress,  or  it  may  remain  for  7nonths  in  the  pocket  of  an  unused 
coat,  to  be  fished  out  at  last  as  virulent  as  ever. 

Bearing  in  mind  these  observations  in  the  outskirts  of  an  epidemic,  if  one  reflects 
upon  the  focus  of  germs  in  the  bed  chamber  of  diphtheria,  the  view  will  be  as  alarm- 
ing as  the  truth  will  bear. 

It  remains  to  say  much  that  is  of  better  cheer.  It  is  quite  possible  to  confine  the 
evil  influence  of  a  case  of  diphtheria  to  a  radius  of  six  feet  or  so,  and  to  make  a 
nurse  within  such  narrow  bounds  reasonably  secure  against  infection.  The  poison 
of  diphtheria  is  not  easily  diffusible.  The  patient's  breath,  though  often  offensive,, 
is  not  noxious.  No  particle  of  active  virus  can  escape  from  his  body  except  in  the 
form  of  discharge  from  his  mouth  or  nose,  nor  can  any  attendant  become  infected 
unless 

Some  Ponderable  Portion  of  this  Discharge  is  Conveyed  into  Nose,  Month  or  Eyes. 
Surely  then  the  attendant  commands  all.  the  avenues.  Knowing  this  much  she  will 
easily  avoid  direct  transfer  of  the  infection  from  the  patient  to  herself.  To  guard 
against  indirect  transfer  by  means  of  handkerchief,  towel,  cup,  spoon,  or  worst  of  all, 
fingers,  is  not  so  easy.  Only  unrelaxed  vigilance,  and  a  devout  observance  of  details 
will  serve  this  end. 

If  then  a  case  of  diphtheria  occurs  in  your  house,  do  these  things  religiously. 
Strip  the  sunniest  room,  at  the  top  of  the  house,  of  its  carpets,  curtains,  upholstery, 
chairs,  pictures,  ornaments,  trunks.  Empty  closets  and  drawers.  As  far  as  possible 
send  out  everything  and  bring  in  nothing  which  cannot  be  baked,  boiled  or  burned* 
If  you  have  a  cheap  cot  which  can  be  made  comfortable  with  a  quilt  or  two,  you 
have  the  best  possible  bed.  In  addition  to  the  necessary  queensware,  you  want  a 
pail  or  two  to  hold  antiseptic  solutions.  You  must  have  a  little  pile  of  towels  for 
your  own  exclusive  use,  and  a  large  assortment  of  cloths,  mostly  small  ones,  to 
serve  the  patient  in  place  of  towels,  napkins  and  handkerchiefs.  Now  bring  your 
patient  in  and  from  this  moment  you  must  not  permit  either  yourself  or  anything  in 
the  room  to  pass  the  door  without  first  going  through  the  most  rigid  antisepticuritual 
that  you  can  conveniently  practice.  The  little  cloths  which  the  patient  uses  must 
do  but  one  single  service,  and  then  either  be  burned  or  dropped  into  a  pail  of 
bichloride  solution. 

Every  sjioon,  cup,  thermometer  or  other  article  must,  after  use,  be  immediately 
immersed  in  an  antiseptic  solution,  and  left  there  until  needed  again,  when  it  must 
be  rinsed  in  clear  water. 


APPENDICES.  907 

The  expectorated  or  vomited  matters  and  the  discharges  from  the  bowels  and 
bladder  must  be  treated  with  antiseptic  solution  at  once,  and  before  being  carried 
from  the  room  the  utensil  should  be  wrapped  in  a  cloth  wet  with  bichloridi  solution. 

four  own  hands  and  tliose  of  your  patient  are  to  be  objects  of  momentary  solic- 
itude. Keep  a  bowl  of  bichloride  solution  always  ready,  and  wash  your  hands  every 
time  you  touch  your  patient  or  Ins  bed.  Never  touch  your  own  face,  nor  that  of 
your  patient,  nor  move  a  chair,  nor  fetch  a  utensil,  nor  turn  the  door  knob, 

Except   with   Hands  Fresh  from  the  Bichloride  Solution. 

Prevent,  if  possible,  your  patient  from  touching  his  own  fare,  and  if  lie  does  so. 
clean  his  hands  instantly  with  a  bichloride  cloth.  You  will  certainly  not  permit  the 
patient  to  touch  your  face.  When  you  must  leave  the  room  do  not  touch  any  person 
or  thing  that  can  be  passed  without  contact. 

II7;<,,  tin  doctor  comes,  take  away  from  the  bed  the  chair  which  you  have  used, 
ami  place  for  him  the  only  other  one,  which  you  have  not  used,  and  must  not  use. 
Give  him  a  bichloride  towel  if  he  wants  one,  and  hold  a  bowl  of  bichloride  solution 
for  him  to  drop  instruments  into.  Let  him  have  bichloride  for  his  hands,  a  nail 
brush  and  a  fresh  towel.  When  he  is  ready  to  leave,  open  the  door  for  him,  and  let 
him  <j"  away  as  clean  as  In-  came. 

I,,  your  ""■/'  person  and  dress  be  as  clean  as  circumstances  will  permit.  However 
careful  you  habitually  are. 

Double  Your  Customary  Care  of  Teeth,  Throat,  Month  and  Nose. 
If  after  two  weeks  another  case  of  diphtheria  appears  in  your  household,  it  may  he 
impossible  to  say  who  or  what  furnished  the  infection,  but  if  you  have  faithfully 
followed  these  rules  yon  will  have  the  comfortabli  belief  that  none  of  the  poison 
which  you  carried  into  the  room  ever  leaked  out.  On  the  other  hand  if  you  slurred 
the  details,  and  took  avoidable  chances,  you  will  not  be  able  to  meet  a  fresh  case 
without  some  guilty  fear  that  you  have  let  the  enemy  through. 

John  s.  Fulton, 
Secretary  <;/'  //"  State  />'<<<o</  <>f  Health  <>/  Maryland. 

Tablets  of  Bichloride  of  Mercury  can  be  bought  at  any  drug  store  in  bottles  of 
100  with  printed  directions  for  making  solutions. 


NO.  77. 

MEASLES. 


BOABD   ok    111:  A  1  mi. 

:;•_'   Pkmhkkton   SQl   \kk, 

Boston,  June  L,  1888. 

The  Heard  of  Health  issues  the  following  circular  of  recommendations,  witli  the 
hope  'hat  those  who  are  not  familiar  with  the  proper  means  to  lie  used  in  cases  oi" 
Measles  to  present  the  spread  of  the  disease.  nun  he  benefited  thereby. 

This  disease  is  like  Small-poi  and  Scarlet  Fejer  in  its  power  to  spread  from  per- 
son to  person  by  contagion  or  infection. 

it  may  be  contracted  directly  fr the  person  who  is  ill  with  the  disease,  or  i< 

may  be  taken  from  the  room,  olothing   or  anything    that    ha,  been  used  l»y  or  aboul 

the  si.k  person,  and  which  has  not  been  thoroughly  disinfei  ted. 

It  attacks  persons  o!  all  Bgflfl  ami  at  all  seasons  of  the  year. 

It  manifests  itself  in  aboul  a  week  after  exposure  to  the  disease,  and,  as  a  ml.', 

occurs  hut   once  ill  t  he  same   person. 

When  a  case  oi  Measles  occurs,  put  the  patienl   in  a   room  apaii   from  the  other 

inmates  of  the  house  and  allow  no  person  to  enter  such  room,  excepi  the  nurse  and 


908  APPENDICES. 

physician.  Have  the  sick  chamber  properly  warmed,  exposed  to  the  sunlight,  well 
aired  and  relieved  of  all  unnecessary  furniture  and  other  articles  which  cannot  be 
cleansed  without  injury. 

All  clothing  removed  from  the  patient,  or  the  bed,  should  be  at  once  placed  in 
boiling  water,  or  in  a  tub  of  disinfecting  fluid, — 3  pounds  of  sulphate  of  zinc  and 
1|  pounds  of  common  salt  to  each  10  gallons  of  water.  Water-closets  and  privies  in 
the  house  should  be  disinfected  frequently  with  a  solution  of  copperas, — two  pounds 
to  a  gallon  of  water.  Every  kind  of  filth  in  or  about  the  house  should  be  removed 
and  disinfectants  freely  used. 

Children  in  the  family  should  not  attend  school,  or  mingle  with  other  children, 
until  the  patient  has  wholly  recovered,  and  all  infected  articles  have  been  disinfected. 

On  the  recovery  or  death  of  the  patient,  the  most  thorough  disinfection  should 
follow.  ■  The  room  and  all  articles  in  it  should  be  at  once  subjected  to  the  fumes  of 
burning  sulphur  as  follows:  Close  the  room  tightly,  and  burn  two  pounds  of  sul- 
phur to  each  thousand  cubic  feet  of  space. 

After  four  or  six  hours  open  the  room  and  expose  it  to  free  currents  of  air. 

Anything  that  can  be  boiled  without  injury  may  be  so  treated.  The  walls  and 
ceilings  should  be  dry  rubbed  or  lime  washed,  and  the  floors  washed  with  some 
disinfecting  liquid.  When  death  occurs  the  body  should  be  immediately  placed  in 
a  tight  coffin,  with  disinfectants,  and  the  coffin  tightly  and  finally  closed. 

Xo  public  funeral  should  ever  take  place  at  the  house  where  the  patient  died, 
untir  the  coffin  has  been  tightly  sealed,  and  the  most  thorough  disinfection  has 
taken  place. 

Nurses  ought  to  be  particularly  careful  to  remove  all  infection  from  themselves 
and  their  clothing  before  leaving  the  house. 

Note. — The  fumigation  by  sulphur  will  be  done  by  the  Board  of  Health,  if 
desired,  free  of  expense. 

By  order  of  the  Board  of  Health, 

SAMUEL    II.  DURGIX,  M.  U., 

Chairman. 


NO.   78. 

Restriction  and  Prevention 

OF 

WHOOPING-COUGH. 


Document  Issued  by  the  Michigan  State  Board  of  Health. 

May,  1899. 


1.  Whooping-Cough  is  a  Dangerous,  Contagious  Disease,  hence  it  is  a  "disease 
dangerous  to  the  public  health"  under  the  laws  in  Michigan,  and  the  observance  of 
the  following  precautions  is  of  importance. 

2.  Inasmuch  as  whooping-cough  is  one  of  the  most  contagious  diseases  and 
when  uninfluenced  by  treatment  runs  a  course  of  from  two  to  three  months,  an 
average  of  ten  weeks,  and  is  spread  by  those  sick  with  it  before  the  "whoop?1 
appears,  therefore,  in  order  that  its  restriction  shall  be  most  complete,  it  is  import- 
ant that  the  early  symptoms  be  generally  known.  The  first  or  catarrhal  stage 
resembles  an  ordinary  cold.  The  symptoms  are  a  cough,  usually  rather  severe  with 
a  tendency  to  become  paroxysmal,  sneezing,  sometimes  watering  of  the  eyes,  and 
often  a  slight  fever.  Restlessness,  with  a  loss  of  appetite,  and  increased  thirst, 
usually  accompany  these  symptoms.     It  is  often  necessary  to  wait  for  the  second 


APPENDICES.  909 

stage,  which   is  characterized  by  the   "whoop'1   before  the  disease  can  be  distin- 
guished.    When  a  child  or  young  person  lias  symptoms  of  whooping-cough,  or  a 
cold  or  cough  unusually  severe  with  a  tendency  to  become  paroxysmal.it  should 
immediately  be  kept  separated  from  all  other  persons,  except  necessary  attendants 
until   it    is  ascertained  whether  or  not  it  has  whooping-cough,  or  some  other  coin 
municable  disease. 

3.  Period  of  Incubation. —  The  interval  between  the  date  of  infection  and  that 
of  the  outbreak  of  symptoms  of  whooping-cough  usually  varies  between  four  and 
twenty-one  days. 

4.  Every  person  known  to  be  sick  with  whooping-cough  should  be  promptly  and 
thoroughly  isolated  from  the  public;  uo  more  persons  than  are  actually  necessary 
should  have  charge  of  or  visit  the  patient,  and  they  should  be  restricted  in  their 
intercourse  with  other  persons. 

•">.  Plain  and  distinct  notices  should  be  placed  upon  the  premises  or  housi  in  which 
tht  re  is  a  person  sick  with  whooping-cough. 

6.  Householders  and  Physicians  must  immediately  give  notice  of  the  first  case 
and  of  every  cass  of  whooping-cough  to  the  local  health  officer.  This  is  required 
by  law. 

DUTIES   OF   THE    LOCAL    BOARD   OF    HEALTH. 

7.  Upon  the  receipt  of  notice  of  the  occurrence  of  whooping-cough,  the  health 

officers  and  the  Hoard  of  Health  have  duties  to  perform  in  taking  measures  to 
restrict  the  spread  of  the  disease,  which  it  is  a  violation  of  public  trust  for  such 
officers  to  neglect  or  postpone.  That  no  time  may  lie  lost,  it  is  the  duty  of  every 
hoard  of  health  to  make  provisions  for  prompt  action  by  its  health  officer,  author- 
izing and  directing  him  to  he  prepared  at  all  times,  as  executive  officer  of  the  hoard, 
to  take  action  without  waiting  for  a  meeting  of  the  hoard,  whenever  a  case  of  diph- 
theria, scarlel  fever,  measles,  whooping-cough,  small-pox,  <//•  other  disease  dangt  rous 
to  the  public  health  occurs  within  its  jurisdiction.  The  duties  of  the  local  hoard  of 
health  relative  to  the  restriction  and  prevention  of  diseases  are  treated  of  in  a  cir- 
cular No.  [120]  issued  by  the  Male  Hoard  of  Health. 

Li  TIE8    OF   THE    Hi:  A  I. ill    l  IF]  tCI  B. 

Some  of  the  duties  of  the  health  officer  generally  required  by  law,  may  be  briefly 

suggested  as  follows:  Whenever  he  has  reason  to  believe  that  there  is  in  his  juris- 
diction a  case  of  whooping-cough,  he  should, — 

a.     I'd »ni pt  Is  investigate  the  subject. 

ii.  Order  the  prompt  and  thorough  isolation  of  those  sick  or  infected  with 
whooping-cough. 

c.     See  that  no  person  suffers  foi  lack  of  nurses  or  supplies. 

./.  Give  public  notice  of  infected  places  bj  placard  on  the  premises,  and  other- 
wise it  necessary. 

Notify  teachers  or  superintendents  ol   schools  concerning   families  in  which 

there  are  cases  of  whOoping-COUgh. 

/'.     Supervise  funerals  of  persons  dead  from  whooping  cough. 

!/.     Disinfect  i s.  clothing  and  premises,  and  all  articles  likelj  to  be  infected, 

before  allowing  them  to  he  used  by  other  persons  than  those  m  isolation. 

A.  Keep  the  |, resident  ,,i'  this  hoard  ..i'  health  and  the  secretary  oi  the  State 
Board  of  Health  constantlj  informed  respecting  everj  outbreak  "i  \\  I ping  cough. 

In  the  absence  of  regulations  made  bj  the  local  hoard  of  health,  conflicting  there- 
with, orders  by  the  health  officer  in  the  lawful  performance  of  these  duties  have  the 
force  of  regulations  by  the  hoard  of  health. 

1'nless  otherwise  ordered    bj   the  local  hoard  of    health,  these  duties  are  required 

of  the  health  officer  i>y  Act  187,  laws  of  ivv-.  Section  _  of  this  act,  as  amended  by 
\.  i  No.  34,  approved  March  28,  L889,  provides  thai 


910  APPENDICES. 

''Whoever  shall  knowingly  violate  the  provisions  of  section  one  of  this  act,  or 
the  orders  of  the  health  officer  made  in  accordance  therewith,  shall  be  deemed 
guilty  of  a  misdemeanor,  and  upon  conviction  thereof  he  shall  be  punished  by  a  fine 
not  exceeding  one  hundred  dollars,  and  the  costs  of  prosecution,  or  in  default  of 
payment  thereof,  by  imprisonment  not  exceeding  ninety  days  in  the  county  jail,  in 
the  discretion  of  the  court." 

This  penalty  seems  to  apply  to  the  health  officer,  or  to  whoever  violates  his 
orders.  The  health  officer  should  also,  in  due  time,  give  certificates  of  recovery  and 
of  freedom  from  liability  to  give  whooping-cough,  but  not  until  after  thorough  dis- 
infection following  complete  recovery. 

THE    RESTRICTION    OF    WHOOPING-COUGH. 

8.  The  room  in  which  one  sick  with  whooping-cough  is  to  be  placed  should 
previously  be  cleared  of  all  needless  clothing,  carpets,  drapery,  and  other  materials 
likely  to  harbor  the  poison  of  the  disease.  This  room  should  constantly  receive  a 
liberal  supply  of  fresh  air,  without  currents  or  drafts  directly  upon  the  patient. 

9.  The  discharges  from  the  throat,  nose,  and  mouth  are  liable  to  communicate 
the  disease,  and  should  be  received  in  vessels  containing  a  strong  disinfectant,  or  on 
soft  rags  or  pieces  of  cloth  which  should  immediately  be  burned. 

10.  Nurses1  and  attendants'  hands  should  be  washed  and  disinfected  by  chlo- 
rinated soda,  their  hair,  (and  beard  if  any),  should  receive  attention,  and  their  cloth- 
ing should  be  disinfected,  before  they  go  in  public. 

11.  Every  person  recovering  from  whooping-cough  should  be  considered  danger- 
ous. The  duration  of  infectiousness  may  be  three  weeks  before  the  "  whoop"  and 
four  or  six  weeks  after  apparent  recovery;  therefore  such  a  person  should  not  be 
permitted  to  associate  with  others,  or  to  attend  school,  church,  or  any  public 
assembly  until  in  the  judgment  of  a  careful  and  intelligent  health  officer  he  can  do 
so  without  endangering  others;  nor  until  after  all  his  clothing  has  been  thoroughly 
disinfected.  Nor  should  a  person  from  premises  in  which  there  is  or  lias  been  a  case 
of  whooping-cough,  attend  any  school,  Sunday-school,  church,  or  public  assembly, 
or  be  permitted  by  the  health  authorities  or  by  the  school  board  to  do  so,  until  after 
disinfection  of  such  premises  and  of  the  clothing  worn  by  such  person,  if  it  shall 
have  been  exposed  to  the  contagion  of  the  disease. 

12.  No  public  funeral  should  be  held  at  a  house  in  which  there  is  a  case  of 
whooping-cough,  nor  in  which  a  death  from  whooping-cough  has  recently  occurred. 
No  child  should  attend,  and  it  would  be  better  in  most  cases  that  few  adults  attend 
a  funeral  of  a  person  dead  of  whooping-cough. 

HOW    TO    AVOID    AND    PREVENT    AVHOOPING-COUGII. 

15.  Avoid  the  special  contagium  of  the  disease.  Do  not  let  a  child  go  near  a 
«ase  of  whooping-cough;  this  is  especially  important  to  be  observed  by  guardians 
of  children  between  one  and  two  years  of  age.  Do  not  permit  any  person  or  thing, 
or  a  dog,  cat,  or  other  animal  to  come  direct  from  a  case  of  whooping-cough  to  a 
child.  Unless  your  services  are  needed,  keep  away  from  the  disease  yourself.  If 
you  do  visit  a  case,  bathe  yourself,  and  change  and  disinfect  your  clothing  before 
you  go  where  there  is  a  child. 

16.  Do  not  permit  a  child  to  ride  in  a  hack  or  other  closed  carriage  in  which  has 
been  a  person  sick  with  whooping-cough,  except  the  carriage  has  since  been  thor- 
oughly disinfected  with  fumes  of  burning  sulphur,  as  specified  in  paragraph  15. 

IT.  Do  not  permit  a  child  to  wear  or  handle  clothing  worn  by  a  person  during 
sickness  or  convalescence  from  whooping-cough. 

18.  Beware  of  any  person  who  has  a  cough  with  a  tendency  to  become  paroxys- 
mal; do  not  permit  a  child  to  kiss,  or  take  the  breath  of  such  a  person,  nor  to  drink 
from  the  same  cup,  blow  the  same  whistle,  or  put  his  pencil  or  pen  in  its  mouth. 


APPENDICES.  9 1 1 

IMPORTANT  K   OF  BE8TBICTING    WHOOPING-COUGH. 

In  Glasgow  the  annual  mortality  from  whooping-cough  for  forty  years.  1855-94, 
was  nearly  fourteen  (13.5)  per  ten  thousand  inhabitants,  and  exceeded  those  from 
any  other  dangerous  communicable  disease. 

In  all  England  and  Wales  in  1891,  the  deaths  from  whooping-cough  (13,612), 
were  nearly  five  (4.68)  per  ten  thousand  inhabitants,  and  exceeded  those  from 
measles  (12,673),  diphtheria  (5,036),  scarlet  fever  (4,959)  or  typhoid  feveT  (4,875). 

In  Michigan,  the  reported  deaths  from  whooping-cough  are  several  times  as 
many  as  from  small-pox;  for  the  twenty-four  years.  1870-1893,  they  averaged  1 4-~> 
per  year.  If  we  assume  that  only  three-fourths  of  the  deaths  were  reported,  the 
deaths  in  Michigan  from  whooping-cough  have  been  about  193  per  year.  If  the  in- 
habitants of  Michigan  now  number  two  and  a  quarter  millions,  and  the  mortality 
from  whooping-cough  were  to  equal  that  in  England  and  Wales  in  1891,  the  deaths 
from  that  disease  in  Michigan  would  equal  a  little  over  one  thousand  per  year. 

It  is  claimed  that  the  high  mortality  in  whooping-cough  is  due  to  the  complica- 
tions and  sequelae  which  are  said  to  occur  probably  in  one-third  or  one-fourth  of  all 
cases.  If  that  is  true,  it  would  be  no  extravagance  to  presume  that  the  mortality 
from  whooping-cough  would  be  still  higher  if  all  the  deaths  directly  or  indirectly 
due  to  it  were  completely  reported,  as  it  is  a  fact  that  when  a  secondary  affoction 
attacks,  the  primary  disease  is  sometimes  lost  sight  of  entirely. 

According  to  Dr.  Farr's  law — of  increase  of  contagious  diseases  as  density  of 
population  increases — the  deatli  rate  from  whooping-cough,  unless  restrictive 
measures  are  taken,  will  undoubtedly  rapidly  increase  in  Michigan  with  the  rapidly 
increasing  population,  and  especially  with  the  rapidly  increasing  lines  of  railroads 
and  other  facilities  for  easy,  frequent,  and  rapid  movements  of  the  people.  The 
present  vei\  considerable  mortality  from  whooping-cough,  and  also  the  much 
greater  mortality  which  may  be  expected,  supply  urgent  reasons  why  the  measures 
herein  recommended  should  be  generally  and  thoroughly  adopted  and  enforced. 

This  document  is  published  by  the  State  Board  of  Health,  for  gratuitous  distribution  through- 
out the  State.     A  copj   may  be  obtained  by  applying  to  the  Secretary  of  rHE  State  Board  of 

ii  i:  w  i  ii.  La  sst  so,  Michigan. 


NO.  7i>. 
TYPHOID  FEVER 


II  i    \  i  in    DKPAB  imi;\  i  . 

( >ld  Court   House, 

B(  tston. 

This  circular  is  issued  for  the  purpose  of  inducing  greater  care  in  preventing  the 
spread  of  typhoid  fever,  which  may  be  contracted  by  infection,  directly  from  the 
patient,  or  indirectly  from  anything  which  h:is  been  infected  by  the  patient. 

'I  he  discharges  from  the  bowels  and  bladder  of  i  lie  typhoid  patient  are  the  princi- 
pal if  not  the  6nly  sources  of  dangerand  they  maj  infeel  the  sick  chamber,  drain, 
cesspool,  vault,  or  by  percolation,  may  infeel  the  well,  cistern  or  other  source  of 
drinking  water,  and  so  foods,  especially  milk,  fruit,  greens,  etc,  and  produce  the 

disease   ill   o|  her   pel's.. lis. 

Win  M  a  case  of  typhoid   fever  occurs  in  any  family,  the  sick  person  should  be 

placed   in  a   loom  apart   Ii<>im  the  other  inmates  of  the  house  and  should  be  nursed  as 

possible  bj  one  person  only.     The  sick  chamber  should  be  well  ventilated, 

warmed  and  exposed  to  sunlight  ;    its  furniture  should  be  such  as  w  ill  permit  cleans- 
ing without   Injury,  and  all  extra  articles  should  be  removed  from  the  r i.     All 

doubtful  cases  should  be  referred  foi   diagnosis  t"  the  laboratory   of  the  Health 

I  lepart nt. 


912  APPENDICES. 

No  person  who  is  in  any  way  connected  with  a  case  of  typhoid  fever  as  nurse  or 
attendant,  or  who  handles  anything  which  may  have  been  soiled  by  the  discharges 
of  a  person  while  suffering  from  typhoid  fever,  should  touch  any  kind  of  food  or 
water  or  receptacles  for  such  food  or  water,  which  may  be  used  by  other  people. 

Keep  on  hand  a  solution  of  the  best  fresh  chloride  of  lime  (one-half  pound  to  a 
gallon  of  water)  in  a  jug  well  corked,  and  put  one-half  pint  or  more  of  this  solution 
into  the  vessel  immediately  before  it  is  used  to  receive  the  discharges  of  the  patient. 
The  discharges  should  always  be  well  mixed  and  covered  with  the  disinfecting  solu- 
tion, anfl  remain  for  thirty  minutes  before  being  removed. 

The  same  disinfectant  should  be  freely  used  in  all  wash-bowls,  sinks,  water- 
closets  and  slop-hoppers.  Vaults  and  cesspools,  if  used,  should  receive  large 
quantities  of  dry  chloride  of  lime. 

All  clothing,  bed-linen,  etc.,  which  comes  in  contact  with  the  patients  should  be 
put  into  a  disinfecting  solution  of  corrosive  sublimate  (one  drachm  of  corrosive  sub- 
limate and  eight  drachms  of  common  salt  to  each  gallon  of  water  (1  in  1000),  in  a 
wooden  vessel  marked  poison)  and  then  boiled  for  one-half  hour. 

This  disinfecting  solution  may  be  used  on  all  hard  surfaces  not  metallic.  For 
metallic  surfaces  use  5  per  cent,  formalin.  Every  kind  and  source  of  filth  in  and 
around  the  house  should  be  removed,  disinfectants  freely  used  and  drains  put  in 
good  condition. 

On  the  termination  of  the  disease,  the  room,  bedding  and  clothing  should  be 
thoroughly  disinfected,  as  recommended  in  this  circular. 

Typhoid  patients  may  be  a  source  of  danger  to  the  community  until  their  urine 
is  free  from  typhoid  bacilli.  This  dangerous  condition  of  the  urine  may  last  several 
weeks  after  recovery,  and  during  this  time  the  urine  should  be  disinfected.  The 
presence  of  the  bacilli  in  the  urine  and  their  disappearance  later  will  be  tested,  on 
request,  at  the  laboratory  of  the  Health  Department. 

By  order  of  the  Board  of  Health, 

SAMUEL  II.  DURGIN,  M.  D., 
Revised  October,  1899.  Chairman. 


NO.  80. 

.Size  5i  ix.  x  9  ix. 


O 


ang  this  Card  hi  ///<•  sick  room. 

IX    CASES    OF 

INFECTIOUS  OR  CONTAGIOUS  DISEASES. 

Don't  allow  carpets  or  draperies  in  the  sick  room. 

Don't  send  the  bed  or  body  linen  to  the  wash  without  disinfection. 

Don't  use  dishes  again  which  have  been  in  the  sick  room  without  boiling 
them  15  minutes  in  Sal-Soda  water. 

Don't  throw  the  discharges  into  the  water  closet  or  privy. 

Don't  bury  them  until  they  have  been  thoroughly  disinfected. 

Don't  leave  the  room  or  eat,   without  first  washing  your  hands   in  a  good 
disinfecting  solution  of  Bichloride  of  Mercury  or  of  chlorinated  Soda. 
(For  further  particulars  see  Infectious  Disease  Circulars.) 


Circulars  of  information  in  regard  to  smallpox  are  not  very  necessary,  as  such 
patients  are  usually  removed  to  the  hospital.  Circulars  urging  vaccination  are 
more  useful.  Excellent  vaccination  circulars  have  been  issued  by  the  state  boards 
of  health  of  Alabama,  Maine,  and  Connecticut. 


APPENDICES.  913 

NO.    81. 

FULL  QUARANTINE  NOTICE. 

Fob  Use   in   Casks  of  Smallpox,    Typhus    Feveb,    Choleba,    Diphthebia, 

and  Sc  lblet  Feveb. 
To 

having  been  reported  to  me  as 

being-  in  your  family,  you  will  see  that  all  persons  and  things  now  on  the  premises 
or  in  the  house  occupied  by  you  are  at  once  isolated  from  all  other  persons  and 
things:  you  will  allow  no  communication  between  any  person  now  on  the  premises 
or  in  the  house  occupied  by  you,  and  any  other  person  whatever,  except  that  articles 
of  food  and  drink  and  such  fuel  and  clothing  as  are  necessary  for  the  comfort  and 
health  of  those  persons  under  quarantine,  papers  and  letters,  may  be  received,  and 
such  pails,  cans,  bottles  or  boxes  of  metal  as  are  necessary  for  the  conveyance  of 
the  above  may  be  given  out,  all  in  the  manner  and  under  the  conditions  prescribed 
by  the  Health  I  (fficer. 

And  further  exception  is  berebj  made,  so  that  all  drugs,  food  and  oilier  articles 
sary  to  the  proper  treatment  of  the  sick  maybe  received  by  you,  and  the 
attending  physician  may  enter  and  leave  your  premises  at  pleasure,  provided  such 
measures  are  used  as  to  prevent  carrying  the  infection  outside. 

No  other  person  whatever  shall  enter  or  leave  your  premises  during  the  existence 
of  this  quarantine,  except  as  permitted,  in  writing,  by  the  Health  Officer. 

You  will  carefully  observe  the  above  quarantine,  under  penalty  of  the  law.  as 
prescribed  in  No.  103,  Laws  of  189G,  until  such  time  as  the  quarantine  shall  be 
terminated  by  a  written  notice  signed  by  the  Health  <  officer. 

Health  Officer  for 

Town  (or  (  ity)  of 


MODIFIED  QUARANTINE  NOTICE. 

Fob  Use  in  Cases  of  Measles   wi>  Whooping-Cough. 

To 

...having  been  reported  as  being 
in  your  family,  you  will  see  that  no  person  now  in  your  family,  who  has  not  had 
this  disease,  is  allowed  t"  leave  the  house  or  premises  occupied  by  you.  and  that  no 
person  who  has  nol  had  this  disease  is  allowed  to  enter  your  house  or  premises  until 

further  notice,  under  penalty  of  the  law.  as  prescribed  in  No.   !"•"'.    Laws  of  1896. 


Health  i  >fficer  for 


Town  for  <   ity  I  "I 

.    189 


NO.    S>. 

Size  •">,  in.  s  8  in. 
OFFICE  OF  THE   BOARD  OF   II  E  \  I. Til. 

Hi  \  ni no.  p  \ 1895. 


Information  lias  been  received  at  this  office  thai  a  contagious  disease  < 

i  exists  in  your  house,  No Street. 

You  are  hereby  notified  uot  toallov.  any  child  or  inmate  of  your  house  to  attend 
an>  school  until  the  attending  physician  has  given  a  certificate  to  the  Health  Office 
that  all  danger  from  contagion bj  reason  ol  such  disease  lias  passe. I  away. 
■ 


914  APPENDICES. 

Extract  from  the  Rules. 
Sec.  14.  No  principal,  teacher,  or  superintendent  of  any  school,  and  no  parent 
or  guardian  of  any  child  attending  urn/  school,  shall  knowingly  permit  any  child  sick 
with  any  contagious  or  infectious  disease,  or  any  child  residing  in  any  house  in  which 
such  disease  shall  exist,  to  attend  any  school  until  this  Board  shall  have  given  its 
permit  therefor. 

Penalty  for  refusing  or  neglecting  to  comply  witli  the  Rules  of  the  Board  as  pre- 
scribed by  Act  of  Assembly,  from  $10  to  $100. 

By  order  of  the  Board  of  Health, 


Iliiillh'  (  ommissioner. 


NO.  83. 

Size  7  in.  x  9  in. 
City  of  Indianapolis. 

DEPARTMENT    OF    PUBLIC    HEALTH    AND    CHARITIES. 


Sanitary  Survey. 

No Date 189 . . 

Disease Name  of  Patient 

Street  and  No Sex Age 

Name  of  tenant Number  of  people 

Name  of  owner Agent 

Frame.     Brick.     Kind  of  foundation 

Old.     New.     State  of  repair 

Number  of  rooms Any  well  ? Dug.     Driven.     Public  supply. 

Surroundings  of  well 

Filled  ground 

Any  cellar  ?     Yes.     No.     Extent  and  condition 

Name  of  dairyman  ? Iceman 

Sinks.     Number  and  condition 

Cesspools.     Number  and  condition 

Vaults.     Number  and  condition 

Distance  of  vault  and  cesspool  from  well On  premises  or  adjacent 

Direction  of  ground  trend 

Sewer  connection  ?     Yes.     No Properly  trapped  ?     Yes.     No 

Name  of  physician 

Diphtheria,  measles,  scarlet  fever,  or  typhoid  within  a  year 

Any  deaths  '?     Yes.     No.     Cause  of  death 

Where  has  patient  been  in  last  30  days  ? 

School  attended  by  patient 

School  attended  by  any  of  family Teacher. 

Condition  of  adjacent  premises 

Place  of  business  of  patient 

Remarks 


Officer. 


APPENDICES  915 

>0.    S4. 

Size  8j  i\.  x  14  in. 
HEALTH  DEPARTMENT. 


COT    OF    ROCHESTER. 

Inspector Date 189 

Streel   No Size  (if  Lot Per  cent,  covered 

Buildings 

Owner Address 


I     Private          I                                   Rooms, 
House-        JSSSLt    ,    *"■  of  Stories 


pan 
tenement.     |  Occupants, 


Condition 


l 
Rooms  without    windows, 


Vent  ilal  i<>n 


Halls 


Light-shaft,  sky-light,  or  ventilating  shafts,  transoms: 

Heating Has  furnace  an  air  box  '.'... 

Where  does  it  open Condition 

Cellar Depth. 

How  floored No.,  size  and  condition  of  windows. . 

Drainage 

Plumbing       Is  house  connected  with  sewer  or  cess-pool 

Is  sewer  in  streel Is  Hemlock  water  used 

Number  of  fixtures Fixtures  withoui  t  raps 

Main  waste  pipe  :     Iron.    lead.     Joints 

Water  Closets      Number Kind 

Sufficient  water  flushing Condition 

Is  the  room  ventilated 


llniisc  drain      tiling   ,  underground  or  exposed. . ..  

I    wood    \ 

•loints,  etc 

Mam  oi  running  i rap  Fresh  air  inlet 

Sard 

•  ,;n bage,  li"v.    kept? 

Ashes,  how  kepi  .' 

When  removed  '.' 

Privy       <  "list  ruction 

\  ent  dated Is  il   full 

When  was   it   last  cleaned 

ited ft.  from  bousi  .ft.  from  nearest  adjoining  house 

ft.  from  \.  lii I'  lot.  ft.  from  S.  line  .ft.  from  E.  line 

ft.  from  W.  line. 


916 


APPENDICES. 


Disease Age Sex School  and  Grade 

School  and  Grade  attended  by  other  children 

Occupation  and  Place Milk Ice ... . 

Occupation  and  place  of  employment  of  every  member  (if  the  family. 


Have  there  been  any  cases  of  contagious  diseases  where  the  patient  lives  or 
where  he  has  lived '? 

Are  the  members  of  the  family  subject  to  sore  throat  or  catarrh  ? 

Has  any  one  with  sore  throat  recently  visited  the  patient '? 

What,  if  any,  means  are  provided  for  isolating  the  patient? 

How  are  the  discharges  from  the  mouth  and  nose  received  ?. 

Well  ? Disinfection  and  Disposition  of  Stools  ? 

Probable  Source  of  Disease  ? 

Health  Officer's  Notice  to  Abate  Nuisance 

Nuisance  Abated 

Referred  to  Medical  Officer 


Citation.  . .  . 

Order 

Referred  to . 


NO.    So. 


Postal    Card. 


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APPENDICES.  917 

XO.  86. 

Kkim.y    PoSTAr  Card. 

Chicago 189. 


Tiik    Principal 


Si    1 1 1  n.l.: 


Tin:  Health  Department  has  just  learned  of  the  existence  of  a  ease  of 
Diphtheria,  Measles,  Scarlet  Fever,  Whooping  Cough. 

in  the  family  of 

I i vino;  at 

in  the  vicinity  of  your  school. 

For  the  protection  of  your  pupils  you  are  hereby  authorized  to  exclude  from 
school  attendance,  and  from  the  buildings  and  grounds  under  your  charge,  all 
persons  of  said  family,  especially  school  children,it  there  be  any  such  in  the 
family. 

This  exclusion  must  be  maintained  until  you  are  notified  by  the  DEPARTMENT 
that  the  disease  has  terminated  and  that  the  premises  have  been  disinfected. 

Yon  are  also  requested  to  warn  the  pupils  of  your  School  against  any  com- 
munication or  contact  with  the  members  of  the  afflicted  family  during  the  period 
nf  exclusion. 

Respectfully M.  !>.. 

Medical   Inspector. 


School, 

Chicago 189. . 

Received  from  Dr notification 

of  a  case  i  »f 

Diphthi  8carlel  Fever,  Measles,  H  hooping  Cough, 

;i     No    in 

family  named 


Principal. 


018 


APPENDICES. 


NO.    87. 

Size  3  in.  x  .">  in. 


Feb.  Diph. 

No St.  or  Ave Ward 

Date 189 Name 

Age M.  F M.  S No.  Case Date  first  Case Kind  of  House.. . 

No.  Fams No.  Adults  ....  No.  Children No.  Sell.  Children 

Reported  by M.  D 

Isolation  —  Home. . .  Hospital Result 

Bac.  Exam True Pseudo Final  Bac.  Exam.  No 189. 

Disinfected 189 Milk  Supply 

Treatment  —  Anti-Tox City.  .Other. .  .  .Not  used. .  .  .Water  supply 

Remarks O     Quarantine  raised 

Indcrtaker Date  of  Funeral 


Mule  bv  Library  Bureau.  Chicago. 


NO.   SS. 

Size  5*  in.  x  10  in. 


Residence. 


DIPHTHERIA, 


04 

Occupation. 

Members  of  Family. 

X 

>  r. 

Age. 

Date  of      ~ 
Attack.1    iJ 

1  i 

Results  of  Cultures. 

til 

-r 
W 
to 

Residence 
Physician 

Water,  Pawt.uxet 

Iceman 

Milkman 

Grocer 

Marketman 


(REVERSE.) 


Inspector 

Visits 


Laundry 
Paper  Boy 


Disinfection 
Permits 


APPENDICES.  919 

NO.  89. 

Size  4  in.  x  '■>  in. 


CITY    OF    CLEVELAND, 

Dep't  of  Police.  Public  Hkai.tii  Division,  189 

No.  102  City  Hall. 

Mr... 

No st. 

You  are  hereby  notified  to   have  the   Physician  in  charge  of  persons   sick  with 
Contagious  disease  sign  this  notice,  when  they  have  fully  recovered,  otherwise  the 

children  cannot  attend  school  at School. 

By  order  of  the  Public  Health  Division. 


Health  Officer. 

By 

Sanitary  Patrolman. 

I  Hebeby  Cebtift,  That 

of Street,  has  fully  recovered  from 

Physician. 

Address 

Date  convalescence  commenced 189. . 

Brim;  this  ticket  to  102  <  its  Hall,  as  tin-  children  will  not  be  allowed  to  return  to  school,  ami  con- 
tagion disease  caul  will  not  I'm-  taken  down  from  your  home  by  this  Division  until days  after 

convalescence  and  disinfection  of  the  premises. 

NO.  90. 

Reply   Postal  Card. 
DEPARTMENT    OF    II KALTH:— CITY    OF    CHICAGO. 


Do<  roB: — 

Your  report  of  Contagions  Disease  at  address  named  on  accompanying  Reply 
Postal  Card,  is  received. 

As   the    Principal    of   the    Scl 1    attended   by    the    patient    or  children   .4'   the 

family  will  not  admit  to  School  any  one  from  the  house  until  permission  is  given 
by  this  DEPABTMENT,  you  will  kindly  mail  the  Reply  Postal  Card  when  all 
danger  is  passed. 

The  placard — if  any — will  then  be  removed  from  the  house,  and  the  premises 
disinfected  by  the  Department,  \fyou  so  request. 

D.  however,  you  ;issume  responsibility  tor  the  disinfection,  at  the  termination 
of  the  case,  the  word  not  should  be  written  in  last  line  of  Reply   Postal  <  aid. 

AKTliri;  K.  REYNOLDS,   M.  D. 

'  'omtnlssiom  r  <<f  Health. 
S.  i;.     Formaldehyd  has  supplanted  sulphur  in  all  Depabtmi  nt  disinfection. 


To   BE  SIGNED  B1     rHE  ATTENDING  PHYSICIAN,  D  \ii:t> 
LSD  i:  l   it  BNED  OS    i  i  RMIM  \  MOH  01    i  HE  0  \-i  . 

Chicago, 1899. 

The  case  of  Contagious  Disease  In  the  family  of 


living  al  

lias  terminated. 

.Members  of  the  familj     including  school  children,  if  any     should  be  relieved 

from  an>  further  restriction. 

Disinfection  by  the  Dkpabtmeni  is  requested. 

.  M.  I). 


•  ii  the  attending  Physician  assume*  responslbtlitj  of  disinfection  the  word  not  should  be 
written  in  this  space. 


920  APPENDICES. 

NO.  91. 

State  Board  of  Health  of  Massachusetts. 


TYPHOID  FEVER. 


Date 


C  Of  taking  to  bed 

'  Of  physician's  first  visit. 


Name, ., \-< 

Street  and  No.  (when  taken  ill) : 

Present  address 

Place  of  work,  business  or  school 

Physician  while  ill 

Health  before  attack 

<  Hit  of  town. 

Length  of  illness 

Chills Nosebleed 

Vomiting Diarrhoea 

Headache Tongue 

Fever Delirium 

Pain  in  bowels Eruption 

City Filter 


Drinking 

<j    Canal 

Water. 

[  Spring Well 

Milk Milkman. 

Previous  cases  in  house 

( >ther  cases  near  by 

Privy  or  W.  C Plumbing 

Remarks 


The  fixing  of  the  precise  time  of  infection  is  of  supreme  importance  for  the  inves- 
tigator, and  this  may  often  be  obtained  with  considerable  accuracy  by  the  date  of 
the  physician's  first  visit  or  the  time  of  the  patient's  taking  to  bed.  The  former  can 
usually  be  got  from  the  attending  physician;  the  latter,  in  a  surprising  number  of 
cases  with  tolerable  accuracy,  from  the  patient  or  his  friends.  The  location  of  the 
patient  when  attacked  is  also  highly  important,  as  possibly  indicating  the  place  of 
infection,  the  place  of  work,  business  or  school  giving  alternative  information  of  the 
same  nature.  The  symptoms  are  asked  for  partly  as  a  matter  of  routine,  partly  to 
get  the  patient  or  his  friends  to  talk  and  so  disarm  suspicion,  and  partly  for  use 
when  it  is  denied  that  the  epidemic  is  real. 


APPENDICES.  92] 

NO.  92. 

PRACTICAL  FACTS  ABOUT  CHOLERA. 


[SSUED    HV    THE    STATE    BOABD   OF    HEALTH    OK    MAINE. 


(BE VISED    EDITION.  I 

Cholera,  as  it  appears  in  America,  is  an  exotic  disease:  that  is,  it  never  arises 
spontaneously  on  our  soil.  When  it  lias  appeared  here,  it  has  always  been  possible 
to  trace  it  back  to  European  ports  330$  towns  where  cholera  prevailed,  and  from 
there  to  India,  where  it  always  has  its  origin.  Whenever  it  has  left  its  Asiatic  home 
ami  overrun  Europe,  it  has  invariably,  sooner  or  later,  found  its  way  to  our  own 
country.  In  view  of  the  possibility  of  having  to  deal  with  Asiatic  cholera  in  our 
own  Commonwealth,  the  State  Hoard  of  Health  thinks  it  prudent  to  issue  this 
circular. 

Nature  of  the  Mala dt. 

It  is  a  specific  disease  caused  by  a  specific  organic  poison,  or  disease  germ. 
derived  directly  or  indirectly  from  pre-existing  cases  of  the  same  disease. 

Symptoms. 

Cholera  almost  always  begins  with  a  premonitory  diarrhoea.  Later  come  vomit- 
ing, cramps,  exhaustion,  and  collapse.  In  some  cases  the  advent  of  the  disease  is 
sudden  and  its  course  and  termination  rapid;  in  other  cases  the  disease  advances  no 
farther  than  the  stage  of  simple  diarrhoea,  cases  that  are  fraught  with  grave  danger 
to  the  public,  as  their  true  character  is  often  overlooked. 

How  it  i-  Spread. 

Cholera  is  an  infectious  disease,  but  it  is  infectious  only  in  certain  ways.  It  is 
not  "catching,"  as  smallpox  and  scarlet  feverare  understood  to  be.  In  Calcutta, 
where  cholera  is  always  present,  hundreds  of  cases  have  been  treated  in  the  general 

hospital,  and  oft<  n  in  the  same  rooms  wit  li  pal  i  en  is  sick  with  other  diseases,  with- 
out ever  being  asourceof  infection  to  them.     Physicians  and  nurses  who  care  for 

the  sick  are  little,  if  any.  i e    liable  to  take  the  disease  than  others.      And    yet.  "ti 

the  Other    hand,  a  single  case  may  poison  many  other    individuals,  and   give  rise  to  a 

wide-spread  and  very  fatal  explosion  of  the  disease.  How  can  we  account  for  this 
paradoxical  behavior  of  cholera?  In  this  way:  The  cholera  poison  exists  princi- 
pally in  the  discharges  from  the  bowels  and  in  t  he  vomited  matter.     It  t  his  poison  is 

completely  destroyed  as  s i  as  it  leaves  the  alimentarj  canal,  there  is  no  danger  of 

the  patient's  being  a  source  •  •>  infei  tion  t"  other  persons.  But  if  the  dejections  ate 
thrown,  for  instance,  into  the  privj  vault,  the  cholera  germs  find  all  the  favoring 
conditions  for  their  development  and  increase.  Prom  the  privj  vault,  or  from  the 
Burface  of  tin-  ground,  the  poison  may  percolate  through  the  soil,  many  feet  it  maj 
i>e.  and  gain  access  to  our  wells  or  other  water  supply. 

I.ri  a  i,i  distinctly  bornt  in  mind  that,  /<<  take  tin  cholera,  you  n  utt  <<ii  it  <>,-  drink 
;/.     This  is  in,t  an  esthetic  statement  of  a  general  recognized  tact,  but  it   is  impel 

to  make  ii  emphat  ic. 

Further  tacts  in  relation  to  the  extension  of  cholera,  are  these:  Privj  vaults, 
cess-poois.  sink  drains,  heaps  "t  manure.  Blth-sodden  earth,  and  other  unclean 
plac.s.  once  contaminated  with  the  cholera-germ,  may  serve  as  culture  grounds  for 
them  and  for  their  multiplication,  and  maj  remain  tources  "i  danger  for  some  time. 


922  APPENDICES, 

giving  off  their  infection,  which,  by  being  breathed  in,  may  be  mixed  with  the 
saliva  and  be  swallowed.  The  infection  multiplies  rapidly  in  clothing  or  bedding 
that  has  been  soiled  by  the  cholera  patient,  and,  without  disinfection,  remains 
damp.  Hands  soiled  never  so  little  with  the  infection,  may,  at  a  touch,  infect 
articles  of  food  and  thus  spread  the  disease. 

Articles  of  clothing  from  cholera  regions,  especially  if  soiled  with  the  cholera 
excreta,  may  carry  the  disease  long  distances.  During  the  epidemic  of  1873,  clothing 
packed  up  in  Holland,  Sweden  and  Russia,  made  the  ocean  voyage  and  the  railway 
journey  with  no  harm  to  persons  on  the  way,  but  started  cholera  epidemics  in  the 
far  West  when  the  articles  were  opened. 

Be  reassured  by  the  fact  that  cholera  comes  not  from  a  mysterious  epidemic  con- 
stitution of  the  atmopshere,  but  that  it  comes,  as  explained  above,  in  accordance  with 
certain  laws  which  are  now  well  understood.  Remembering  this,  all  unnecessary 
alarm  maybe  avoided  —  only  that  salutary  fear  is  desirable  which  shall  lead  each 
invididual  to  avoid  and  remove  those  conditions  which  favor  not  only  cholera  but 
typhoid  fever  and  other  diseases. 

How  Prevented. 

When  the  importation  of  cholera  is  threatened,  a  grave  responsibility  rests  upon 
State  and  local  authorities.  Especially  at  ports  engaged  in  foreign  commerce, 
vigilance  should  be  constant  and  action  prompt,  when  required.  If  cholera  should 
be  allowed  to  effect  a  landing,  the  soil  and  the  water  may  be  contaminated  and  the 
"  stamping  out"  of  the  disease  made  impossible. 

Special,  Rules. 

1.  Experience  has  abundantly  proved  that  a  town  or  district  with  a  clean  soil, 
pure  air,  and  pure  water,  may  bid  defiance  to  cholera.  The  rule  is  therefore  imper- 
ative to  search  for  and  abate  all  filth  nuisances.  Remove  all  decomposing  animal 
and  vegetable  substances.  Empty  all  privy  vaults;  drench  them  with  Solution  A. 
Abolish  privy  vaults  as  far  as  possible,  substituting  better  methods  of  disposal  of 
excreta.  Treat  all  cess-pools  in  the  same  way.  Ventilate  rooms  and  keep  the  cellar 
dry  and  well  ventilated.  Of  the  greatest  importance  is  an  assurance  that  the  water 
supply  is  not  polluted,  —  by  filthy  soakage  through  the  soil  in  case  of  wells;  by 
human  excreta  from  sewers  or  otherwise  in  the  case  of  public  water  supplies. 

2.  Never  neglect  the  preliminary  diarrhoea.  During  this  first  stage  the  disease 
is  usually  curable. 

3.  If  possible,  burn  all  discharges  coming  from  the  patient,  as  well  as  all  soiled 
cloths  or  other  articles  that  are  not  too  valuable. 

4.  If  the  discharges  cannot  be  burned,  do  not,  upon  any  consideration,  throw 
them  upon  the  ground  or  into  the  privy  vault.  Have  them  passed  into  a  vessel  con- 
taining several  times  their  bulk  of  Solution  A  or  Solution  E,  and  then  poured  into 
a  deep,  narrow  hole  in  the  ground  remote  from  all  buildings  or  water  supply. 

5.  All  soiled  clothes  from  the  cholera  patient,  before  or  after  death  or  recovery, 
should  be,  as  soon  as  possible,  enveloped  in  a  sheet  wet  with  Solution  C  (1  :  1000)  or 
Solution  E,  carried  to  the  laundry  or  an  outdoor  boiler,  and  boiled  immediately. 

6.  Upon  the  death  of  a  cholera  patient,  the  body  should  be  enveloped  immed- 
iately in  a  sheet  wet  with  Solution  C  (1  :  1000)  or  Solution  E,  on  no  account  to  be 
afterward  opened,  and  buried  privately  as  soon  as  possible. 

After  death  or  recovery,  the  room  should  be  fumigated  thoroughly  by  burning 
sulphur.  After  remaining  closed  twenty-four  hours,  open  doors  and  windows  and 
ventilate  thoroughly.  Burn  all  mattresses  and  other  bedding  or  furniture  that  has 
been  soiled  with  excreta  or  vomited  matter,  and  that  cannot  be  disinfected  with 
boiling  water  or  with  steam.  Wash  doors  and  walls  thoroughly  with  Solution  C  (1  : 
1000)  or  Solution  E.     Repaper  if  need  be. 


APPENDICES.  923 

NO.    !>3. 

Information  fob  Consumptives  am>  Those   Living  with  Them. 


HEALTH    DEPARTMENT. 
No.  SOI  Mott   Street. 

New  Yokk.  February  13th,  1894. 

Consumption  is  a  disease  which  can  be  taken  from  others  and  is  not  simply  caused 
by  ("ids.  A  cold  may  make  it  easier  to  take  the  disease.  It  is  usually  caused  by 
germs  which  enter  the  body  with  the  air  breathed.  The  matter  which  consumptives 
cough  or  spit  up  contains  these  germs  in  great  numbers — frequently  millions  are 
discharged  in  a  single  day.  This  matter,  spit  upon  the  floor,  wall  or  elsewhere,  is 
apt  to  dry,  become  pulverized  and  float  in  the  air  as  dust.  The  dust  contains  the 
germs,  and  thus  they  enter  the  body  with  the  air  breathed.  The  breath  of  a  con- 
sumptive does  not  contain  the  germs  and  will  not  produce  the  disease.  A  well 
person  catches  the  disease  from  a  consumptive  only  by  in  some  way  taking  in  the 
matter  coughed  up  by  the  consumptive. 

Consumption  can  often  be  cured  if  its  nature  is  recognized  early  and  proper 
means  are  taken  for  its  treatment.     ///   a  majority  of  cases  it  Is  not  a  fatal  disease. 

It  is  not  dangerous  for  other  persons  to  live  with  a  consumptive,  if  the  matter 
coughed  up  by  the  consumptive  is  at  once  destroyed.  This  matter  should  not  be 
spit  upon  the  floor,  carpet,  stove,  wall,  or  street,  or  anywhere  except  into  a  cup  kept 
for  that  purpose.  The  cup  should  contain  water,  so  that  the  matter  may  not  dry, 
and  should  be  emptied  into  the  closet  at  least  twice  a  day  and  carefully  washed  with 
hot  water.     Great  care  should  be  taken  by  a  consumptive  that  his  hands,  face  and 

clothing    d i    become   soiled   with    the    matter   coughed    up.      If  they  do   become 

soiled  they  should  be  at  once  washed  with  hot  soapand  water.  When  consumptives 
are  away  from  home,  the  matter  coughed  up  may  be  received  on  clot  lis.  which  should 

be  at  once  burned  on  returning  home.     If  handkerchiefs  are  used  (worthless  cloths 

which  can  be  binned  are  far  better)  they  should  be  boiled  in  water  i>>  themselves 
before  being  washed. 

It  is  better   for  a  consumptive  to    sleep  alone,  and    his  bed-clot  hing  and    personal 

clothing  should  be  boded  and  washed  separately  from  the  clothing  belonging  to 
other  people. 

Whenever  a  person  is  thought  to  be  suffering  from  consumption,  the  name  and 
address  should  be  sent  at  once  to  the  Health  Department,  on  a  postal  card,  with  a 

statement  of  this  fact.  A  medical  inspe<  tor  from  the  Health  Department  will  then 
call  ami  examine  the  person  to  see  if  he  has  consumption,  providing  be  has  no 
physician,  and  if  necessary,  will  give  proper  directions  to  prevent  others  from  catch- 
ing t  he  disease. 

quentlj  a  person  Buffering  from  consumption  may  not  only  do  bis  usual  work 
without  giving  the  disease  to  others,  but  may  als..  get  well,  if  the  matter  coughed 

Up  is   properly  desl  loyed. 

Booms  that  nave  been  occupied  by  consumptives  should  be  thoroughly  cleaned. 

scrubbed,   whitewashed,  painted  or  papered  before  thej   are  again  occupied,     Car 

pets.  rugs,  bedding,  etc,  from  rooms  which  have  been  occupied  bj  consumptives, 

should  be  disinfected.     The  Health   Department  should  be  notified,  when  thej  will 

be  sent  for,  disinfected  and  returned  to  the  owner  free  of  charge,  or,  if  he  so  desires 

they  will  be  dest  roj  ed. 

By  order  of  the  Board  of  Health, 

in  \ki.i-s  ...   \\  1 1  son,    President. 
i-.m  uons  Ci  ibk,  -'  ■  ■/■>  tary. 


924  APPENDICES. 

NO.    94. 

State  Board  of  Health  of  Maine. 


THE  PREVENTION  OF  CONSUMPTION. 


[Revised  Edition  of  1900.] 

That  insidious  disease  which  we  call  consumption,  phthisis,  or  tuberculosis  of 
the  lungs,  is  the  most  terrible  destroyer  of  lives  with  which  civilization  has  to  con- 
tend. 

At  the  present  time  the  fact  of  the  infectiousness  of  consumption  is  firmly  estab- 
lished in  a  scientific  way,  and  enough  is  known  of  the  natural  history  of  the  infective 
agent,  the  bacillus  of  tuberculosis,  and  of  the  ways  in  which  it  is  communicated  to 
man,  to  enable  us  to  lay  down  rules  for  the  prevention  of  the  disease  with  more 
positiveness  than  was  formerly  possible. 

The  source  of  infection  is  two-fold,  from  one  human  being  to  another,  and  from 
tuberculous  animals  to  man.  The  tuberculosis  of  animals  and  human  consumption 
are  of  the  same  nature. 

From  domestic  animals  there  is  danger  of  contracting  the  disease  by  the  use  of 
the  flesh,  and  especially  by  the  use  of  the  milk  from  those  which  are  tuberculous. 
Many  children  die  in  their  earlier  years  from  various  tubercular  diseases,  tubercular 
inflammation  of  the  brain,  "  consumption  of  the  bowels,1'  etc.  Many  of  these  deaths 
are  due  to  living  amid  infectious  surroundings  and  breathing  infected  air,  but  a 
considerable  proportion  die  from  infection  received  in  the  milk  of  tuberculous  cows, 
or  in  that  from  mothers  suffering  from  tuberculosis  in  some  form. 

By  far  the  greatest  source  of  infection,  however,  are  consumptive  human  beings, 
but  fortunately  the  ways  in  which  the  contagion  is  disseminated  are  but  few,  and 
by  intelligent  care  they  may  be  effectually  controlled. 

From  the  human  source,  we  may  consider  the  expectoration  (the  sputum)  as 
practically  the  one  great  danger.  The  consumptive  sputum  usually  contains  an 
abundance  of  the  infection,  the  bacilli,  and  these  microscopic  organisms  are  found 
to  be  capable  of  retaining  their  vitality  and  their  infectious  qualities  for  a  long 
while,  even  after  the  sputum  has  been  thoroughly  dried. 

As  a  general  proposition  the  statement  is  true  that  the  breath  of  the  patient  is 
not  infectious,  and  that  the  same  may  be  said  of  the  sputum  so  long  as  it  remains 
moist.  Later  experimental  work,  however,  indicates  a  possibility  of  infection  in  the 
immediate  vicinity  of  hard,  open-mouthed  coughing. 

Another  line  of  investigation  has  proved  that  the  careless  consumptive  patient  is 
a  focus  of  infection,  and  a  danger  to  all  persons  who  come  much  in  proximity  t<>  him, 
especially  to  those  who  dwell  in  the  same  rooms  with  him. 

The  reason  of  this  is  that  the  expectoration  of  the  patient,  spit  upon  floors, 
carpets,  pocket  handkerchiefs,  or  clothing,  becomes  dried  and  pulverized,  and, 
floated  in  the  air,  still  contains  the  infectious  germs,  and  cannot  be  inhaled  without 
great  danger. 

Though  infection  maybe  regarded  as  the  principal,  the  essential,  cause  of  con- 
sumption, there  are  nevertheless  various  untoward  influences  which  have  much  to 
do  with  increasing  the  death-rate  from  this  disease,  and  they  should  never  be  disre- 
garded. The  most  important  of  these  are  the  breathing  of  impure  air, —  that  of 
unventilated  sleeping  rooms,  living  rooms,  schoolrooms,  and  offices, —  the  use  of 
food  not  sufficiently  nutritious,  and  dwelling  upon  a  damp  soil. 

Heredity,  formerly  thought  to  be  a  potent  cause  of  pulmonary  consumption  and 
other  forms  of  tuberculosis,  is  now  know  to  have  but  little  part  in  the  causation  of 
the  disease.  Since  the  infectiousness  of  the  disease  has  been  shown,  family  groups 
of  consumption,  "  house  epidemics,"  are  now  referred  to  infection  rather  than  to 
hereditary  influence.  Though  heredity  is  possible,  the  best  authorities,  the  world 
over,  now  teach  that  cases  of  hereditary  transmission  of  tuberculosis  are  very  rare. 


APPENDICES.  925 

Prevention. 
jQp^ Rules  for  the  patient. 

Two  farts  should  encourage  the  patient:  One  is  that  there  is  always  an  intrinsic 
tendency  to  recovery  in  the  earlier  stages  of  the  disease,  and  that,  under  modern 
treatment,  a  large  percentage  of  cases  do  recover;  the  other  is  that  there  is  no 
reason  for  any  person  to  think  that  he  is  doomed  by  heredity,  no  matter  what  his 
family  history  may  he. 

It  should  be  impressed  upon  consumptive  patients  and  other  persons  living  with 
them  that  the  sputum  (what  they  cough  up)  is  dangerous  and  must  be  properly  dis- 
posed of.  It  must  not  become  dry.  There  are  several  ways*  in  which  the  sputum 
may  safely  be  eared  for: 

A.  Pressed  paper  spit-cups,  costing  but  little,  are  on  the  market.  One  or  sev- 
eral can  be  used  daily  and,  after  it  has  been  used,  each  cup  with  cover  and  contents 
can  be  burned. 

B.  Paper  cups  held  in  a  metal  frame  may  be  used.  After  use  the  cup  and  con- 
tents are  burned. 

C.  Metal  or  porcelain  spit-cups  or  spittoons,  each  containing  a  small  quantity 
of  disinfecting  solution  1,  2.  or:!,  maybe  used.  The,  final  disposal  of  the  sputum 
may  he 

1.  By  pouring  it  down  the  water-closet. 

2.  By  cremation  when  practicable,  (a)  In  a  small  fire  outdoors,  (b)  In  the 
house  heater,  using  a  stout  sheet  iron  box  with  a  handle  three  feet  long.     Partly 

till  the  box  witli  sawdust,  or  fold  a  paper  inside  it  ;  pour  in  the  contents  of  the  spit- 
cup  or  cuspidor;  with  the  direct  draft  of  the  heater  open,  invert  the  box  over  the 
litejiot.  holding  the  box  in  place  a  moment  until  the  flame  or  the  heat  sterilizes  it. 
When  tlie  sputum  is  to  he  cremated,  hut  a  small  quantity  of  the  disinfecting  solution 
should  he  used  in  the  spittoon. 

:;.  By  setting  the  vessel  aside,  preferably  in  a  warm  place,  so  that  the  disin- 
fectant maj  act  eight  or  twelve  hours  longer.  The  quantity  of  disinfecting  solution 
should  be  in  excess  ot  that  of  the  sputum.  Then  bury  or  otherwise  dispose  of  it  so 
that  flies  and  the  domestic  animals  cannot  reach  it. 

The  patient  should  have  two  spit-cups  or  spittoons  for  alternate  use.  A  cover 
should  exclude  flies.     Cleansing  can  be  done  with  washing  soda  and  boiling  water, 

or  soap  and   hot   water. 

I).  Knopf's  aluminum   pocket  spit-flask  is  very  convenient,  especially  when   the 

patient   is  away  from  home,  is  traveling,  or  is  confined  to  his  bed. 

E.  When  away  from  his  room  the  patient   may  spit   into  Japanese  paper  napkins 

to  he  put  immediately  into  a  rubber  tobacco  pouch  until  they  >an  be  burned. 

F.  Spitting  into  handkerchiefs  should  be  avoided.     If  occasionally  forced  to  do 

this,  the  handkerchief    should    be   boiled    before   the   sputum   dries.      Handkerchiefs 

upon  which  the  sputum  is  allowed  to  dry,  surround  the  user  with  a  balo  of  infec- 
tion, infect  the  pocket  and  everything  else  they  touch,  and  lessen  the  patient's 
chances  of  recovery.  After  coughing,  the  lips  should  not  he  wiped  with  the  hand- 
kerchief used  for  the  nose.  Tin'  lips  ma\  he  wiped  with  paper  napkins  to  lie 
burned  later. 

Repress  cough  as  much  as  possible.  Cough  gentlj  with  the  mouth  closed  as 
much  as  possible.     Sever  swallow  the  sputum.     By  so  doing  you  favor  the  extension 

of   t  lie  disease    tot  lie    inte-.t  inal    t  lad. 

Dm  not  soil  personal  or  hid  clothing  with  the  sputum  nor  the  hands  when  avoid 
a  hie.       Wash  I  he  ha  nils  often.       Male  |,at  ients.   win.  w  8*1  a  mustache  <.r  beard,  should 

keep  it  ch.seiy  clipped. 

Do  not  infect  the  im diate  surroundings  of  the  home,  •  spit  upon  the  grass  or 

hay  or  any  where  else  where  the  sputum  mas   be  eaten  bj  cattle,  chickens,  or  other 

animals. 


926  APPENDICES. 

$^~Rulesfor  attendants. 

The  floors,  woodwork,  and  furniture  of  rooms  in  which  consumptive  patients 
stay  should  be  wiped  with  a  damp  cloth,  not  dusted  nor  swept  i.i  the  dry  way. 

Clothing  may  be  disinfected  by  boiling,  as  in  ordinary  laundry  processes.  Rooms 
may  be  disinfected  with  formaldehyde  fumigation — large  doses  —  supplemented 
with  the  washing  of  the  floor  with  solution  7.  This  should  be  done  every  few  weeks 
when  practicable,  while  the  rooms  are  occupied  by  the  patient.  If  the  floor  or  other 
surfaces  are  accidently  soiled  with  sputum,  the  spots  should  be  wet  and  rubbed 
thoroughly  with  solution  T,  1,2,  or  3. 

Rooms  for  consumptives  should  have  no  fixed  carpets.  A  few  rugs  may  replace 
them.  They  should  frequently  be  carried  into  the  open  air  and  exposed  to  the 
action  of  direct  sunshine  several  hours  at  a  time.  For  the  thorough  disinfection  of 
them  steam  is  the  best.  The  tableware  of  the  patient,  the  knife,  fork,  cup,  and 
spoons  particularly,  should  be  kept  separate  and  washed  by  themselves  in  scalding 
water. 

In  addition  to  the  danger  from  infectious  dust,  if  it  is  allowed  to  be  diffused 
through  the  air,  there  are  other  possible  ways  of  communicating  the  infection.  It 
may  be  carried  directly  to  the  mouth  by  the  fingers,  or  indirectly  by  handling 
articles  of  food.  After  soiling  the  hands,  cleanse  them  carefully.  Guard  against 
inoculating  cuts  or  abrasions  of  the  hands'with  the  sputum. 

ft^^Rulesfor  everybody. 

A.  Anything  tending  to  lower  the  tone  of  the  general  health  may  act  as  a  pre- 
disposing cause, —  insufficient  nutriment,  overwork,  loss  of  sleep,  worry,  close  and 
dusty  air.  Avoid  these.  Give  sleeping  rooms  a  prolonged  airing  and  sunning  by 
clay,  and  as  much  night  ventilation  as  is  practicable.  The  dwelling  place  should  be 
dry  naturally  or  made  so  artificially.  If  it  is  thought  that  there  is  a  family  predis- 
position to  consumption,  an  outdoor  occupation  should  be  chosen.  Live  in  the 
open  air  and  sunshine  as  much  as  possible. 

B.  Every  new  case  of  tuberculosis  comes  from  some  earlier  case.  The  germs  of 
this  disease  retain  their  vitality  and  their  infectivity  a  long  time  under  favoring  con- 
ditions. Therefore  do  not  bring  into  your  house  clothing  formerly  used  by  con- 
sumptives unless  it  has  been  thoroughly  disinfected;  do  not  move  into  an  infected 
house  or  rooms,  until  the  thoroughness  of  the  disinfection  is  unquestionable;  do  not 
put  to  your  lips  or  mouth,  pipes,  wind  instruments,  money  or  anything  else  that  has 
been  used  or  handled  by  consumptives:  do  not  buy  bread,  milk,  or  other  articles  of 
food,  not  to  be  cooked,  from  consumptives;  kissing,  particularly  lip- to-lip,  is  unsafe 
if  one  party  to  the  act  is  tuberculous;  thorough  cooking  for  meat,  or  a  temperature 
somewhat  below  the  boiling  point  (176  F.  for  10  minutes)  for  milk,  will  render  these 
safe  articles  of  food. 

By  observing  the  rules  which  are  expressed  and  suggested  in  the  foregoing,  the 
principal,  if  not  all  danger  of  infection  may  be  avoided. 

The  open  air  treatment  of  consumptives  and  those  who  are  threatened  with 
tuberculous  disease,  has  given  much  better  results  than  any  other.  Particularly  in 
Germany,  and  to  some  extent  in  this  country,  such  treatment  has  been  systematized 
in  "sanitaria"  for  consumptives.  Here  the  patients  have  the  advantage  of  a  life 
under  medical  regulation,  nutritious  food,  and  such  exercise  or  rest  as  each  case  re- 
quires; but  the  chief  curative  agent  is  an  abundance  of  fresh  air.  Even  in  cold 
winter  weather,  patients,  after  a  period  of  gradual  habituation,  and  always  guided 
by  the  judgment  of  the  physician,  pass  almost  the  whole  day  in  the  open  air,  walk- 
ing or  sitting,  or  lying  on  resting  places  comfortably  wrapped  in  blankets  and  furs. 
The  results  obtained  in  these  institutions  have  been  very  successful  even  in  those 
with  climatic  conditions  less  favorable  than  those  of  many  parts  of  Maine.  An 
abundance  of  pure  air  is  the  all  important  thing. 


APPENDICES.  927 

DISINFECTING     SOLUTK  >NS. 

Solution    i. 
Carbolic  Acid  (pure liquified),  7  ounces. 

Water.  1   gallon. 

-Mix.  This  is  approximately  a  5  percent,  solution.  For  the  disinfection  of  cloth- 
ing this  solution  mixed  half  and  half  with  water  will  do. 

Solution  2. 

I.ysol,  .".  ounces. 

Water.  1  gallon. 

Mix.  This  may  be  used  as  a  substitute  for  solution  1.  one-half  the  strength 
sufficing  for  uncolored  clothing.     Many  colors  are  changed  by  it. 

voi n  ;;. 

Solutol  (crude  or  p  I  pint. 

Water,  2  or  3  gallons. 

Mix.  This  is  a  very  efficient  disinfectant  for  excreta,  tuberculous  sputum,  and 
gross  disinfection  generally.  If  to  be  used  in  dwelling  houses,  or  wherever  the 
odor  of  the  crude  produci  would  be  offensive,  pure  solutol  should  be  used. 

Soi  i  HON  T. 
Solution  of  Formaldehyde  (Formalin),  6  ounces. 

Water.  1  gallon. 

Mix.      This  mixture  contains  a  little  less  than  '_'  per  cent,  of  formaldehyde. 
It  is  a  good  plan  to  dissolve  4  or  ">  tablespoonf uls of  common  salt  in  each  quart  of 
solution  l.  tii- solution  •_'.  thereby  increasing  considerably  the  disinfecting  power  of 

the  solution. 

NO.  «.>."">. 

THE  PREVENTION  OF  CONSUMPTION. 


Instructions  to  Consumptives  and  their  Friends. 

Consumption  is  the  most  destructive  disease,  the  number  of  persons  dying  an- 
nually from  this  cause  in  Michigan  amounting  to  about  three  thousand. 

Consumption  is  a  dangerous  communicable  disease,  the  most  dangerous  one  in 
Michigan.  One  consumptive  may  spread  the  disease  to  very  many  healthy  persons. 
The  chief  danger  exists  in  the  expectoration  of  the  consumptive  person,  and  if  this 
expectoration  is  carefully  destroyed  before  il  is  dried,  Little  danger  need  he  feared. 

Consumptives  should  be  instructed  not  to  spit  upon  the  sidewalks,  the  doors  ol 
rooms,  public   balls,  Btreel  and  railway  cars,  and  other  vehicles,  nor  where  fowls  or 

dairy  COWS  may  take  in  the  sputum,  or  the  dust  of  it   with  their  food.        They  should 

spit  into  pieces  of  cloth,  or  receptacles  made  for  the  purpose,  containing  a  saturated 
solution  of  carbolic  acid  (one  part  of  carbolic  acid  crystals  to  aln. ut  fifteen  parts  of 
water).  Such  pieces  of  cloth  should  be  destroyed  by  fire,  before  the  sputa  become 
dry,  and  other  receptacles  should  he  cleansed  with  scalding  water,  their  contents 
baving  been  destroyed  or  otherwise  carefullj  disposed  of.  Handkerchiefs  which 
maj  have  been  used  from  necessity  should  he  boiled  half  an  hour  before  washing. 

li  is  hest  that  all  persons  who  bave  a  cough  should  uarrj  --mall  pieces  "i  doth 
leach  jusl  large  enough  to  properhj  one  sputum)  and  paraffined  paper  envel- 
op! ^  or  wrappers  in  which  the  .loth,  as  - as  once  used,  maj  he  put  and  securelj 

enclosed,  and  with  Its  envelope,  burned  on  the  first  opportunity. 

Remember  that  sputa  must  never  !>•■  allowed  t"  become  dry. 
Office  oi    rin    Secret aby  oi    rm    State  Boabp  oi    Health, 
,i'i.   Wirhigan,  August,  t8SH. 


928  APPENDICES. 

NO.    9<>. 

Size  3i  in.  x  5-i  in. 


No Street 

Record  No 

Name 

Age Sex Occupation  . 

Reported :     Date by 

Assigned  :     Date to . 

Order  No Date 


(reverse.) 


Returned  :    Date by . . . 

i  ( >wner  \ 
C.  ]       or      [ Address  . 

(  Agent   ) 

N.  C.  C.  Reason 

^  (  Patient 

Recom. 

'  Disinfection 


Premises:  San.  Cond Previous  Instructions. 

Instructions  by  Inspector 

~ , .       r,  i  Living 

Otlier  Cases  , n 

'  Dead 

Remarks 


NO.  97. 

Size  hi  in.  x  0  in. 
HEALTH  DEPARTMENT. 


City  of  Chicago,  Bureau  of  Contagious  Diseases. 

DISINFECTOR'S  DAILY  REPORT. 

C.  W.   BEIIM,  M.  D., 

Medical  Officer  in  Charge  of  Disinfection. 

Sir: — I  hereby  report  that  I  have  this day  of 

1 ,  disinfected  for 


The  premises  at 

Miles  from  office 

Number  rooms  disinfected 

Area  of  rooms cubic  feet. 

Formaldehyd  used C.  C. 

Disinfection  began  at M. 

Rooms  opened  up  at M. 

Other  disinfections  performed 


Signature 


APPENDICES.  929 

NO.    98. 

CIRCULAR   CONCERNING    DISINFECTION. 

Before  leaving  the  room  the  patient  should  have  a  bath  and  a  shampoo  and  be 
dressed  in  fresh  clothes  that  have  nut  been  exposed  to  the  infection.  The  clothes 
worn  during  the  sickness  must  he  either  burned  or  disinfected. 

Clothing  that  can  be  boiled  is  most  easily  disinfected  by  boiling  it  for  half  an 
hour.  Clothing  that  cannot  be  boiled  will  be  disinfected  by  the  Health  Department 
men. 

sheets  and  pillowcases  are  disinfected  by  boiling.  Blankets,  feather  beds,  pil- 
lows, mattresses,  and  comforters  will  be  disinfected  by  the  Department. 

Furniture,  floors,  and  woodwork  should  be  washed  in  a  disinfecting  solution  of 
corrosive  sublimate.  The  corrosive  sublimate  will  be  furnished  by  this  Department. 
It  should  be  used  carefully,  according  to  directions,  as  it  is  very  poisonous.  A 
corrosive  sublimate  solution  cannot  be  used  with  soap,  therefore  it  is  better  to  do 
any  necessary  scrubbing  first  and  then  wash  over  with  the  disinfecting  solution. 
The  wall  pajk'r  may  be  removed  and  burned,  or  the  walls  may  he  wiped  oil"  witli  a 
cloth  placed  on  a  broom  and  the  cloth  may  then  be  burned.  The  ceiling  is  not  very 
likely  to  be  infected.  It  may  be  whitened.  Small  articles  should  be  wiped  with  a 
doth  wrung  out  in  a  disinfecting  solution. 

Upholstered  furniture  should  not  be  kept  in  the  room.      If  such  by  chance  should 

lie   infected,   it   should  be  thoroughly  sprayed  or  dampened   with  a  disinfectant. 

Formalin  is  the  best  for  this. 

Lastly  the  room  should  be  thoroughly  aired. 
The  following  are  good  disinfecting  solutions: 

I.      Carbolic  acid ;  a  half  cupful  of  the  strong  acid  to  a  pail  of  water. 
II.      Corrosive  sublimate;   three  drachms  to  a  pail  of  water. 

The  box  furnished  by  the  Health  Department   contains  enough  for  one 
pail  of  water. 
IIJ.      Formalin,  one  ounce  to  three  pints  of  water. 

The  buttle  furnished   by  the   Health   Department   contains  enough  for 
three  pints  of  water. 

Corrosive  sublimate  and  formalin  will  be  furnished  by  the  Health  Department 
when  requested. 

Usually  the  Department  men  can  do  their  part  of  the  disinfecting  the  next  daj 
after  they  receive  orders  from  the  Superintendent.  Sometimes  a  longer  delay  is 
necessary.     The  Department  does  its  part  of  the  work  free  of  charg 

PROVIDENCE,    November.    1890. 


NO.  99. 

Size  6  in.   \  ''■     in. 
Hetttrn  Swab  and  both  Tuben. 

DIPHTHERIA. 

Name  of   Pal  iciil  ^ge. 

Address.    , 

Attending  Phj  sician  \dd  ress 

\'a f  Maker  of  Culture 

I  late Time      Mo.  Of   Culture. 

1  )urat  ion  of    Disease 

I  low    (  .ml  railed  " 

Ib.u  Man>  in  Famib  ?     Idults  Children 

( 'an  < lase  be  Isolated  ' 

Does  Patient  attend  School  '  Where 

Local  ion  of  Membrane.         

ill  ure  [noculat  ion  Katisfactorj  ? 
( 'linical  Diagnosis 

If    made   hei I.xaniiiiat  ion 

//.  '  urn  Hwab  and  both  I  uht  >. 


930 


APPENDICES. 


NO.  lOO. 

Size  3  in.  x  5  in. 


DIPHTHERIA. 


Date 


Name 


Laboratory  No 

Male  White 

Female        Colored 


Address 

Age 

How  long  Sick? 

Location  of  Membrane: 

Where  contracted: 

Clinical  Diagnosis. 

How  much  Antitoxine 
used  ? 

How  long  since  an  antiseptic    1    Number  of  children 
was  used  in  throat?                        immunized: 

Doctor's  Name: 


Address : 


Report  by  mail  or  telephone: 


Telephone  number: 


Please  state  number  of  culture,  whether  1st,  2d,  3d,  etc.,  in  this  space: 

What  school  has  the  child  been  attending?    I  Remarks: 

ThefoUowing  blank  spaces  are  t<>  be  filled  out  by  tlnj  Health  Department: 

Bacteriological,  Examination:    Date,  1st 2d. . .  .3d 4th 5th. . . 

6th...  .7th.  ..8th 9th.  ..10th... 

Disinfected  —  Date.  By  whom/""^ 

Please  read  Notice  on  other  side. 


x     Positive  Culture, 
o     Negative      " 


NO.    lOl. 

Size  51  in.  x  84  in. 
DEPARTMENT  OF  HEALTH. 


Municipal  Laboratoby,  Room  317,  City  IIai.l. 

Chicago, 180. 


Dk. 


,  City. 


Dear  Sir: — The  examination  of  the  culture  in  the  case  of. 


has  given  the  following  result: 

Bacillus  diphtheria'  Staphylococcus 

Pseudo-diphtheria  bacillus         Contamination 
Streptococcus  No  growth 

The  case  is  therefore one  of  true  diphtheria. 

M.  D., 

Bacteriologist  and  Director,  Municipal  Laboratory. 


PLEASE  NOTE. — Diphtheria  bacilli  may  be  found  in  the  throats  of  healthy 
persons. 

In  a  small  number  of  cases  the  bacillus  is  not  found  in  the  first  culture  when  it 
may  be  found  in  later  ones.    . 

The  bacillus  sometimes  disappears  before  the  membrane  does. 

Accuracy  of  results  depends  primarily  upon  careful  inoculation  of  the  culture 
tube. 

Where  the  pseudo-bacillus  cannot  be  positively  distinguished,  the  case  will  be 
regarded  as  true  diphtheria  until  second  cultures  are  examined. 


APPENDICES.  931 

NO.   102. 

Sl/.K    Sj     IN.    X    8    IN. 

Laboratory  No 

HEALTH   DEPARTMENT. 


Division  of  Pathology,  Bactebiologt  and  Disinfection. 


New  Yoi:k 180. . . . 

Dr 

Dear  Sir: 

The  examination  of  the culture  made  by  inoculating  the  tube 

with  the  exudation  from  the  throat  of 

on dors  not  admit  of  an  exact  bacteriological  diagnosis, 

foj-  the  following  reasons: 

A.  The  inoculation  was  made  at  so  late  a  period  in  the  disease  that  it  is  possible 
1  lie  diphtheria  bacilli,  though  now  absent,  were  at  an  earlier  time  present. 

/;.  The  growth  on  the  culture  medium  was  so  scanty  that  it  is  possible  the 
i  noc ulation  was  not  properly  made,  or  that  some  antiseptic  had  been  applied  to  the 
throat  shortly  before  the  tube  was  inoculated. 

<  .  The  culture  was  in  some  way  contaminated  by  saprophytic  bacteria,  covering 
the  medium,  and  obliterating  the  growth  of  throat  bacteria. 

I).      The  culture  medium  was  dry. 

/;.  The  bacilli  present,  though  resembling  diphtheria  bacilli,  were  not  sufficiently 
characteristic  for  positive  identification. 

/•".  No  diphtheria  bacilli  were  found;  but  the  location  of  the  lesion  (laryngeal) 
precludes  the  certainty  that  they  may  not  be  present. 

1.     A  prompt  confirmatory  culture  is  requested. 
j.     The  case  will  be  treated  as  one  of  diphtheria. 

."..  The  case  will  be  treated  as  one  of  false  diphtheria,  unless  the  physician  in 
charge  of  the  case  requests  otherwise. 

Examined    by 

Hi  km  w\   m.   Biggs,  m.  I».. 
Pathologist  and  Director  of  the  Bacteriological  Laboratory. 


NO.    103. 

Size  5 1   1 \ .   t  8  in. 
HEALTH     DEPARTMENT. 

Di\  i-io\  ,,1   Pathology,   Bacterio ->    in»  Disinfection. 

SPUT1  M   FROM    \   CASE  OF  SUSPECTED  TUBERCULOSIS. 

Name  of  pal  lent 

Sej 

Address 

<  >ccii  pation 
\  Mending  Physician 

Address 

clinical    Diagnosis 

Duration  of    Di 

Have  there  been  cases  of  consumption  in  the  familj  " 

II..U   man]  ? 

Relation  to  pal  lent 


I  >ate  "I  last  case 


932  APPENDICES. 

NO.    104. 

Size  5  in.  x  5  in. 
Bacteriological  Laboratory,   Beffalo,  N.  Y. 


Directions  for  Collection  of  Sputum  for  Bacteriological   Examination  in  Pulmonary 

Tuberculosis. 


Sputum  should  be  collected  only  in  clean,  wide-mouthed,  well-stoppered  bottles, 
with  a  capacity  of  at  least  four  ounces. 

Care  should  be  taken  that  bronchial  and  not  pharyngeal  secretion  is  collected, 
and  the  expectoration  discharged  early  in  the  morning  is  to  be  preferred.  If  the 
expectoration  is  scanty,  the  entire  amount  discharged  in  twenty-four  hours  should 
be  collected. 

NO.  105. 

Size  5|  in.  x  8  in. 

Laboratory  Xo. 

Health  Department,   Baltimore. 


TYPHOID     FEVER. 
Physician Date . 


No.  of  .Specimen. 


Address Agglutination 


to  be  tilled  out  \ 
at  department  J 


Patient 

Address 

Motility 

Age 

Day  if  Disease Diagnosis. 


History  of  previous  attacks 

Clinical  Diagnosis 

Quinine  or  Blood  test  for  exclusion  of  malaria  (if  made) 
( >ther  symptoms  ( in  brief) 


NO.    10(>. 

Size  3  in.  x  5|  in. 

illinois  state  hoard  of  health. 
PERSONAL    CERTIFICATE   OF  VACCINATION. 

(1) ,  HI. 

I  hereby  Certify  that  I  have,  this  (2) day  of 180.  .  .  . 

examined  (3) and  pronounce 

(4)    .       '   in  my  judgment,  properly  protected  against  Small-Pox  or  Varioloid  by 

reason  of  (5) 
(A)     Successful  recent  primary  vaccination.         (C)      ..unsuccessful  recent  attempts 

at  vaccination. 
(  B)     Successful  recent  re- vaccination.  (D)     Previous   attack   of   small-pox 

or  varioloid. 

(0) M.  D. 

Explanation  of  figures:  1 — Write  in  the  name  of  city,  town  or  village.  2 — 
Date.  3 —  Give  name  in  full.  4  —  Strike  out  supertluous  pronoun.  5  —  Check  the 
initial  "A,11  "  B,"  "C"  or  "D"  which  indicates  the  "  reason."  If  it  be  "  C," 
insert  number  of  attempts.  6  —  Signature  of  certifying  physician,  who  should  in  all 
c  tses  in'  a  legally-qualified  practitioner. 


APPENDICES. 


933 


NO.    lOT. 

Size  •*>,.   in.  x  8  in. 
ILLUSTRATIONS    OF    MODES    <>F    USING    THE    VACCINATION   RECORDS. 


Note. — It  will  be  understood  that  t lie  figures  and  words  or  phrases  printed 
in  italic,  in  these  illustrations;  are  hypothetical  —  the  reporting  physician  will,  of 
course,  insert  his  own  figures;  give  his  own  reasons  for  preferring  bovine  to  human- 
ized virus  (or  vice xersaj)  and  furnish  the  proper  address  of  the  propagator  whose 
bovine  virus  he  has  found  most  trustworthy. 

Where  the  physician  has  met  with  noteworthy  vaccinal  complications,  sequela  or 
results,  it  is  especially  desired  that  these  be  reported  separately,  with  as  much  fullness 
"f  detail  as  may  he  deemed  necessary.  Facts  concerning  reported  fatal  results,  am- 
putated anus,  communicated  disease.  </  ccet.,  should,  in  all  cases,  he  furnished. 
••  Facts1    "iily  can  set  the  public  mind  at   rest  on  these  points. 

of  more  purely  professional  interest  would  he  data  concerning  unusual  latency  of 
virus  (as  manifested  by  prolonged  delay  in  manifestation  of  activity;)  final  success 
after  repeated  failures;  successful  vaccination  after  an  attack  of  variola;  frequent  suc- 
cessful vaccinations  of  the  same  individual;  success  of  bovine,  after  failure  of  human- 
ized virus  (or  the  reverse;)  modes  of  performing  tin  operation. 

Proper  credit  will  be  given,  in  the  published  report,  for  all  information.  To  this 
end  records  and  statements  should  be  dated,  post-office  address  given,  and  name  of 
reporting  physician  signed  in  full. 


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934  APPENDICES. 

NO.  108. 

.Size  3-A-  in.  x  8  in. 
BOARD   OF   HEALTH    BLANK. 


Physician's  Certificate. 


Philadelphia 189 


I  hereby  certify,  from  personal  examination,  that. 

Age Residence 

is  successfully  vaccinated,  or  has  had  Smallpox. 


.M.  D. 

. . . .  Residence. 


NO.  109. 

Size  .">  in.   x  8  in. 


The  Principal  will  please  destroy  this  Permit  upon  admitting  pupil. 
HEALTH   DEPARTMENT. 


Sanitahy  ■  Bureau. 


DIVISION   OF    CONTAGIOUS    DISEASES. 


Criminal  Court  Building, 
Centre,  White,   Elm.  and  Franklin  Streets. 

New  York 189 

The  bearer lias  been  vaccinated  ( ) 

and  may  attend  school. 

This  is  not  a  certificate  of  successful  vaccination,  but  is  only  a  permit  to  attend 
until  examined  by  an  officer  of  this  Department. 

Chas.  S.  Benedict,  M.  D., 

<  'hii'f  Inspector. 


APPENDICES. 


935 


no.  no. 


Sl/.K    6    IN.     X     11    IN. 


Stub  to  be  retained   at 


Stat  inn. 


FOE  GRATIS   USE. 


Furnished    ..vial. .    No. 

To  Dr 

Dale lN'.C 

II' Mil' M. 

Culture  tube  received. 

Date 189? 

Hour. m. 


To  lie  forwarded  to  the  Health  Department  with  Culture- 
Outfit.     Diagnosis  and  Report  not  Required  for  Anti- 
toxin \ii.  i,  which  is  used  only  for  Prophylaxis. 

Received    from    the     Chicago    Health     Department, 
through  Diphtheria  Antitoxin  Station  No. ........  10  c.  c. 

vial   . .  .Diphtheria  Antitoxin  No.  .  .  .for  gratis  use  in  the 

ease  of  1 ) 

2) 

payment  for  which  remedy  /  hereby  Certify,  upon  infor- 
mation and  belief,  would  he  a  hardship  to  the  patient  or 
fa  mily. 

It  is  understood  that  the  conditions —  hereby  accepted 
by  i  ne  —  upon  which  the  Department  furnishes  this  Anti- 
toxin without  charge  are  — 

First,   that   the  diagnosis  of  the  case  shall  be  sub- 

mitted  to  bacteriologic  investigation,  for  which  purpose 

I    undertake   to   return    to    this    Station    within    twelve 

hours  after  receipt  of  the  serum  a  culture  tube  properly 

charged  with  exudate  from  the  throat  of  the  patient. 

Second,  that  1  will  make  a  clinical  report  of  the  case 
promptly  upon  its  termination,  to  the  Bureau  of  Con- 
tagious Diseases  on  the  blank  form  furnished  by  the 
I  department  for  that  purpose. 

S) SID. 

4) 

Dai.':  :>) 1895. 

Hour:  til in. 

Culture  tube  returned 1895,  hour m. 

Note.  Spaces  nuiiii.cn'. i  l  name  >.i  patient),  S  address  ..( 
|. client  ,3 and  i  signature  and  address  ol  physician),  5 and  6  will 
!>.•  fllled  in  bj  the  physician  who  receives  the  Antitoxin.  All  other 
spaces  will  i.e  Ailed  in  by  the  druggist .  who  will  send  this  Receipt 
i..  I  Mr  Department,  with  the  Culture  Outfit. 


936 


APPENDKKs. 


NO.  111. 


Size  5i  in.   x  5^  in. 


CLINICAL    BLANK. 


Date . 


Add 


N 

Pliys. :     Name. 

Patient :     Name Age Add 

Antitoxine  make Units  injected . 

Duration  of  Disease  at  time  of  injection 

Location  and  Extent  of  Exudate  or  Pseudo-Membrane 


189 


Result  of  Culture 

Case  Intubated  ? Tracheotomized  ? . 

Case  Recovered  ? Died  ?     (Day  of  Decease) 

Complications  (Skin,  Heart,  Kidneys,  Nervous  System,  &c 


Remarks. 


Cases  Immunized:     No Result,  (after  0  weeks) 

Signed 

Please  return  this  blank  as  soon  as  the  above  information  can  be  furnished. 


Cn/riRE 


NO.  118. 

Size  4  in.  x  6  in. 
Diphtheria  189  . 


Antitoxin. 


No.                 Name 

No                     St.  Ave.  A'y               Ward 

Yrs.  Sex             Color 
Clin.   Diagnosis 
Mild         Severe           Site  Exudate 

Dr.                                         No. 
St,  Ave. 

Date  culture     111     days  Loc.  Membrane 

Clin.  Diagnosis 

Date  Exam.             Bact.  Diagnosis 

Injected                          M.         C.  C. 

Croup  began  before  after  first  injection 
Recovery         Urticaria         Joint  pains 

Convalescent  Exx. 

Contagious             days 

Death             hours  after  first  injection 
M.  the            day   of              189  . 
from 

Tracheotomy         Dr. 
Intubation                                            189  . 

Reported              Antitoxin 

As                            Returned                     \~) 

APPENDICES.  93' 

NO.    113. 

.Sl/.K    8    IX.    X    11     IX. 

A  I  1    \NT  \.     GrA 

T<>  WHOM   IT  MAY  CONCERN: 

Tut-  i-  to  Certify,  That  Mr 


on  oath  says  tliat  lie  lias  been  in  Atlanta,  »'\. 

Date 

from 

Issued  to jor days,  ami  tliat  he  has  aot  been 

who  has  been  in  Atlanta.  Ga.,  exposed   to   the    infection   of    Yellow    Fever,    or 

',("" Smallpox,    and    has  not   been    in   any    infected    or 

suspected  locality  for days. 

for days,  and   has 

not  been  in  an  infected  or  sus- 

pected   locality  of  Smallpox  or  Description:     Age years.     Weight 

Fellow  Fever  for days.  I""""1"     HeiSh< Complexion 

<  ertificate  issued  by  lla"' Eyes 


Secretary  Hoard  of  Health. 
Sworn  and  subscribed  this day  of 

Notary   Public,  Fulton  County.  Ga. 

NO.    114. 

Size  7  in.  x  7,  in. 
SI  \TK    QUARANTINE. 


1.  At  what  Station  did  you,  or  anj  irresponsible  person  traveling  in  your  charge, 

gel  on  i  his    Train  '.' 
Answer Destination?    

2.  Where  have  you.  or  lias  any  irresponsible  person,  traveling  in  your  charge,  been 

for  the  pas!  ten  days? 

Answer 

s'  ■  far  as  you  know,  bave  you.  or  has  any  irresponsible  person  t  ra\  eling   in  your 
charge,  been  exposed  to  yellow  fever  within  the  past  ten  days? 

.  I  nsiri  /• 

i.     Have  you.  or  lias  any  irresponsible  person  traveling  in  your  charge,  been  within 

the  pasl  ten  days,  in 

or  any  other  place  infected  with  yellow  fever,  and,  if  so,  In  w  hat  place? 

. !  nsxoer 

5.     When  were  you,  oi  was  any  irresponsible  person  traveling  in  your  charg* 

in  either  of  the  ai«o\e  named  places,  and  it  there,  for  bow  long? 

.  I  iisin  r 

1 do  solemnly  swear  thai   the  answers  to 

the  foregoing  questions  are  true,  So  Help  Mi    God! 

Sworn  to  and  subscribed  before  me  this  daj  "t  .1890. 

I ,» i    \  l :  \  s  i  !  n  i      i  >  i  i  1 1  i  i ; . 

Note.      Untrue  answers  to  anj  of  the  above  questions  will  expose  the  affiant   to 

■m-\ ere  penalties. 


938 


APPENDICES. 


NO.  115. 


Size  3i  IK.   x  5  ix. 


GARBAGE. 


ASHES. 


PAPER. 


All  Vegetable  Matter. 

t  Sauce  Bottles. 

t  Only  catsup  and  other 
sail  re  bottles  should  be 
put  into  the  garbage  can; 
all  other  bottles  into  the 
paper  barrel. 
t  Tin  Cans. 

X  Fruit,  vegetable  and 
meat  cans  should  be  put 
into  the  garbage  can;  other 
cans  into  the  paper  bar- 
rel. 

*  Where  there  is  a  large  quantity,  as  at  a  res 
taurant,  they  must  be  hauled  by  the  owners. 

(OVER.) 


Sawdust, 

Broken  Bottles, 

Broken  Glass, 

Broken  Crockery, 

Floor  and  Street  Sweep- 
ings, 

*Oyster  and   Clam  Shells, 

Tobacco  Stems. 


Bottles, 
Rags, 
Tin  Cans, 
Excelsior,' 
Straw, 
Mattresses, 
Old  Ch.thes, 
Pasteboard  Boxes, 
<  )ld  Shoes, 

Leather  and  Rubber 
Scrap, 

Carpets, 

Combustible  Refuse  gen- 
erally. 


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APPENDICES.  939 

NO.  116. 

Size  s,  in.  x  11  in. 

Philadelphia 189 

To  th<  Board  of  ll<;Uh  : 

The  undersigned   respectfully  app for  a   License  to  clean  privy  wells  and 

sinks,  and  to  remove  the  ((intents  thereof,  under  the  provisions  of  the  Laws  of  the 
State,  and  in  conformity  to  the  rules  and  regulations  of  the  Hoard. 

bona  fide  the  owner  of horses pumps tanks, 

trucks barrels feet  of  rubber  hose hoods 

feet   air    hose furnaces,  etc.  which  number intend    to   employ  in  the 

business.     Said  apparatus  are  all  in  good  working  order,  and  the  accommodations 

for  keeping  them  are  under  cover  and  out  of  public  view also  state  that 

not   in   collusion  or  combination  with  any  person  or   persons  to  deceive  or 

defraud    the    Hoard,  and   further  that   the  representations   herein  contained   are  all 

true. 

propose 

Residence 

And 

Residence 

as  sureties  upon bond. 

Very  respectfully,  your  obedient  servant. 


Residence 

I'lace  of  business. : 

I  Cebtift,  That  the  above  applicant  is  the  owner  of  the  number  of  horses, 

vehicles,  and    apparatus    named    in    the  application,  and   that    they  are   all    in    g 1 

working  order,  and  that  the  law  has  in  every  respect  been  fully  complied  with. 


//.,-///,  Officer. 
Philadt  Iphia 189 

|  ki.\  EB8E.) 


l'llll    M.l.l.lMIlA 189 

being  duly  sworn  or  affirmed  according  to  law,  doth 

depose  and  say,  that  the  allegations  made  in  Petition  for  License  to  than 

Privy  Wells,  are  i  me,  ;11"'  that  i ne  is  interested  or  c serned  in  the  said  Li.  ense, 

except  those  named  in  the  said   Petition,  and  that  will  do  no  work 

for  Parties  not  owners  or  Agents  of  Properties,  except  by  order  of  Hoard  of  Health. 
.  or  affirmed,  <in<l  Hubncribed  be/ore  m-  thin  \ 

day  of , 

.1.  h.  189  \ 

//.-////,    OfflCCT. 

no.    in. 

«/.  The  apparatus  for  the  removal  of  the  contents  oi  privj  wells,  vaults,  sinks, 
etc.,  Bhall  consist  of  pumps,  tanks,  nose,  deodorizing  furnaces, ther  efficienl  de- 
odorizing apparatus,  tents  or  hoods,  dunnigans  or  barrels,  and  trucks  u  hereinafter 

lied. 

/,.    The  pumps  shall  be  suitable  for  the  purpose  required,  and  shall  have  valves 

not   less  than  four  inches  internal  diameter,  whlchwill  allow  obstructive  rubbish  and 

•  mentitious  matter  to  pass  freely   through  the  pump,  and  he  I 
through  tin-  hose  to  the  tank. 


940  APPENDICES. 

c.  The  hose  shall  be  of  rubber,  or  some  other  material  impervious  to  water, 
and  shall  have  an  inside  diameter  of  not  less  than  four  inches,  and  shall  be  well 
secured  at  the  joints  by  efficient  couplings.  No  strainer  or  other  device  to  prevent 
the  free  ingress  of  material  shall  be  used  while  the  induction  end  of  the  hose  is  in 
the  well  or  vault. 

ij.  Each  tank  shall  have  its  capacity  measured  and  the  number  of  cubic  feet  it 
contains  stamped  or  branded  on  the  rear  end  by  a  sworn  measurer  of  the  Board  of 
Health.  Each  tank  shall  have  an  indicator  conspicuously  placed  on  the  rear  end. 
which  shall  correctly  indicate  the  quantity  in  the  tank. 

e.  The  gases  escaping  from  the  tank  while  being  tilled  shall  be  thoroughly  de- 
odorized. If  by  fire,  a  suitable  furnace  protected  by  the  intervention  of  a  screen  or 
other  suitable  device  between  the  tire  and  the  ignitable  gases  in  the  tank,  to  prevent 
explosion,  shall  be  used. 

/.  The  tent  or  hood  shall  be  made  of  canvas,  and  so  constructed  as  to  give  space 
for  one  or  more  barrels,  and  so  erected  as  to  form  a  close  joint  with  the  walls  of  the 
privy  building  and  the  pavement  or  ground,  completely  enclosing  the  door,  and  so 
secured  that  no  odor  can  escape  except  through  the  air  hose. 

ij.  The  air  hose  shall  be  made  of  some  air-tight  material,  expanded  by  a  spiral 
wire,  or  other  suitable  device,  and  shall  have  an  inside  diameter  of  not  less  than  five 
inches,  and  shall  be  at  least  ten  feet  in  length.  When  in  service  the  air  hose  shall 
be  attached  with  a  tight  joint  to  the  tent,  at  a  point  not  less  than  four  feet  from  the 
ground,  by  one  end,  and  the  other  connected  by  a  practical  air-tight  joint  with  the 
deodorizing  apparatus  or  furnace  when  vised,  so  that  no  air  can  enter  below  the  grate 
of  the  latter  except  through  the  air  hose  from  inside  of  the  tent. 

h.  The  pitting  furnace  shall  be  so  constructed  that  the  air-hose  connection  shall 
give  its  only  supply  of  air  below  the  grate,  and  shall  always  be  full  of  burning 
material,  while  in  operation,  to  ensure  a  strong  draft  from  the  inside  of  the  tent. 

i.  The  dunnigans  or  barrels  shall  be  water-tight,  and  have  their  capacity 
measured  and  branded  or  stamped  thereon  by  a  sworn  measurer  of  the  Board  of 
Health.  The  lid  shall  be  of  iron,  secured  to  the  barrel  by  clamps  or  cams,  and  made 
tight  by  means  of  a  rubber  gasket  between  the  lid  and  the  chime. 


NO.    118. 

Size  5  ix.  x  Ti  ix. 


Xo.  of  Permit 

City  of  Yoxkkks,   X.  Y 18 

The  Beaker, City  Scavenger,   is  hereby  authorized  to 

DISINFECT    AXD     EMPTY    TO    THE     BOTTOM,  the 

on  the  premises  Xo ,  the  said  work  to  be  com- 
pleted within  48  hours  from  date  of  permit. 

M.  I).  Health  Officer. 

City  of  Yoskkhs,  X.  Y 18 

The  undersigned  Scavenger  deposes  and  says:  that  on  the day  of 

18         he  did  empty  to  the  bottom,  the 

on  premises  Xo containing cubic  feet: 

that  he  did  thoroughly  remove  the  entire  contents  of  the  said , 

and  that  he  did  dump  the  same  on  the  premises  designated  by  the  Health  Officer. 

Scavenger. 

City  of  Yonkeks,  N.  Y 18 

I  have  this  day  examined  the Xo 

and  found  the  same  thoroughly  emptied  and  disinfected. 

Sanitary  Inspector. 


APPENDICES. 

NO.  119. 

Size  4  in.  x  H3  in. 


941 


>         V- 


z.  s 

—      r. 


•:-  "E  ■&  3 


-.  - 


—  —  "  - 


■z    - 


-  — 


's.   -r     93 


r     bf  -E     - 


>.      r       ~ 


-       = 

■=■     7. 


942 


APPENDK  ES. 


NO,  120. 

The  following  form  is  issued  in  Baltimore.  The  stub  is  filed  under  the  scaven- 
ger's name  and  the  permit  is  endorsed  at  the  night-soil  dock  where  a  fee  has  to  be 
paid  for  each  load  put  on  the  scow,  and  is  then  returned,  and  riled  with  the  stub. 

Size  4  in.  x  9  in. 

Not  Good  Unless  Signed  by   Commissioner 
of  Health. 


Application    for    permission     to    open 

and  clean  privy  on  premises  No St. 

( )wner  or  Agent  Mr 

loads.     Work  to  be  done  by 


Address. 


DUPLICATE. 

Application  for   permission   to   open 

and  clean  privy  on  premises  No 

St. 

Owner  or  Agent  Mr 

Permission  is  given  to   do   this  work  in 

loads.     Work  to  be  done  bv  ..  ■.,      ,,  ,   ..  t     ,i 

■'  compliance   with    the     regulations   of    the 

Health  Department;   and  this   permit,    en- 
dorsed by  the  Superintendent  of  the  Dump. 

Address shall  be  returned    to  this   office   within   48 

hours  from  this  date. 


NO.  131. 

Size  .">i  in.  x  8  in. 
NIGHT    SCAVENGER    PERMIT. 

No 


Mr whose  registered  license  is  No 

is  hereby  ordered  to  remove  contents  of  and  clean Privy  Vault  at  No 

Street Ward,  which  is  owned  by 

and  remove  the  same  to  beyond  city  limits 

within  five  days  from  date,  and  make  report  to  this  office,  according  to  Sec.  212  of 
the  General  Ordinances  of  the  City  of  Milwaukee,  passed  Nov.  10,  1800,  and  amend- 
ment passed  Nov.  14,  1892. 

Milwaukee, 180 


Gominifosionev  <>f  Health. 


No OF    RETURN. 

I  hereby  certify  that  I    have  cleaned. Privy  Vault  at. 

Street, Ward,  by  order  of 

and  removed yards  from  said  premises  to 

on  the day  of 

according  to  permit  issued  by  the  Health  Commissioner,  on 

189 ,  and  charged  for  said  wcrk  the  sum  of  $ 


Scavenger  License  Nt 


Milwaukee, 189 


189. 


APPENDICES.  943 

NO.  122. 

Size  %\  in.  x  11  in. 

REPORT  OF  MEDICAL  INSPECTOR  <>k  SCHOOLS  AND  AGENT  OF 
THE  BOARD  OF  HEALTH.  »>F   BOSTON. 

For  the  Month  of 189  . 


List  of  Diseases  Foi  n  d 

IN  SCHpOIiS. 


Schools. 


Totals. 


Number  of  pupils  examined  in  the  schools 

Number  recommended  to  be  seni  home 

Number  consultations  with  teachers  (about  pupils  returning  to 
school,  etc.) '• 

Medical  Inspector  of  School* 
and  Agent  Board  of  Health. 


\o.    12:;. 

I,'i    r.E9     I'M; 

CARE    OF    INFANTS. 


Departmeni  <m    iii  \i  in.  Cm  iii    Mi  u   York,  > 
t  Irlminal  Cour!  Building, 
Centre,  White,  Elm  and  Franklin  Streets.  \ 

June,    1808 

The  following  series  of  rules  (approved  bj  rnanj  physicians)  for  the  management 
of  children  during  the  liot  season,  witli  :i  view  i"  prevent  the  large  annual  ruortalitj 
of  this  class,  submitted  bj  the  Santtarj  Committee,  is  approved  and  published  bj 
the  Board: 


944  APPENDICES. 

I.  Nursing  of  Infants. 

Over-feeding  does  more  harm  than  anything  else;  nurse  an  infant  a  month  or 
two  old,  every  two  or  three  hours. 

Nurse  an  infant  of  six  months  and  over,  live  times  in  twenty-four  hours,  and  no 
more. 

If  an  infant  is  thirsty,  give  it  pure  water,  or  barley-water,  no  sugar. 

II.  Feeding  of  Infants. 

Boil  a  teaspoonful  of  powdered  barley  (ground  in  coffee-grinder)  and  i  pint  of 
water,  with  a  little  salt,  for  fifteen  minutes,  strain,  then  mix  it  with  half  as  much 
boiled  milk,  add  a  lump  of  white  sugar,  size  of  a  walnut,  and  give  it  lukewarm  from 
a  nursing-bottle.  Keep  bottle  and  mouth-piece  in  a  bowl  of  water,  when  not  in  use, 
to  which  a  little  soda  may  be  added. 

For  infants  live  or  six  months  old,  give  half  barley-water  and  half  boiled  milk, 
with  salt  and  a  lump  of  sugar. 

For  older  infants,  give  more  milk  than  barley-water. 

For  infants  very  costive,  give  oatmeal  instead  of  barley.  Cook  and  strain  as 
before. 

When  your  breast-milk  is  only  half  enough,  change  off  between  breast  milk  and 
this  prepared  food. 

In  hot  weather,  if  blue  litmus-paper,  applied  to  the  food,  turns  red,  the  food  is 
too  acid,  and  you  must  make  a  fresh  mess,  or  add  a  small  pinch  of  baking-soda. 

Infants  of  six  months  may  have  beef-tea,  or  beef-soup  once  a  day,  by  itself,  or 
mixed  with  other  food;  and  when  ten  or  twelve  months  old,  a  crust  of  bread  and  a 
piece  of  rare  beef  to  suck. 

No  child  under  two  years  ought  to  eat  at  your  table. 

Give  no  candies,  in  fact,  nothing  that  is  not  contained  in  these  rules,  without  a 
doctor's  orders. 

III.  Summek  Complaint. 

It  comes  from  over-feeding,  and  hot  and  foul  air.  Keep  doors  and  windows 
open. 

Wash  your  well  children  with  cool  water  twice  a  day,  or  oftener  in  the  hot 
season. 

Never  neglect  looseness  of  the  bowels  in  an  infant;  consult  the  family  or  dispen- 
sary physician  at  once,  and  he  will  give  you  rules  about  what  it  should  take  and 
how  it  should  be  nursed.  Keep  your  rooms  as  cool  as  possible,  have  them  well 
ventilated,  and  do  not  allow  any  bad  smell  to  come  from  sinks,  privies,  garbage* 
boxes,  or  gutters  about  the  house  where  you  live.  See  that  your  own  apartments 
are  right,  and  complain  to  the  Board  of  Health,  Centre,  White,  Elm  and  Franklin 
Streets,  if  the  neighborhood  is  offensive.  Where  an  infant  is  cross  and  irritable  in 
the  hot  weather,  a  trip  on  the  water  will  do  it  a  great  deal  of  good  (ferryboat  or 
steamboat),  and  may  prevent  cholera  infantum. 

By  order  of  the  Board, 

Michael  C.  Murpht, 
Emmons  Ci-ahk,  President. 

Secretary. 


APPENDICES.  945 

NO.  1^4. 

HEALTH  DEPARTMENT. 


S estions  fob  the  Care  of  Infants. 


The  proper  food  for  an  infant  is  its  mother's  milk. 

If  the  mother's  milk  fails  use  cow's  milk. 

Milk  must  befresh,  sweet  and  pure.     Adulterated  milk  makes  sickly  children. 

Except  in  cold  weather,  /ml  the  milk  as  soon  as  rec<  i»<  d  in  a  prest  rvejar  and  scald 
it  :  s.  rew  on  the  cover  tight,  and  keep  it  on  ice  if  possible. 

For  an  infant  under  four  months,  the  milk  should  be  diluted  with  one-third  to 
one-half  water.  After  that  time  it  may  gradually  be  made  stronger.  It  is  a  good 
plan  to  add  sugar  of  milk  (never  ordinary  sugar)  and  sweet  cream  to  the  milk.  A 
teaspoonful  of  sugar  of  milk,  and  four  tablespoonfuls  of  cream  to  a  pint  of  milk 
is  a  good  proportion.  The  milk  should  be  diluted,  and  the  cream  should  lie  added 
before  the  milk  is  sterilized,  and  the  sugar  of  milk  afterwards. 

Never  givt  condensed  milk,  or  any  other  food,  •>*■  any  molasses  candy,  sugar,  or 
anything  else  whatever,  without  the  advice  of  a  physician. 

Nursing  bottles  should  have  a  rubber  nipple  attached  directly  to  the  neck  of  the 
bottle.  Never  use  "  nursing  bottlt  with  a  /"».'/  tube.  The  "Graduated  Nursing 
Bottle,"  with  the  tablespoonfuls  marked  in  glass,  is  the  best  ami  cheapest.  When 
not  in  use  the  bottles  should  be  filled  with  saleratus  water,  ami  the  nipples  should 
also  be  kepi  in  such  water.  Scald  immediately  after  using,  and  keep  bottles  and 
nipples  perfectly  clean.     Rinse  again  before  using. 

Infants  are  frequently  fed  too  much  and  too  often.  They  are  more  apt  to  cry 
from  stomach-ache  after  over-feeding  than  thej  are  to  fret  because  they  are  hungry. 
The  time  of  feeding  and  amount  of  food  vary  with  the  age. 

The  quantities  given  below  are  not  for  the  undiluted  milk,  but  for  the  milk  properly 
diluted.  Dilute  the  milk  first,  then  measure  out  the  proper  amounts.  If  the  milk 
is  to  he  sterilized,  dilute  ami  measure  before  sterilizing.  fever  feed  oftener  than 
once  !u  two  hours. 

For  the  1  i i-. t  week         .         .  not  over    '■)  tablespoonfuls  every  _'  hours. 

From  the  first  week  to  the  sixth    "     "       4  "  "      •_' 

"    six  weeks  to  four  months,    "     "      B  "  "     3 

"     four  months  to  ten  months,  "     "     12  •■  '*     '■'< 

At  ten  months  -  -  -  "      lt       Hi  "  "       :'.       " 

At  three  months  an  infant  can    readily  go  six    hours  i  at   trig  lit  I   without    f I,  and 

at  six  months  it  can   go  from  10  o'clock  P.  \i.  until  B   \.   \i. 

ing  infants  take  the  breast  at   the  same  hours  that   bottle  babies  are  ted. 

Peed  //"   baby  at  regular  hours,  even  if  it  has  to  '».•  waked.     This  is  trerj  import 

ant .  hot  h  for  t  lie  mol  her  and  t  he  baby. 

The  baby  should  also  sleep,  have  its  bath  and  go  out  at  as  near  the  same  time  as 
possible  every  day. 

Do  not   have  the  food  too  hot  or  too  Cold;   always  aboul    Id 1  warm. 

l)o  not  wean  a  babj  or  change  its  food  duringthe  summer  months,  (between 
June  1st  and  October  i>t  i.  without  the  advice  of  a  physician. 

gleet  vomiting  or  looseness  of th(  bowels.     Consult  a  doctoral  once;  bj  so 

doing  J  on  w  ill  save  him  many  \  isits. 

no  paregoric,  laudanum,  soothing  syrup  m-  other  medicine  without  •<  doctt/r's 
advia  . 

When  an  infant  purges  or  \ its  give  it  nothing  to  eat  for  four  or  si\  hoars. 

\u  infant  should  have  from  one  t"  three  movements  everj   twenty-four  hours. 
Thej  should  be  soft  and  yellow.     If  they  are  nol   right  consult  the  doctor.     Don't 
attempt  to  dose  t be  child  > ourself. 
bo 


946  APPENDICES. 

Give  the  baby  a  batli  every  day.  The  water  should  be  about  blood  warm,  the 
room  should  be  warm,  and  there  should  be  no  draughts.  Do  not  keep  the  baby  in 
too  long.     Five  minutes  is  long  enough.     Use  Ivory  or  Castile  soap. 

Always  have  woolen  next  to  the  baby's  stomach.  A  knitted  band,  not  too  tight, 
with  shoulder  straps,  is  the  best,  but  a  flannel  one  will  do. 

Take  the  baby  out  in  the  fresh  air,  morning  and  afternoon.  Do  not  let  the  sun 
shine  in  its  eyes. 

Remember  that  must  stomach  and  bowel  troubles  are  caused  by  improper  food. 
Follow  the  directions  given  above  for  infants,  and  be  careful  in  the  diet  of  older 
children.     Never  let  them  have  unripe  or  decayed  fruit. 

Every  child  should  be  vaccinated  before  it  is  a  year  old.  It  is  best  to  do  it  in 
cold  weather.  Free  vaccination  at  the  Fourth  Ward-room  every  Friday  afternoon 
between  2  and  3  o'clock. 

Additional  copies  of  this  circular,  either  in  English,  French  or  Italian,  may  be 
obtained  at  this  office. 

OFFICE  OF  THE  SUPERINTENDENT  OF  HEALTH. 
Providence,  Dec.  18,  1893. 

NO.  125. 

Size  81  in.  x  T  in. 

Forms  very  similar  to  the  following  are  used  for  children  who  work  in  manufac- 
turing establishments: 


DEPARTMENT  OF  HEALTH,   CITY  OF   NEW  YORK, 

Criminal  Court  Building,  Borough  of  Manhattan. 

Certificate  of  Employment,  Mercantile  Establishments. 

No New  York 189 ... . 

The  Department  of  Health  of  the  City  of  New  York  Hereby  Certifies, 

That has  complied  with  all  the 

provisions  of  Chapter  384,  Laws  of  1896,  and  is  qualified  for  employment  in  any 
Mercantile  establishment  in  this  city,  in  the  position  herein  designated;  and 
further  certifies  that  he  is  physically  able  to  perform  the  work  which  he  intends 
to  do,   as* 

JUNIOR  HELPER. 

and  further  certifies  that  the  date  of  birth 

in  this  certificate  is  correctly  stated,  or  cannot  be  ascertained,  and  that,  after 
careful  examination,  it  is  satisfied  that  said  child  is  fourteen  years  of  age  or 
upward.  * 

Name Date  of  Birth 

Residence Place  of  Birth 

Color  of  Hair Color  of  Eyes 

Height feet inches.         Weight pounds. 

Facial  Marks 

By  order  of  the  Board  of  Health, 

President. 

EMMONS  CLARK,  Secretary. 

Countersigned Inspector. 

*The  designation  "Junior  Helper  "  includes 
the  positions  (male  and  female)  known  as 
"  Minor  Sales,"  "Cash,"  "Messenger."  "Small 

Parcel    Wrapper."    "  Errand,"    "  Stock,"    the      '''.,'.'''. '.- 

duties  under  the  above  designations  being  those  Signature  of  person  named  in  above 
usually  performed  by  such  employees  in  Mer-  ( 'ertifirate. 

cantile  establishments. 


APPENDICES.  947 

NO.    Vli\. 

Size  v    in.  x   14  in. 

DEPARTMENT  OF  HEALTH  OF  THE  CITY  OF  NEW  YORE". 

Borough  df 


(Mercantile    Establishments,  r 


New  York 

To  //"  Boai  d  of  Eft  tilth,  <  Hty  of  X<  to  York  : 

Gentlemen:  —  Application  is  hereby  made  for  a  Certificate  of   Employment  by 

the  undersigned he   being   physically  able  to  perform  the  duties  of  Juniob 

Helper. 

Signature  of  Applicant) 

(Address) 


Affidavit  of  Parent,  Guardian  or  Persons  Standing  in  Parentai 
Relation  to  the  Applicant. 

Extract  from  Section  168,  Chapter  415,  Laws  of  1897. 

Certificate  tor  Employment,  How  Issued.  Such  certificate  shall  be  issued 
by  the  executive  officer  oi  the  board,  department  or  commissioner  "f  health,  <>f  the 
city,  town  <ir  village  where  such  child  resides  or  is  to  be  employed,  or  by  such  other 
officer  thereof  as  maj  be  designated  by  resolution  for  that  purpose,  upon  the  appli- 
cation of  the  child  desiring  such  employment  At  the  time  of  making  such  appli- 
cation there  shall  be  filed  with  such  board,  department,  commissioner  <>r  officer  the 
•atiidu\it  of  the  parent  or  guardian  of  such  child  or  the  person  standing  in  parental 
relation  thereto,  showing  the  date  and  place  of  birth  of  Buch  child.  Such  certificate 
shall  not  be  issued   unless  the  officer  issuing  the  same  is  satisfied  that  such  child  is 

fourteen  years  of  ag ■  upward,  and  is  physically  aide  to  perform  the  work  which 

he  intends  tn  do. 

No  fee  shall  be  demanded  or  received  for  administering  an  oath  as  required  by 
t  Ins  sect  ion. 

Stati    "i    \  i  \\   York,  ) 
City  of  New  York,      [ 

residing  at in  i  he State  of 

being  dulj  sworn,  say  that       .he  is  (father,  mother,  guardian,  or  stands  In  parental 
relation  t"  the  above-named  applicant);  that  said  applicant  was  born  at 
in  on  t In- day  of  in  the  yeai  I 

i  Signal  ure) 

sw mil  tn  before  me  this  daj  » 

Votary  Public. 


948  APPENDICES. 

Certificate  of  School  Attendance. 

To  the  Board  of  Health,  City  of  New  York: 

Gentlemen  :  —  I    Hereby  Certify  that 

residing  at in  the of attended school 

situated  at in  the uf 

State  of for  a  period  equal  in  length  to  one  school  year,  during 

the  year  previous  to  h  arriving  at  the  age  of  fourteen  years,  or  during  the  year 
previous  to  date;  that  reading,  writing,  spelling,  arithmetic,  English  grammar  and 
geography  were  regularly  taught  in  said  school. 

(Signature) 

Dated 189     . 

(Official  Designation) ". 

(REVERSE.) 

Certificate  of  Special  Instruction. 

To  the  Board  of  Health,  City  of  Nero  York: 

Gentlemen  :  —  I    Hereby  Certify  that 

residing  at in  the of State  of 

has  received  the  benefit  of  instruction  in  reading,  writing, 

spelling,  arithmetic,  English  grammar  and  geography,  or  equivalent  instruction,  by 
a  competent  teacher,  elsewhere  than  at  a  school,  for  a  period  equal  in  length  to  one 
school  year,  during  the  year  previous  to  his  arriving  at  the  age  of  fourteen  years,  or 
during  the  year  previous  to  date. 

(Signature) 

Dated 189     . 

(Official  Designation) 


Certificate  of  Inspector. 

I  Hereby  Certify  That  I  have  examined 

the  above-named  applicant,  and  I  am  satisfied  that         he  is  fourteen  years  of  age  or 
upward,  and  is  physically  able  to  perform  the  duties  of  Junior  Helper. 

M.  D., 

Inspector. 
Dated 189     . 


Information  as  to  Applicant. 


Name Date  of  Birth 

Residence *  .  Place  of  Birth 

Color  of  Hair Color  of  Eyes 

Height feet indies.  Weight pounds. 

Facial  Marks. 


Remarks. 


Application  No Filed, 189 

Certificate  dated 189     Certificate  No 


APPENDICES.  949 


NO.   127. 

Size  s j  i \ .  \  1 1   i \ . 

TENEMENT  <>i:   LODGING   BOUSE  CERTIFICATE, 


I  »l IP  IRTMEKT   OF    IIkai.i  II. 

Office  of  Ilealtli  Commissioner. 

ERNEST  WENDEM   D.  BUFFALO,    X.  Y 189      . 

Health  <  Commissioner. 

Tin-  i>  to  Certify,  Tliat  I ,  residing-  at  No 

Street,  in  the  city  of State 

of am  the  owner  of  the house  at  No 

street,  in  the  city  of  Buffalo,  X.  V.,  That 

"f  Xo Street,  is 

the  resident  agent  for  the  management  of  said house.   That  said 

house  is  situated  at  No Street,  in  said  city  of  Buffalo, 

and  contains sets  of  apartments,  with rooms  to  each  set  of  apartments. 

The  ii i milier  of  persons  occupying  each  apartment  is  as  follows: 


That  the  following  trades  and  occupations  are  carried  on  in  said bouse : 

That  I  filed  on  the day  of 18. .  .in  the  office  of  the 

Department  of  Health,  in  said  city,  a   plan  or  diagram  of  the   lot  on  which  said 

1  louse  is  situated,  and  of  each  tloor  of  said house, 

in  accordance  with  the  provisions  of  Sec.  123  of  Ordinances  of  the  city  of  Buffalo, 
regulating  tenement  and  Lodging  houses,  and  thai  no  changes  have  been  made  affect- 
ing said   plan  or  diagram  previously  hied  with  said  Department  of  Health,  except 


.  Oipmi  r. 


INDEX. 


Abatement  of  nuisances.  See  Nui- 
sances. 

Abattoir  :  public,  2<>o. 

Abbott.  I>r.  S.  \V.  :  paper  on  adultera- 
tion, 341. 

Adulteration  of  food:  324  <t  x<  -/.  :  ges* 
eral  laws.  324-327 :  execution  of  laws. 
337  et  aeq.     See  Food. 

Advisory  board  of  health,  25,  26. 

Ailantus  trees.  156. 

Air  pressure  test,  linn. 

Air  space:  for  dwellings,  139,  154,  155; 
for  tenements.  825,  829;  for  lodging 
houses.    832. 

Albany  filter,  280. 

Aldermen:  appoint  board  of  health.  '11 : 
as  board  of  health,  14-16;  on  board  <>i 
health,  :.•:;. 

Alleys:  car '.    147-1  18. 

Aluminum  boxes  for  diphtheria  cultures 
561. 

Ambulance:  628-631;  undertaker's  wagon 
used  as.  628;  St  Louis  ambulance  a 
disgrace,  628;  communicable  disease 
in  general  ambulance,  628;  construc- 
tion of.  629;  cities  which  have  629; 
disinfect  ion  of.  629;  horse  for.  <'.::<>: 
physician  for.  630:  at  Providence, 
629  :  ai   Brookline,  .Mass..  631. 

American  Reduction  Company's  process 
rbage  disposal,  71-"-. 

Ammonia:  from  garbage,  709;  t<>  neu- 
tralize  formaldehyde,   540. 

Analysis:  of  food.  340;  of  garbage,  702; 
of  milk.  385 :  of  water,  273. 

Anatomical   material,    104. 

Animals:    carriers    of    communicable    'lis 

162  :    c nunicable   diseases   of. 

765   »/    aeq.     See    Communicable    'lis 

driving  through  Btreets  207; 
federal  inspection  of.  338;  state  in 
spectrin.  339;  diseased  food  from,  309, 
310,  326;    food   from  over  heated   ami 

feverish,    .ll";     w ided,    310: 

nam.  :;i  1  ;  emaciated,  .".l  i  ;   Immature, 

313;  unclean  do)   '"  i Bed  for  food. 

:vi ]  .     used     for    f I    must     be    bled, 

.leaned  and  cooled,  -".II  '  diseased,  milk 
from.    •".'•''  I.    699    '  I    H  ■/■  ; 

keeping  of,  169;  yarding  of,  I7'»:  in 
dwellings,  170;  noisy  animals.  170; 
breeding  of.    171 


Antitoxin:  free  distribution.  598,  599, 
601;  application  for,  935;  circular, 
599;  amount  furnished,  599;  report  of 

u se.  ( '>( « >.  !  i.' II  i :  record  of  ca  se,  '•  ••' '>• ! : 
production  of.  600;  regulation  of  pro- 
dint  ion.  tHU  :  control  of  by  state.  581  ; 
study  of  in   New   York.  Nil'. 

Appointment    of  board   of  health.  26. 

Arnold   process  of  garbage  disposal:    708. 

Asbetos  formaldehyde  generator,  537. 

Asbury  Park  smallpox  hospital,  603. 

Ashes:  see  Dry  refuse;  for  ashes  and 
garbage,  aee  Mixed  refuse:  excluded 
from  garbage,  666;  notice  in  regard 
to.  938;  sale  of.  734  :  value  of  as  fuel. 
735. 

Assistance  for  the  poor  in  communicable 

disease.   487,   4!H">. 

Attorney:  on  board  of  health.  29;  as 
health  officer,  4.  S:  for  health  depart- 
ment. 38;   city,  on   board   of  health.  23. 

Autoclave:    Trillat's.   536. 

BABY   farms,  sir.'. 

Bacillus   of   diphtheria.     See    Diphtheria 

bacillus. 
Bach  air  pipes,  242. 

Back    pressure    valve.    239. 

Bacteria  :   in   vaccine   virus.  582. 

Bacteriological  laboratories:  553  et  seq.; 
first  established.  556;  state,  556 :  mu- 
nicipal,   556;    cost    of,    557;    uses   of. 

557;  material  for  by  mail.  556;  cities 
Which  have.  559;  for  diagnosis  ,,f  diph- 
theria. 559  < '  aeq.;  record  of  diphthe- 
ria work.  567 :  reporl  of  results  to 
physicians,  •"•'•7.  568,  930,  •  ■•■i:  for 
diagnosis  of  tuberculosis.  569;  for 
miosis  of  typhoid,  569;  for  the  diag- 
nosis of  malaria.  .">7 1  ;  of  cerebro- 
spinal     ningitis,  571  :    of    influenza, 

.-.7"_' :  of  glanders,  ~>~-  ;  of  rabies,  .~i7'_' ; 
precautions   tO   be   taken    in.   ."i7'J. 

Bacteriologists,    and    their    salaries,    558. 
disinfection    of.    663 :    of    rail- 
road   passengers,    disinfection   of.   655, 
056   657. 

Baker:  not  i"  sell  forbidden  food.  350, 

Bakeries:  318-320;  consumption  in.  522. 

Baki  is'  .aris.  320. 
rder,  '■'•'■'•'■'<■ 

Ballasl  :   1  reatmenl   of,  G  17. 


952 


INDEX. 


Barbers  :  control  of,  800. 

Barney  clumping  scow,  736. 

Barns.     See  Stables. 

Barrels  for  removal  of  ni°-ht  soil :  744. 

Barren  Island:  garbage  disposal  at,  703. 

Bathing :  in  public  water  supplies,  207. 

Baths:  in  schools,  781;  public,  791  et 
seq.j  summer  baths.  701  ct  seq.; 
floating  baths.  701,  792 ;  swimming 
pools,  793;  in-door  baths,  794-800; 
cost,  maintenance,  number  of  bathers, 
795-800. 

Bath  tubs  required,  249. 

Bedding  in  ambulance  disinfected,  630. 

Beer :  adulteration  of,  327.  328. 

Bi-chloride  of  mercury :  spraying  with. 
507,  509,  539,  540:  tanks  for,  540, 
546 ;  washing  with,  507.  509,  513,  548, 
553 ;  washing  with  at  quarantine,  648. 

Bill  of  health  :  to  be  shown  at  quaran- 
tine. 636,  643,  644. 

Bi-partisan  boards  of  health,   29. 

Births :  enumeration  of,  71 ;  returns,  71- 
77.  845,  856 ;  time  for,  73 :  items  on, 
75-77 ;  return  for  completing  record, 
857. 

Births,  marriages  and  deaths :  recording 
officers,  87;  records,  89,  863-865;  in 
public  institutions,  90 :  index,  91 ;  cor- 
rection of  records,  92 ;  original  re- 
turns, disposition  of,  80 :  copies  of 
record,  93 :  returns  to  state  registrar, 
866-867 ;  returns  of  non-residents,  63, 
73,  84. 

Bissell,  Dr.  Wm.  G. :  tubercle  bacilli  in 
second-hand  clothing,   210. 

Blanks.     See  Forms. 

Blindness ;   prevention  of,   803. 

Blown  veal  and  mutton,  312. 

Board  of  administration  the  board  of 
health,    23. 

Board  of  communicable  diseases  at  pri- 
vate hospitals,  615. 

Board  of  health :  advisory,  '-o,  26 ;  ear- 
liest, 22 ;  organization,  29 ;  size  of, 
28 :  appointment  of,  26 ;  executive 
functions,  32 ;  legislative,  43 ;  judi- 
cial, 47. 

Boarding  vessels  at  quarantine,  642. 

Bodies  dead  of  communicable  disease : 
470;  disinfection  of,  470,  902,  903; 
to  be  in  air  tight  coffin,  472,  902,  903 ; 
time  of  burial.  473.  902  :  funeral,  473, 
902;  transportation  of,  100,  476,  902, 
903;  disposal  of,  476,  902,  903. 

Boilers.  249. 

Bonds :  for  officials,  29,  39 ;  for  night 
soil  scavengers,   743;  plumbers,   256. 

Bones.  See  Grease,  bones,  etc..  also 
Junk. 

Books  and  communicable  disease:  4(12 ; 
disinfection  of,   554. 


Boroughs :   sanitary  organization,   13-16. 

Boston :  communicable  disease  hospital, 
619 :  smallpox  in  1678,  1,  425 ;  yellow 
fever,  2,   19. 

Bottles  for  milk.  416,  417. 

Bovine  virus.     See   Vaccine  virus. 

Boxes  for  diphtheria  culture  outfits,  561- 
564. 

Branding  of  food.      See  Marking. 

Bread.  Mill).  322.  331. 

Brewers'  grains  for  cows,  370. 

Brighton    abattoir,    205. 

Broad  irrigation  for  sewage,  300. 

Brookline,  Mass. :  ambulance,  631 ;  hos- 
pital.  621;   bath,   796-?.  18. 

Brooklyn :  preparations  for  cholera  in, 
517. ' 

Brown  garbage  crematory,   726. 

Brownlee  garbage  crematory,   726. 

Buckwheat,  332. 

Buildings  must  be  sanitary,   155. 

Bureau  of  animal  industry.  338,   765. 

Bureau  of  health,  24.  26. 

Burial:  time  of  100;  in  cemetery  only, 
101 :  only  a  single  body  in  a  grave, 
102;  permits,  58-63,  847-849:  who  is- 
sues, 59 ;  forms,  60,  847-850 ;  return 
of,  61 ;  for  out-of-town  deaths.  62  ;  of 
communicable  disease,  time  of,  473 ; 
of  dead  animals,  762. 

Butchers'  frocks,  317. 

Butter:  361-365;  defined,  364;  process, 
or  renovated  butter,  365 ;  Quinness 
patent,  365. 

Butterine:  361-365:  federal  law,  361; 
marking  of,  362 ;  sale  of,  363,  365 ; 
coloring  of,  364,  365. 

By-laws.  29,  30. 

Cabbage  stalks.  156. 

Calf:    flesh   of  immature,   313.   844. 

Camps,  detention:  in  inland  quarantine, 
661, 

Candles:    paraform,   539:    sulphur,    530. 

Candy.  334,  335. 

( 'anned  goods,  322. 

Canvas  bags  and  sheets  for  removal  of 
goods  for  disinfection,  552. 

Capillary  tubes:    (vaccine),  592. 

Captains  of  vessels.     See   Masters. 

Carbolate  of  lime :   for  disinfection.   .">.">4. 

Carbolic  acid :  for  washing.  548,  519, 
553. 

Carbon izer :  for  garbage.  097. 

( 'aid   index  :   vital  records,  91. 

Carriages:  at  funerals  in  communicable 
disease,  474.  902.  See  also  Communi- 
cable disease,  removal  of. 

Cars:  for  transportation  of  garbage, 
687;    railroad,   disinfection  of,   664. 

Cat:   not  for  food,  321.  323. 

Cats  :   in  communicable  disease.  462. 


IXDEX. 


953 


Catsup,   336. 

Cattle.  See  Dairy,  farms;  Animals; 
Cows;   keeping  of  in  cities,  171. 

Cattle  Commissioners:  appointment  and 
duties.    77" >. 

Cause  of  death:  how  reported.  65-69; 
investigation  of,  66,  67,  68. 

Causes  of  sanitary  organization:    19; 

Cellars:  for  sleeping,  152;  must  be  san- 
itary. lo.'J:  in  tenements,  824,  825, 
827. 

Cemeteries:  '■>'■>:  and  water  supplies,  100, 
267-268. 

Cemetery  committee:  chairman  of,  on 
hoard  of  health,  •_'.".. 

Cerebro-spinal     meningitis:      to     be 
ported.   139;  to  be  placarded,  444:  pri- 
vate  funeral   in,    177:   laboratory  diag- 
nosis of,  571. 

Certificate.  See  Marriage;  Vaccination ; 
Plumbing:  of  disinfection,  ~>~>'2;  of 
freedom  from  sickness.  937;  of  owner- 
ship of  tenement  or  lodging  house, 
949. 

Cess Is:    184-186.  843. 

Chamberlain  process  of  garbage  dis- 
posal. 7U». 

Chapin,  \V.  II..  Dr.:  investigation  of 
typhoid  in  Springfield,  531. 

( iharters  for  cities,  it. 

chc.se.   358-361. 

Chicago:  method  of  formaldehyde  disin- 
fection, .">.*:'.•:  Chicago  small  pox  hos- 
pital, 609-611. 

Chicken  Pox:  to  be  reported,  439;  t<>  l>e 
placarded,    111  :  and  small  pox,  •~><>1. 

Children  in  infected  house:  isolation  "t". 
152,  I 55 :  institutions  fur.  805;  pro- 
tection  of   weikin-.  804,   946,   !I47. 

Chloride  of  lime:  disinfection  with.  555. 

Cholera:  to  be  reported,  l-">7.  844;  t"  l>" 
placarded.  143;  isolation  of  persons 
exposed  to.  456;  private  funeral  in, 
ITT:  outbreaks  of,  516;  sanitary  prep 
arations  for,  516;  preparations  in 
Brooklyn,  ."»17:  preparations  in  New 
York,  r>17:  rags  from  dumps  nol  t'>  be 
sold,  518;  circulars.  518,  921;  quaran 
tine,  stringency  of,  518;  hospitals 
for.  ~>|N:  management  <d'.  518;  quar- 
antine for  at   Canadian  border,  655. 

t  'hurch  funeral  forbidden,   IT-". 

(  icatris  of  vaccination  its  significance, 
586. 

Cider  vinegar,  328,  329. 

Cigar  factories)  supervision,  806. 

Circulars:  of  information,  815;  concern- 
ing >'. lunicable  disci  •      186    004  ei 

V- ./. ;  care  of  infants,  '■'  13,  II  b~> : 
cholera,  921;  consumption,  923,  924, 
'.  r_'T  :  disinfection,  550,  553,  554,  927, 
929 :   diphtheria,    906 ;     measles,    907 


scarlet  fever,  905:  typhoid,  911,  912; 
vaccination,  598;  whooping  cough,  908. 

Cities.  See  Munici] ia!i ties  :  sanitary  or- 
ganization. C>.  12-16;  under  general 
laws.  20;  charters  for,  1~  :  to  establish 
quarantine,  650,  652;  quarantine  es- 
tablished by.  657. 

Citizens   to    report   communicable   d 
431. 

City  Councils:  as  boards  of  health,  14-HJ: 
to  appoint   board  of  health.   14-16. 

Civil  service  regulations,  41. 

Cleanliness:  prescribed,  144:  of  markets. 
::i4. 

Clean  outs,  236. 

Cleansing:  premises,  122;  power  of  local 

board.   427  ;   arm   for  vaccination.   593. 

Clergyman:  license.  96;  responsible  for 
violation  of  funeral  rules.  4TT  :  to  re- 
port deaths.  55;  to  report  births.  73; 
and  marriages,  81-85. 

Clerk:  city,  on  board  id"  health,  -•"> :  of 
council,  on   board   of  health.  23. 

Closure  of  schools  for  communicable  dis- 
ease. 469. 

Clothes:  disinfection  of.  506,  509,  519, 
55cs,  554. 

Clothing:  disinfection  of.  .">.".  1. 

Codes:  sanitary,  IN:  model.  843. 

Coffee,  ::::.".. 

Coffin:  air  tighl  for  communicable  dis- 
eases. 472,  '•>":.'.  903. 

Collectors  of  milk  samples:  outfit   Ol 

Coloring  food.  326,  ."..■'«•".. 
( loloring  matter  in  milk.  368. 
Combustible  materials:  deposit  of.  195. 
Commissioner     of    health.    25;     appoint- 
ment of.  27. 
(  ommissioners  of  cattle,  7T<». 
Commissioners  of  quarantine,  632,  633. 

Con in  carrier:  anil  communicable  dis- 
eases.   100,    ITT. 

Communicable  disease:  case  of  defined, 
135:  in  iiciial  institutions,  606;  in  bak- 
eries   319;  and   the  milk  supply,    119; 

relation    l<»    milk    business.     Hi_;    not    to 

lie  imported,  Ml;  infected  goods,  161, 
'.in".-  animals  in.    162:   public  libraries. 

162;    animals    in.    162;    public   libraries. 

162  :  importance  of  i ecording,  s I". ; 
record  of  cases,  190,  191,  918;  card  rec- 
ord, 191;  man  record,  191;  prevention 
oukIiI  io  be  taught  in  s.hnoi.   169;  dis- 

I     of    bodies    dead     ol.      170,     903  \     I'll 

ii.  r.ds   in.    it::.    194,   845,  902 :    investi- 
•  iii  ..f  outbreaks  81  I  ;  form  for.  920. 

Communicable  diseases  of  animals.  765  I  I 

845;  con!  rid  of,  765,  77 1  :   impor 

tation    of.    766,    TTI  :    reports   of.    766; 

ins| tors  io  search  for.  T<'.T  :  diagnosis 

of,  767;  isolation  of,  768;  slaughter  of 
clise:is«cl    animals.    768,    TT'J  TT.'i  :    com 


954 


INDEX. 


pensation  for  slaughtered  animals,  769, 
772-775 ;  disposal  of  slaughtered  ani- 
mals, 769 :  disinfection  of  premises, 
7i"0;  executive  officials,  770;  inspectors, 
appointment  of,  770:  duties  of,  7G7. 

Communicable  disease,  control  of  :  earliest 
425  :  statute  law.  428  :  local  rules,  428  : 
rules  of  state  board  of  health,  428 ; 
state  control  of.  425-428;  local  boards 
of  health  to  control.  427 :  have  quaran- 
tine power,  427  ;  may  care  for  sick,  427  : 
may  disinfect,  427 :  to  report  communi- 
cable disease  to  state  board,  427,  S41. 
897 ;  extraordinary  powers,  427 ;  diag- 
nosis of  communicable  disease,  483 ;  in- 
vestigation of,  484,  920 ;  circulars  con- 
cerning, 480,  904  et  seq.;  police  assist- 
ance in,  480 :  sanitary  survey  in.  487, 
014,  915;  unsanitary  conditions.  487: 
order  for  isolation,  913 :  daily  inspec- 
tion in,  493 ;  guards  for,  493  :  nurse  as 
guard.  493 :  report  of  recovery,  494, 
919 ;  assistance  for  poor  in,  487,  496 ; 
duties  of  state  board  of  health.  499; 
duties  of  marine  hospital  service.  499. 
See  also  Medical  inspectors. 

Communicable  disease,  exposure  to :  iso- 
lation after,  452  et  seq.,  456,  493,  (545 ; 
isolation  after  in  smallpox,  503  :  exclu- 
sion from  school  after,  466,  467. 

Communicable  disease  funerals,  473, 
404,  9(12:  carriages  at,  474,  902:  place 
of,  475,  902 :  funeral  notice.  475 :  in 
what  diseases  to  be  private,  477,  '.102; 
disinterment  of  bodies,  104  ;  inspectors, 
494 :  disinfection  of  draperies.  476. 

<  'onununic  able  disease  hospitals  :  author- 
ity to  construct,  602 ;  required,  604 ; 
location  for,  605,  608,  617 :  forcible 
removal  to,  605 ;  removal  of  infected 
persons,  606:  removal  of  patient  to, 
precautions,  519 ;  removal  of  smallpox 
to.  502 ;  removal  of  yellow  fever  to, 
508:  diseases  which  require,  607;  cities 
without,  007,  612  ;  cities  with.  608,  616, 
618 ;  for  scarlet  fever  and  diphtheria, 
612,  615;  board  of  patients  at  private 
hospitals,  615 ;  private  hospitals.  615. 
til7:  rules  for,  010;  cost  of  mainte- 
nance, 616  ;  for  smallpox,  504  :  for  tu- 
berculosis, 522-525;  at  Boston,  619; 
Brookline,  Mass..  021;  Cambridge, 
Mass..  627:  Lynn,  Mass.,  c>28;  Pater- 
son,  624,  625;  Portland,  Me..  618; 
Providence,  022.  023 ;  Syracuse.  627 ; 
Trenton.  626;  Worcester,  020;  commu- 
nicable disease  in  general  hospital,  615. 

Commuuicable  disease,  isolation  of:  state 
laws,  448;  duty  of  local  board.  427- 
429;  responsibility  for,  4  IS.  450,  454; 
guarding  premises.  44S.  606;  no  dis- 
ease in  public  place  or  conveyance,  448,. 


454 ;  local  regulations,  449,  450 ;  ab- 
solute isolation,  449,  450,  452 ;  in  one 
room,  450,  451 ;  in  a  house,  451 ;  on 
premises,  452  ;  of  family,  452  et  seq, : 
wage  earners,  452,  453,  899,  900; 
teachers,  453 ;  visits  to  infected  house 
forbidden.  454;  nurse,  454,  455;  physi- 
cian, 454 ;  other  families  in  the  house, 
455 ;  persons  exposed  to  disease,  456, 
645;  duration  of,  456  et  seq.;  decided 
by  health  officer,  456 ;  by  physician, 
457 ;  fixed  by  law,  456 ;  enforcement  of 
rules,  492  :  after  death  of  patient,  459 ; 
during  incubation,  456  ;  „of  smallpox  at 
home,  501,  503;  yellow  fever  at  home, 
508 ;  orders  for  to  be  left  at  house,  486, 
913  ;  duration  of  determined  by  medical 
inspector,  492 ;  placards,  427,  442  et 
svq.     See  Placards. 

Communicable  disease,  removal  of,  448, 
459,  477  :  responsibility  for,  448.  460 ; 
to  hospital,  502,  508,  519,  605,  606 ;  in 
public  conveyance,  448,  454,  461,  477, 
844 ;  removal  of  bodies  dead  of,  903 ; 
removal  of  well  persons  from  infected 
house.  4<'p.">;  carried  in  general  ambu- 
lance, 628 ;  removal  of  infected  goods, 
461.  903. 

Communicable  disease,  reports  of:  earliest 
laws.  429;  state  laws,  430;  persons  re- 
quired to  report,  430-433.  844 ;  to  whom 
made,  433 ;  how  made  434 ;  time  for 
making,  434 ;  suspected  cases  to  be  re- 
ported, 435 :  exposed  persons  to  be  re- 
ported, 435  ;  subsequent  cases  reported, 
435 ;  diseases  to  be  reported,  436  et 
seq. :  to  be  in  writing,  440 ;  forms,  440, 
893-896;  payment  for  reports,  440; 
false  reports,  441 ;  reports  to  state 
board  of  health,  441,  896;  penalty  for 
not  reporting,  442. 

Communicable  disease  and  school  attend- 
ance, 463  et  seq. ;  rules  for,  463 ;  per- 
sons excluded,  464 ;  permits  for  attend- 
ance, 465,  901.  919 ;  schools  included, 
467 ;  duration  of  exclusion,  467 :  teach- 
ers to  exclude  communicable  disease, 
466,  467;  rules  to  be  posted  in  schools, 
469;  closure  of  schools,  469;  exclusion 
of  teachers,  parents  and  janitors,  404  ; 
responsibility  for  exclusion,  466;  of  ex- 
posed persons,  466,  467  ;  notices  to  be 
sent,  488,  489,  913,  916,  917:  orders 
for  exclusion,  486;  permits  for  return, 
468.  001.  019.  See  also  Bodies  dead 
of  :  Animals  ;  Disinfection  ;  Hospitals  ; 
Placards:  Quarantine. 

Complaints  of  food  by  citizens,  324. 

Composition  of  garbage,  702. 

Compound  cheese,  358;  flour,  331;  lard, 
336. 

Compulsory   vaccination.  579. 


INDEX. 


955 


Condemnation  of  food,  o47. 

Condensed  milk.  .".".">. 

Conductors:  duties  at  quarantine,  651, 
653;  to  report  communicable  disease, 
432. 

Confectioners:  National  Association  of. 
334. 

Connection  with  the  sewer  required,  189- 
192,  843. 

Consumption:  in  bakeries,  319;  in  mar- 
kets ami  bakeries,  522 :  to  be  excluded 
from  school.  4<*>4 :  circular  concerning, 
923,  '•|-4.  uiiT:  report  of  examination 
of  sputum,  931,  932;  record  of  cases 
and  deaths.  928.  See  also  Tuberoulo- 
sis. 

Contract  :  for  garbage  collection,  688;  for 
sale  of  forbidden  foods,  354. 

Conveyance,  public:  communicable  dis- 
ease in,  44s.  460,  477:  disinfection  of. 
460. 

Copies   of    records    of   births,    marriages 

and  deaths,  93. 

Copperas  t"<>r  disinfection,  554. 

Correction  <>t'  records  of  births,  marriages 
and   deaths.  92. 

Cosr  of  garbage  disposal.  See  Garbage 
disposal. 

( lottage  hospitals,  616. 

Council  of  cities:  appoints  hoard  of 
health.   .17. 

Council  of  towns  and  cities  and  nui- 
sances,  110,   111. 

Council:  president  of,  on  hoard  of  health. 

<  'olllisel.       See   Attorney. 

County  and  township:  relative  import- 
ance, 'i,  10. 

County  hoards  under  general  laws.  20. 

County  commissioners:  as  boards  of 
health.   7. 

Countj  sanitary  organization,  6  l". 

Cows.     See  Dairy  farms;  Cattle;  garbage 

for,     699:     distillery     slop     for,     .:7i>: 

stables,     115;     stabling    of,    L71,  369; 

feeding  of,  369;   inspection  of,    l"i   ei 

:  tagging  of,    104 ;  t  aberculim 

of,  in  1  ■  l"7  :  i ber  oermil  ted  in  cit  ies, 

HO;  space  prescribed  for,    1 !»'. :  gr n 

niir  of,  1 16  :  water  for,  I L6  ;  udders, 
washing  of,  H6 ;  milk  from  diseased, 
369. 

Crabs   ".17. 
im,  •■'•7.">. 

(  'r.-ini  of  tartar.  .;."..".. 

< 'reameries  :  law  to  protect,  860. 

Cremation:  of  dead  animals.  762 :  of  an 
male   killed    for   communicable  di 
769;    of    night    toil,    755,    7.">7  :    of    the 
d<  ad,   63,    104 ;  ol  3ee  G 

bj  cremation. 

Cremators  :   for  mixed  refuse,  711. 


Crew  of  vessels  at  quarantine :  treat- 
ment of,  645. 

Crop:   removal  from  poultry.  312. 

Croup:  to  be  reported,  437,  S44  :  to  be 
placarded,  443,  446;  private  funeral  in, 
477. 

<  Juban  fishermen,  i*>41. 

Culture  method  of  diagnosis,  559-568. 
See  Diphtheria;  outfits  for  diphtheria. 
559;  directions  for  use  565;  form  for 
physician's  report  of  case.  564,  565, 
929;  outtits  how  distributed.  ."<;.">: 
method  of  collecting,  566,  567;  report 
of  examination,  930,  93]  :  culture  re- 
quired after  recovery,  458;  from  all 
members  of  the  family.  159;  for  re- 
moval of  well  children  from  infected 
house,  465 :  for  school  attendance,  465; 
in  suspected  diphtheria,  interpretation 
of,  483;  to  be  taken  by  medical  inspec- 
tor, 188;  for  termination  of  isolation. 
495;  taken  by  school  inspectors,  785. 

Custody  of   records  of  births,   marriages 

and  deaths,  '.i^. 
Customs  officials  at  quarantine.  ti.",7. 

D.uuv  commission,  383,  400. 

Dairy  farms:  control  of,  384,  400  ei  seq.; 

inspection  and  license  of,  379,  I'M.  102, 
103,  11":  inspected  by  veterinarian. 
103;  tuberculin  test.  104-407;  volun- 
tary tuberculin  test,  107.;  frequency  of 
inspection,  408;  results  of  inspection, 
109,    110;   cities   which   practice,   411; 

reports  of   inspection.   891,   *'■>'+:    list    of 
farms  to  be  kepi  by  dealers.  382. 
Dairy    rules:    of   department    of   agricul- 
ture, 412;  in  certain  cities.  414;  of  the 

Illinois  stati'  board  of  health.    111.    Il">; 

of  Massachusetts  Association  of  Boards 
of  Health.  U7,  119. 
Day  nurseries:   notified  of  communicable 

disease.    190. 

Dead  animals.  T« "■< ►  >i  acq.;  to  be  reported, 
761;  rules  for  disposal  of,  761,  762; 
disposal  of  small  animals.  7i><>:  burial 
required,  762;  cremation  of,  7'Vj  :  ren- 
dering of,  762;  iu  garbage,  667;  cost  of 
removal,   760;    vehicles   for,   763;    food 

from.    311. 

I  »•  ad  borse  wagons,  763. 

Death:  cause  of,  how  reported,  65-69;  in- 
\  esl  igal  Ion  of,  66,  ,-'7.  i 

Deaths:  enumeration  of,  5  I  ;  returns  of, 
how  obtained,  54-63;  bj  physicians  55, 
.".7:  by  clergj n,  55;  by  head  of  fam 

lly,    55;    b.V    pole.,    68;    bj     undertaker. 

50;  register  of  bj  physicians,  57;  of 
noil  '  ime   limit,   57  ; 

items  required,  68-71;  forms  for  re- 
turns, 845,  846,  v-"'i 

on  of  court  :  in  regard  to  abatement 


956 


INDEX. 


of  nuisance,  122  ;  on  payments  for  re- 
ports of  communicable  diseases,  440 ; 
on  payment  for  damage  by  disinfection, 
r>28  ;  in  regard  to  filling  low  land,  196, 
107 :  in  regard  to  use  of  lactometer, 
389 :  in  regard  to  the  inspection  of 
milch  cows,  401 ;  in  regard  to  removing 
privy  vaults,  190,  191  ;  concerning 
quarantine  of  railroad  trains,  656;  in 
regard  to  separator  milk,  374 ;  in  re- 
gard to  smoke  laws.  213-218;  invali- 
dating rule  prescribing  stable  floors. 
163  :  power  of  state  board  of  health  to 
make  rules,  43,  428 ;  concerning  vac- 
cination, 575,  57*;. 

Delegation  of  powers,  47. 

bensity  of  population  and  sanitation,  1. 

Department  of  agriculture,  338. 

Desquamation,  isolation  during,  in  small- 
pox and  scarlet  fever.  457. 

Destruction :  of  goods  in  disinfection, 
528;  of  unsanitary  buildings,  140. 

Detention  camps  in  inland  quarantine, 
061. 

Diagnosis  of  communicable  disease.  483 ; 
in  animals.  757. 

Diagnosticians :  official,  481,  485. 

Diphtheria:  to  be  reported.  437,  844;  to 
oe  placarded,  443,  446 ;  isolation  of 
family  in,  4.">2.  453 ;  isolation  of  per- 
sons exposed  to,  456  ;  duration  of  isola- 
tion. 457 :  private  funeral  in,  477 ;  to 
be  excluded  from  school.  404.  465;  dis- 
putes concerning  diagnosis.  483  ;  circu- 
lar, 906  ;  culture  method  of  diagnosis, 
559;  outfits  for  culture.  559  et  seq.; 
directions  with  outfit,  565 :  smear  ex- 
aminations. 507 :  records  of  bacterio- 
logical examinations.   567. 

Diphtheria  bacilli:  meaning  of.  483;  iso- 
lation while  present.  457. 

Diphtheria  hospitals.  612.  615. 

Diphtheria  outbreaks :  514 ;  results  of, 
514  ;  closure  of  schools,  515  ;  inspection 
of  schools,  515  ;  culture,  systematic  use 
of,  515:  diphtheria  in  institutions,  ."(15. 

Directions    for    the    care    of    vaccination, 

..JO. 

Disinfectants :  given  to  the  householder, 
549. 

disinfection:  52S  et  seq. ;  authority  for, 
427 ;  power  to  make  rules  for.  429  ;  dur- 
ing the  disease.  527  :  compulsory,  526, 
550;  by  householder,  528;  charge  for, 
528;  payment  for  injuries  in,  528:  de- 
struction of  goods  in,  528 ;  methods  of 
disinfection,  528  et  seq.;  sealing  of 
openings.  530,  ~>.'!1 :  circulars  concern- 
ing, 550,  553,  554,  1)27.  929;  apparatus 
loaned.  550;  tests  of,  546,  813;  report 
of.  928 :  records  of.  551  :  family  during 
disinfection,  .V>:t:  by  burning,  506,  509, 


529 ;  with  electrozone.  554  :  with  carbo- 
late  of  lime.  554 ;  with  copperas,  554  ; 
with  bichloride  of  mercury.  507,  509, 
513,  539,  540,  546,  548.  553;  by  wash- 
ing woodwork,  etc.,  513,  519,  548 ;  in 
smallpox,  506 ;  in  tuberculosis,  522 ;  in 
yellow  fever,  509,  555  ;  by  asphalt  fur- 
nace. 509,  555;  by  chloride  of  lime. 
555 ;  of  ambulance.  629 ;  of  funeral 
draperies,  476 :  of  bodies  dead  of 
communicable  disease,  470 ;  of  room 
after  death.  471 ;  of  undertaker,  471  ; 
of  coffin,  471 ;  of  carriages  after  funer- 
als. 475 :  of  public  conveyance,  460, 
461 ;  infected  goods,  461 ;  animals,  462  ; 
books,  463 ;  vehicles.  461,  544,  552 ;  of 
premises  occupied  by  diseased  animals, 
770. 

Disinfection  at  detention  camp.  663 ;  of 
baggage,  663 ;  of  cars.  064 :  of  mail, 
664. 

Disinfection  of  vessels,  639.  648 :  of  oal- 
last.  648:  of  baggage.  645.  646,  655. 
657. 

Disinfection  with  formaldehyde,  ."nil.  529, 
530  :  by  wood  alcohol,  533  ;  by  genera- 
tion of  gas  from  formalin.  534-537 ; 
with  paraform.  538 :  by  spraying  for- 
malin, 539;  paraform  candles.  539. 

Disinfection  with  steam.  513.  529,  540; 
first  municipal  plant.  542:  cities  which 
employ,  542  :  apparatus  described.  542- 
548 :  cost  of  apparatus.  546 ;  portable 
apparatus.  548:  removal  of  goods  for, 
519.  552  ;  at  quarantine,  648,  656. 

Disinfection  with  sulphur,  506,  509,  513, 
519,  528,  529;  sulphur  candles.  530; 
chamber  for  in  the  District  of  Colum- 
bia, 544 ;  at  quarantine,  648,  656. 

J  Hsinfection  of  vaults,  509,  554 ;  yards. 
509,  554;  gutters,  554;  streets,  554;  of 
garbage  vehicles.  686 :  of  night  soil, 
753. 

1  >isinfectors :  number  and  salary.  550 : 
duties,  551-553;  precautions  taken, 
553;  report  by,  928;  to  remove  pla- 
card, 496. 

Disinterment,  ll  >4.  130;  permit  for,  868; 
application  for  permit.  867. 

Disposal  of  garbage.     See  Garbage. 

Disposal  of  the  dead,  99-104. 

Distillery  slop  for  cows,  370. 

1  >ixon  garbage  crematory,  718-723. 

Documents,  municipal:  size  of,  817. 

Dogs  :  not  for  food,  321 :  in  communicable 
disease.  4H2  ;  rabies  in.  770:  muzzling 
of.  777. 

Drain:  house  drain,  149.  150,  222.  226- 
229,  843:  surface  drain.  240:  subsoil 
drain.    250. 

Drugs:  adulteration  of,  3ns.  325,  327. 

Drug  stores:  culture  outfits  kept  at,  565. 


IXUEX. 


'.'•-.7 


Dry  refuse,  ~'1~  el  seq.;  definition,  727- 
7:J'.>:  from  building  operations,  7l"*>  : 
from  steam  boilers,  728;  from  manu- 
factories, 728;  ira rcl.-ii  refuse,  7"Js ;  to 
he  put  on  streets,  T'js  :  weight  of.  7'_".>: 
collected  separately  from  ashes,  729; 
receptacles  for.  7:'.i»:  locution  of.  730; 
hours  for  removal.  T."!1  :  frequencj  ■• 
removal,  7:'.l  :  collection  of.  728,  7-"..'; : 
department  whicu  collects.  733;  amount 
collected  in  various  cities.  ~'.'A  :  ... 
collection  in  various  cities.  7.'!4  :  ve- 
hicles for  collection,  731,  732;  disposal 
of.  733-738;  l>.\  deposit  in  water,  7 ■".."> ; 
for  filling  low  land.  7:!7  :  by  cremation 
of.  737  :  transportation  by  scows,  736. 

Dumping:  of  garbage,  698,  699;  ashes 
ami  dry  refuse,  7:'.-".:  mixed  refuse.  7  In  ; 
night  soil.  755,  7.~»i'>. 

Dumping  grounds,  193;  at  Borne,  193; 
utilization  of  junk  on.   7">7.  741. 

lunation  of  isolation.  452,  156,  I'-'::.  503, 
645  :  of  exclusion  from  school.  4<17. 

Durgin,  Dr.  8.  II.:  and  medical  inspec- 
tion <d"  schools,  784  :  long  service  of.  31. 

Dust:  trades  which  produce,  211. 

Dusty  materials:  to  In-  covered  when  car- 
ried   in    the   Street.    [46. 

Duties  of  officials.  See  Health  Officer; 
Inst tors.  .•!■•. 

Dyer,  Dr.  Isadore:  on  venereal  diseases, 
526. 

Dysenterj  in  "epidemic"  form  to  he  re- 
ported.   139. 

Earliest:  hoard  of  health.  22;  control  of 
communicable   disease.    125;    food   law. 
308;    quarantine,    630,    649;     registra 
tii.n.  52. 

Early  sanitation,  1. 

Earth  closets,  182  1. 

Eas1   I'to\  idence  Biter,  'JV>. 

Education  of  sanitary  officials,    II. 

!  J. st  i:uics.  334,  336. 

Election  of  hoard  of  health.    16,  26. 

Klect  in/one   lor  disinfect  inn.  554. 

Einbalmer's  license,  90. 

Embalming,   I'M. 

Engineer  on  hoard  of  health.  15,  23,  29. 

Engh  ■  rematorj .  715-718. 

Entrance  of  premises:  power  of  food  in- 

'■'.  to  :   health  officials,    12  :   medi 

cal    ins|i. .  !•.:        185  :     milk    inspe< 
S 3  :  nuisance  inspectors,   I  12. 

Enu ration   of   deaths.   54;    births,   71: 

marriages,   84. 

198  :  e\i raordinary  nowers  in. 
duties  of   itate  board   of   health. 
i: ''. i ;  duties  of  federal  government    199 

llpox,   '•'"> .   yellow    fever,  501 
phoid    (<■■>>     ■"■I"     typhus    fever,    512; 
let     !'•  ver     and     diphtheria,     oil. 


cholera.  516;  the  cause  of  sanitary  or- 
ganization,   19. 

Erysipelas:  to  he  reported,  439. 

Examination  of  plumbers,  253-256 :  rules 
for.  255  :  gas  titters.  Mil. 

Exclusion  from  school  in  communicable 
disease.  See  Communicable  disease 
and  school   attendance. 

Excursions  for  sick  children.  804. 

Executive  functions  of  the  health  depart- 
ment, J  I.  32. 

Ex-oflicio  hoards  of  health.  ^:! :  county. 
7  :  township,  1 1  :  cities.  14- Hi. 

Expenses  of  the  health  department.  See 
Finances. 

Extraordinary  powers  of  health  officials 
in   epidemics,   4'J7.    198 


False  representation  in  regard  to  food. 
323,  326. 

false  returns  of  births,  marriages  and 
deaths.    85. 

Family  :   isolation  of,    152. 

Federal  quarantine  established,  630. 

Fee  for  garbage  license.  693;  for  milk 
license.  380,  381  :  for  night  soil  license. 
743;  quarantine,  639,  648;  for  plumb- 
er's license.  256;  for  reports  of  com- 
municable disease.  -I  l'i:  for  vaccina- 
tion. 591  :  for  registrati >f  vital  rec- 
ords. 97-99. 

Fertilizer  made  from  night  soil,  755. 

Fert  ilizers  :  sale  of,  209. 

rrertilizing  ingredients  in  garbage,  702. 

Filth  and  disease.    108. 

Filth:  removal  of,  122:  prohibitions  in 
regard  to,  1(1  >'  seq.;  on  private  prem- 
ises, 144,  1  to  :  not  to  be  placed  in 
streets.  1  to.  1  16;  filthy  water  in  streets. 
145-147;  filth  in  water,  265  267,  843, 
869;  in  rivers.  298-300,  869. 

Filthy   shores.    192. 

Filtration  investigation  in  Massachusetts 
and    in  certain  cities,  812. 

Fill  rat  ion  of  water:  natural  or  sand.  '_'7<'> : 
at  Poughkeepsie,  Lawrence,  Albany, 
280 :  mechanical,  282. 

Finance   committee:    chairroi n    hoard 

of  health.  •_•::. 

Finances  of  health  depart in.  818-822. 

Fire  department:  chief  of,  on  hoard  of 
health,  23. 

Firemen:  rules  for.     See  Smoke. 

Fish:  cleaning  in  ttreets  forbidden,  146; 
markets    for.    315;     peddlers   of,    317; 

■ale  of,  •"•  17  :   -plead  on   land.  209. 

Fish  r  -.ewers.  :v2'2. 

Fit  less  of  officials,    1 1. 
Flies  ;  to  he  kept  from  food.  318. 
Flour.  309,  -17.  322,  331. 

Flush    vaults.     ITs 


958 


INDEX. 


Food.  See  Communicable  diseases  of 
animals ;  defined,  327  ;  adulteration  of 
an  economic  question,  307 ;  laws.  80S. 
324  et  seq.;  adulteration  in  Massachu- 
setts. 341 :  coloring  of  food.  326,  333 ; 
poison  in.  32G,  333 ;  mixtures  and  com- 
pound. 326 ;  mis-branding.  323,  326. 

Food  commissioners,".:^). 

Food  :  diseased,  309 ;  control  of  by  health 
department.  307 ;  danger  in  impure, 
306;  animals  used  for  must  be  bled, 
cleaned  and  cooled.  311  ;  exposure  to 
dust.  317:  from  dead  animals,  311; 
from  emaciated  animals,  311 ;  from  im- 
mature animals,  313,  844 :  from  over 
heated  and  feverish  animals,  310 :  from 
pregnant  animals.  811:  from  wounded 
animals.  810;  packages  for  to  be 
clean,  81S:  protection  from  flies.  318; 
sale  of  impure  and  adulterated.  341) :  as 
a  gift.  840:  possession  of,  350;  taking- 
orders  for.  350 :  unwholesome,  impure, 
tainted,   unhealthy,   808  ct  seq.,  844. 

Food  inspection:  federal,  338;  state,  339; 
local.  341. 

Food,  inspectors  :  duties  of,  340 :  as  milk 
inspectors,  342 ;  other  officials  acting 
as.  842 :  market  inspectors.  842 :  live 
stock,  grocery,  provision  inspectors, 
343  :  number  and  salary  of,  344  :  power 
lo  enter  premises,  345;  at  the  railroads, 
347  :  records  and  reports.  348  ;  analyses 
of  food,  340 ;  seizure  of  food.  314,  316, 
847.  351-353 ;  of  milk.  377  :  samples  of 
food,  340;  power  to  take,  845,  .".40 : 
seizure  of  food,  314.  316,  347,  351-353. 
885. 

Food  laws:  liability  in,  84S  et  seq.;  pen- 
alties for,  351. 

Formaldehyde:  disinfection  with.  529, 
558;  at  quarantine,  648.  See  also  Dis- 
infection. 

Formalin  :  strength  of.  534  :  for  generat- 
ing gas  for  disinfection,  534 :  amount 
required.  537  ;  for  spraying,  539. 

Forms :  undertaker's  report  of  deaths, 
846;  burial  permit.  847-849:  transit 
permit.  850;  certificate  of  death,  851- 
855;  birth  return.  856;  completing  re- 
turn of  birth,  857;  return  of  still  birth. 
858;  marriage  license  and  return.  859- 
862;  records  of  births,  marriages  and 
deaths,  863-865  :  returns  of  births,  mar- 
riages and  deaths  to  state  registrar, 
866-867;  disinterment  permit,  S69 ;  ap- 
plication for,  867 ;  complaint  of  nui- 
sance, 871 :  report  of  nuisance.  871 ; 
report  of  sanitary  inspection.  872-875 ; 
order  to  abate  nuisance  875-878;  or- 
der for  vacation  of  premises,  879 ;  or- 
der for  connection  with  sewer,  S79 ;  ap- 
plication for  plumbing  permit,  8S0 ;  for 


plans  of  plumbing,  881-884  ;  certificate  of 
plumbing,  885  ;  certificate  of  condemna- 
tion of  provisions,  885 ;  certificate  of 
analysis  of  food,  341 ;  food  inspec- 
tor's report,  348 :  milk  inspector's  rec- 
ord books,  391  :  index  cards  for  same, 
394,  395 ;  inspector's  reports,  396 :  no- 
tice to  dealer  having  poor  milk,  398 ; 
index  card  milk  producers.  402  ;  appli- 
cation for  milk  license,  S80.  S87,  888; 
milk  license,  88S-S89 :  for  record  of 
milk  inspection,  889 ;  warning  to  milk 
dealers,  890 :  report  of  inspection  of 
dairy  farm,  891,  892:  index  card  for 
dairy  farm  inspection,  403:  index  cards 
for  inspection  of  cows,  404,  405 :  for 
reports  of  communicable  disease,  440, 
893-896 ;  to  state  board  of  health.  896. 
897 ;  recovery  from,  919 :  records  of 
communicable  disease,  918,  920,  928, 
930;  placards.  898,  899;  order  forbid- 
ding school  attendance.  913.  916.  917: 
permits  for  attendance,  901,  919;  or- 
der for  isolation,  913 :  exclusion  of 
wage  earner  from  work.  899;  permits 
for  work,  900;  report  of  inspection  in 
communicable  disease,  nil.  915;  report 
of  disinfector,  928 :  directions  for  diph- 
theria cultures,  564 :  physicians'  re- 
ports of  cases,  564,  565,  929;  reports 
of  examination  of  cultures,  568,  930, 
931 :  used  in  connection  with  the  exami- 
nation of  sputum.  569  :  used  in  connec- 
tion with  Widal  test,  569,  571,  931* 
932;     report    of    sputum    examination, 

931,  932:    vaccination   certificate,    586, 

932,  934;  reports  of  vaccinations,  933; 
application  for  antitoxin,  599,  935;  re- 
port of  use  of,  600.  936 ;  record  of,  936 ; 
of  master's  statement  at  quarantine, 
643:  certificate  of  pratique,  645;  state- 
ment of  passenger  at  quarantine,  644  ; 
land  traveller's  statement,  987  ;  certifi- 
cate. 937;  train  inspection  card.  654; 
application  for  night  soil  license.  939 : 
permits  for  cleaning  vaults.  940-1)42; 
school  house  inspection,  7S3  ;  report  of 
medical  inspector  of  schools,  785,  943  : 
directions  for  treatment  of  pediculosis 
7S0 ;  permit  for  child  to  work,  946;  ap- 
plication for,  941;  tenement  inspection, 
830,  890  ;  registration  of  lodgers,  833 ; 
inspection  of  lodging  house.  834 ;  re- 
port of  local  board  of  health  to  state 
board  of  health,  841 ;  certificate  of 
ownership  of  tenement  or  lodging 
house,  949. 

Forum:  article  on  lodging  hous?s,  834. 
Fowls.  171. 

Freight :  quarantine  of,  658. 
Fresh    air   inlet :    for   furnaces,    153 ;    for 
plumbing,  241. 


INDEX. 


959 


Fresh  air  societies  notified  of  communi- 
cable disease,  490. 

Fries  Bros. :  formaldehyde  generator,  536, 

Fruit.  321. 

Fruit  jellv,  335. 

Fruit  trade:  control  of,  646. 

Fuller:  report  on  mechanical  filter,  285. 

Funerals.  See  Communicable  disease  fu- 
nerals. 

Furnace:  disinfection  by  asphalt  furnace, 
509,  555;  fresh  air  inlets  for,  1.53. 

Game,  309. 

Garbage:  definition  of,  665,  666;  what  is 
included  in,  666  et  seq.j  data  concern- 
ing, should  l»'  carefully  prepared,  812; 
Eleriug's  report  on,  665;  in  markets. 
315;  composition  of,  7< »i! :  junk  con- 
tained in.  Tn2 :  value  of,  101  ei  seq.j 
fertilizing  ingredients,  T< »'J  :  water  in, 
702;  weight  of  cubic  yard,  667,  702. 

Garbage,  collection  of,  688  ci  seq.j  sepa- 
rate collection,  669;  notice  concerning, 
938;  collection  by  contract,  688;  by 
municipal  employes,  689;  department 
ecting,  74ii:  license  for,  692;  rules 
for,  692;  Fee  for  license,  693;  cost  of 
collection  in  various  cities,  695;,cos1  of 
private  collection,  694;  amount  col- 
lected in  various  cities.  695;  per  capita. 
7<i.", ;  buildings  from  which  it  is  col- 
lected, 668;  hotel  collection,  668;  mar- 
kets, collection,  668;  frequency  <>J'  re- 
moval, 676-678;  hums  for  removal, 
678. 

Garbage,  disposal  of,  697  et  seq.j  on  the 
premises,  691,  6U7;  by  feeding  to  ani- 
mals. 699;  i"  cows,  :'.7n :  by  feeding  to 
e,  701  :  profit  in,  7<H  ;  by  dumping 
mi  land,  698;  dumping  in  water.  699; 
i    fertilizer,  698;   by   ploughing   in, 
l..\   sale  of,  T» » 1  ;  1>.\  cr<  mat  ion,  71  I 
n  seq.;  [deal  furnace,  7'_'7 :  1. ester  fur- 
•     7'J7  :  McKay  furnace,  7l'7  :  Rider 
furnace,     726;     Risley     furnace,    7"_'7 . 
Brown    furnace,    726;     Brownlee    fur- 
nace,  726;   burning   In  open   air,   714; 
■  .a    furnace,     7lv7i'.'::     Engle    fur- 
7  1"'  718;  Smith  furnace,  7*_"J  7 '_'."> : 
Vivartos    furnace,    i27;    bj    reduction 
processes,   7ni    ci   seq.j   American    lie 
duction    Company's    process,    7K'. :    Ar- 
nold   process,    708;    Chamberlain    pro- 
7  1"     Holt haua  process,  711,  712; 
Merz   process.   703,   7i»."> :   at    Paterson, 
714;    at    New    Bedford,    714;    Bimonin 
700,  707;  at  Utica,  Til. 
Garbage   disposal,   cost    of:    I"    dumping, 
(KMJ;  b}  ploughing  in,  699;  i>>  dumping 

in  899;    bj    f linu   to  swine, 

7"l  :  l>.\  Merz  process,  706;  bj  Bimonin 
i.i ...  rCt      bj    Arnold   process,  7i»'.' . 


by  Chamberlain  process,  7M:  by  Holt- 
haus  process,  7VJ:  by  American  Re- 
duction Company's  process,  714:  by 
burning  in  open  air,  715;  by  cremation 
in  Bngle  furnace.  71<'>.  718;  in  Dixon 
furnace.  720,  ~i-2  :  in  Smith  furnace. 
726;  in  Rider  furnace.  7"_'f> :  in  Brown- 
lee furnace  726;  in  Meal  furnace.  7U7  : 
in  McKay  furnace,  7"J7 :  in  Lester  fur- 
nace, 7l'7  :  in  Risley  furnace,  TUT. 

Garbage,  receptacles:  670;  covers,  * "> T 1  : 
handles.  671;  size.  671;  material.  t>7"-!  : 
enforcement  of  rules.  672 :  wooden  re- 
ceptacles. 672;  care  of,  673;  garbage  to 
be  kept  in,  »;7.". :  location  of,  <*>74 ;  in 
tish  markets,  681. 

Garbage,  vehicles  for  removal  :  use  of  bar- 
rels. 680;  size  of,  683;  care  of  on 
streets.  684;  movable  bodies,  684; 
marks  upon.  686;  owned  by  the  city, 
686;  regulations,  678;  to  be  water 
tight,  679;  covers.  679;  cost  of,  *>7'.». 
681,  682,  683,  684;  number  of  horses. 
<i7'.»:  number  of  men.  679;  cleansing  of, 
686;  disinfection  of,  686;  garbage  not 
to  be  carried  in  milk  wagon,  416; 
transportation  by  ear.  687;  transporta- 
t  ion  by  scows.  687. 

Garbage  urease.     See  Grease. 

Garbage  and  ashes.      See  Mixed  refuse. 

Gas :  not  to  be  turned  off,   153. 

<  las  fitting  :  regulal  ion  of,  801. 
Gas  works.  Jim. 

General   hospitals:  communicable  disease 

in.  615. 
General    laws   for   sanitary   organization, 

19. 
Generators  for  formaldehyde,  532. 
Geneste    Herscher   i\-   Co.'s   formaldehyde 

gi  aerator,  539. 
German  measles:  to  be  reported,   1  •">'•' ;  t<> 

lie    excluded    from    school.     16  I. 

Getty,    Dr.    S.    E. :     milk   distribution   at 

Vollkers.     122. 

< llanders  :      com  rol 

diagnosis  of,  ~'7l! 
Glycerinized  virus. 
Goats,  17'_'. 
Governor:  appointment  of  board  of  health 

by,    I.  5,  26;   maj    declare  Quarantine, 

634 
Grain   332 

( I  rave,  regulat  i<m  of,  102. 
i  Iraj .  Mr. :  long  Ben  ice  of,  '■'<  1. 
Grease,    bones,    etc.;    rules    for    removal. 

757  759 
Urease  from  garbage,  702,  7"."..  7m.  709 

712,   713. 

<  ; mini:    of    cow  s.     1  III. 

kI    water:    record    of    height,    Aslmrv 

Park,  815. 


of,    776;    laboratory 
io  lie  reported,  i  W. 

S.  .•    Vaccine    virus. 


960 


INDEX. 


Guards    for    communicable    disease,    493, 

606;  for  inland  quarantine,  660. 
Gutters.     See  Streets. 

Halibut,  323. 

Harrisburg  smallpox  hospital,  014. 

Health  commissioner.  14-10.  25;  on  board 
of  health,  23.     See  also  Health  Officer. 

Health  department :  expenses  of.  See 
Finances. 

Health  inspector  on  board  of  health,  23. 

Health  officer  :  appointment  of,  4,  5,  34  : 
in  counties.  4,  8,  9 ;  in  cities,  14-16 ;  in 
townships,  11;  required,  34:  compensa- 
tion, 35 ;  duties  of,  33,  37,  846 ;  educa- 
tion of,  41 ;  fitness  of.  35,  41 ;  fine  for 
failures,  40  ;  legislative  power,  43  ;  ob- 
struction of.  41  ;  other  titles,  34  ;  term 
of  office.  35 ;  and  communicable  dis- 
eases, 481 :  to  post  placards.  445 :  to 
fix  duration  of  isolation.  4.17.  459 ;  to 
remove  persons  to  hospital.  606;  and 
nuisances.   111,   112. 

Health  officer  of  port  on  board  of  health, 
2::. 

Heating  and   ventilation  of  schoolhouses, 

781. 
Herds.      See  Dairy  farms. 
Ilering,  Rudolph:  report  on  garbage,  065. 
Ilolthau's    process    of    garbage   disposal, 

711.  712. 
Honey.   330,  331. 
Horlbeck,  Dr. :   long  service,  31. 
Horse  for  ambulance,  030. 
Horse  meat,  323. 
tiospital :   general,   managed  by  board  of 

health,  sue,.  810;  communicable  disease 

in.  615. 
Hotel  garbage:  collection  of,  668. 
Hotels :  sale  of  food  in,  320,  350. 
Hours  of  service  for  health  officials.  39. 
House  :  isolation  of  inmates,  455. 
House  to  house  inspection.  132  :  in  small- 
pox,  501 ;   house   to  house   vaccination, 

590. 
Householder:  to  disinfect.  528;  to  report 

communicable  disease.  431.  432  :  deaths. 

50 ;  births.  72. 
Humanized  virus.      See  Vaccine  virus. 
Hides:  dealing  in.  208-9. 
Hydrants,  151. 
Hydrophobia:    to   be   reported.   439.     See 

also  Rabies. 

Ice:  examination  of,  296;  how  cut  from 
public  water  supply,  207  :  no  driving  on 
ice  on  water  supply.  207  ;  pollution  of. 
292;  laws  regulating  the  sale  of.  293- 
295;  license  of  dealers.  294;  in  milk 
wagons,  418;  undertakers  not  to  place 
in  street.   104. 

[ce  l.oxes,  318. 


Ideal  garbage  crematory,  727. 

Immature  animals  food  from,  313,  844. 

Immigrants:  vaccination  of,  573.  639, 
044. 

Incubation  of  communicable  disease.  450  ; 
isolation  during,  450. 

Independent  boards  of  health,  23 ;  in 
counties,  8 :  in  townships,  cities.  14-16. 

Index  for  vital  records,  91. 

Infants :  boarding  houses  for,  802 ;  cir- 
cular on  care  of,  943,  945. 

Infected  goods,  401,  902. 

Infected  milk,  399. 

Infected  persons,  removal  to-  hospital.  006. 

Influenza  :  laboratory  diagnosis  of,  572. 

Ink  for  records,  90. 

Inspection.  See  Milk  ;  Plumbing  ;  Medi- 
cal inspectors  ;  Communicable  diseases  ; 
Nuisances. 

Inspection  :  authority  to  enter  premises, 
42.  112.  345,  385.  485;  obstruction  of 
officers,  42,  113 ;  house  to  house  inspec- 
tion, 132  :  reports  of,  872-875 ;  of  cigar 
factories,  800;  of  dairies,  379;  of  i<-e, 
200;  of  kerosene,  807;  of  laundries. 
807;  of  lodging  houses,  831-834;  of 
schoolhouses.  7S1  et  seq. ;  of  sponge 
fleet,  041 ;  of  slaughtering,  346,  347 ;  of 
tenement  houses.  825,  826,  830,  831; 
of  trains,  051.  653,  05'.).  663;  of  vessels 
at  quarantine,  038,  641,  042;  of  water 
shed.  271. 

Inspectors:  impersonation  of.  113:  ob- 
struction of.  113;  authority  to  enter 
premises.  42.  112.  345,  385.  485;  of  fu- 
nerals. 494;  live  stock  inspectors.  .".4.'!; 
medical.  See  Medical  insnectors.  481 ; 
of  milk,  383  :  of  night  soil  scavenging, 
750;  of  nuisances.  See  Sanitary  in- 
spectors, 126-130 ;  of  plumbing.  2.">T  : 
of  schools.  784 ;  duties  of,  784,  785. 

Institutions  for  children,  805. 

Instruction  in  hygiene,  41. 

Intermittent  filtration  for  sewage,  301. 

Investigation  of  communicable  disease: 
authority  for,  484. 

Itch  :    to  be  excluded  from   school,   404. 

Ivory  points  for  vaccine,  592. 

Ivy:  poisonous,  150. 

Jail.      See  Penal  institution. 

Janitors  excluded  from  school,  464. 

Jelly,  335. 

Jimson  weed,   150. 

Joints :   in  drains,  soil,   and  waste  pipes, 

223   229   232. 
.Indue:    appointment   of   board    of   health 

by.  10.  27. 
Judicial  functions  of  board  of  health,  47- 

40. 
Junk  in  garbage,  7<>2  ;  in  dry  refuse.  737; 

utilization  of  on  dumps.  741. 


INDEX. 


961 


Junk,  rags  and  bones:  collection  of,  759. 

Jurisdiction  of  board  of  health:   county, 

8,  '».  10;  township,  1  12 :  municipal,  18. 

Kerosene:  control  of  sale  of,  807;  in- 
jection of  animals  killed  for  dis.  ase 
with.  Tin;  on  condemned  fond.  :;.".:;. 

Klebs-Lceffler  bacillus.  See  Diphtheria 
bacillus. 

Knopf,  Dr.  S.  A.:  writings  on  tubercu- 
losis, 520  - 1  xi  </. 

Knowledge:  advancement  of.  Ml. 

Kny's  formaldehyde  generator,  534. 

Kny-Sheerer's  formaldehyde  generator. 
536. 

Kuhn's  formaldehyde  generator,  533. 

Laboratories.  See  Bacteriological  lab- 
oratories. 

Lactometer,  389;  use  of.  392 ;  by  milk 
dealers,  399. 

Lactosc-ope,  389. 

Lamb:  flesh  or  immature,  313,  Ml. 

Lance  for  vaccination,  593. 

Lanciani  :  accounl  of  dumping  grounds  al 
Rome,   193. 

Laid.  330. 

Laundrj  :  clothes  disinfected  before  sent 
to.  553  :   iuspecl  ion  of,  807. 

Lawrence  filter,  280. 

Lawyer  on  hoard  of  health,  '_"••:  as  health 
officer,   I.  8. 

Layman  on  board  of  health,  lis. 

Legislative  functions  of  the  board  <>\ 
health,  42-47:  in  single  headed  deparl 
mcni.   -1~>. 

Lentz's  formaldehyde  generator,  530. 

Leprosv :  management  of.  525;  to  be  re- 
ported,   139. 

Lester  garbage  crematory,   7:27. 

Liability  of  oiii.ials  in  discharge  of  duty, 
40. 

Libraries.  See  Public  libraries;  Office 
library. 

Library  books.     See  Hooks. 

Library  of  the  health  deoartment.  810. 

I  See  Pediculosis. 

License.  See  Marriage:  for  garbage  col 
lection,  092;  for  ice  dealers,  294;  for 
milk  producers,  HO;  for  milk  dealers, 
::7^  382 :  io  !.<•  posted,  382 :  for  night 
soil  scavengers,  7 12 :  offensive  trades, 
203  204  :  lor  plumbers,  252  :  physi 
ciann,  midwives,  clergymen,  under tak 
ers.  90  :  gas  fitters,  801. 

Lily's  formaldehyde  generator,  534. 

Lincoln:   smallpox   hospital  at,  008. 

Liquor:  in  candy  334;  adulteration  of. 
324,  327,  328. 

Live  stock  inspectors,  3  13. 

Lobsters,  .".•J'-'. 

(51 


Location  for  communicable  disease  hos- 
pital, 605,  »'><>s.  617. 

Lodgers  :  register  of.  883. 

Lodging  houses:  licenses  for.  831,  832; 
rules  for.  831  :  air  space  required,  832; 
inspection  of.  831,  834;  registration  of 
lodgers,  833;  in  New  York.  Chicago 
and  Philadelphia,  834;  report  of  in- 
spection, 83 1. 

Low  land  :  filling  of.   190,  843. 

Lozenges,  •"••■'>.">. 

Lying-in  hospitals.  802. 

Lyle,  Dr.:  consumption  hospital  ai  Cin- 
cinnati. r>°.4. 

MAGRl  mi:.    Surg.  :    report    of   smallpox    in 

Birmingham,  506. 
.Mail:  disinfection  of.  664;  bacteriological 

material  sent  by,  556. 
Malaria:  laboratory  diagnosis  of,  ">71  :  to 

he    reported,     1  10. 

Malt  liquors,  327,  328. 

Map  for  communicable  diseases.  491,  492 ; 

for     tuberculosis   cases.    521;     locating 

dairy  farms,  402. 
Maple  sugar,  331. 
Marine  hospital  service  in  epidemics,   199; 

quarantine   powers,    <'>'■'<-.   652;     yellow 

(f\<-v  outbreaks,  control  of.  660. 

Ma  rl.et  :  inspect  ion  of  food  in.  342  : 
cleanliness  id'.  .".11  :  control  of.  316, 
•  117.  consumption  in,  ~>'2'2 :  control  of 
food  in.  353;  garbage,  collection  of. 
608;  managed  l>.\  hoard  of  health.  806! 

Marking  cheese,  360;  butterine,  362; 
ski led       milk.      :;7 1  :       milk      dealers' 

wagons,  381,  382. 
Marriages:  registration  by  health  depart 
incut.  77:  forbidden  in  cases  of  venereal 
disease.  526;  legal  restrictions,  minors' 
permits.   82;    certificates,   81;    licenses, 
78-81,    859-862;    where    required,    78; 

fees     for.     78;     bj      whom      issued.      .  s:  ; 

items,  80;   register  of.  83;   returns  of, 
77  85,  845,  859  802  ;  time  for   84. 
Master   of    vessel:    duties    in    quarantine, 
035,   636,   641  :    Btatemenl    of.   643 :    to 

report     ion Uicable    disease.      132. 

.Mayor  mi  hoard  of  health,  1  I  16,  23  :  to 
appoint  board  of  health.  U7. 

McKaj   garbage  crematory,  7:27. 

McLellan  vent,  243. 

Meal,  309. 

Measles:  to  he  reported,  138,  844;  to  he 
placarded,  I  !•">.  117:  duration  of  isola- 
lion  159.;  private  funeral  in.  177:  cir- 
cular. !>o7. 

Mea  mi  ers  of  nighl  soil,  750. 

Meal  cased,  blown,  plaited,  i  a  ised, 
stuffed,  impure,  etc.,  309;  meat  to  he 
tagged,  -'117. 

Mechanical  stokers,  jis. 


962 


INDEX. 


Medical  inspection  of  schools.  7*4  et  seq.j 
schools  inspected.  784;  salary  of  in- 
spectors. 784,  787,  788 ;  teachers'  du- 
ties. 784  ;  by  board  of  health,  784,  787. 
788 :  by  board  of  education,  788 ;  re- 
sults of,  787-89. 

Medical  inspectors  :  list  of,  salaries,  481 : 
duties.  482 :  authority  to  enter  prem- 
ises. 485;  no  one  to  obstruct  or  assault. 
485 :  investigation  of  cases,  485 ;  to 
give  directions,  4SG  ;  to  put  up  placards, 
488;  to  take  cultures,  488;  to  vacci- 
nate, 488;  to  send  out  notices,  488: 
frequency  of  visits,  492,  493;  to' ex- 
amine patient  at  termination  of  ease 
493;  reports  of.  4*7,  943. 

Medical  soeie.ty  as  board  of  health,  7 : 
nominates  board  of  health,  8,  10. 

Medicine.      See   Drugs. 

Mercury.      See  Bichloride  of. 

Merz  process  of  garbage  disposal,  703, 
7(  to. 

Meters  for  water.  202. 

Midwife's  license,  96. 

Milk  adulteration:  importance  of.  366; 
legislation,  807  et  seq.,  376-378 :  de- 
lined.  367-368;  liability  for  violation 
of  law.  870 ;  penalty  for.  870 :  seizure 
of  milk.  .".77:  prosecution  for.  8!>7:  col- 
oring  matter  in.  80*:  preservatives  in. 
369 :  standards.  .".71 ;  average  quality 
of.  .".71:  samples,  collectors  of.  386; 
outfit  of.  389;  samples,  how  taken.  ."!*2. 
393 :  furnished  by  dealers,  ."'.lit ;  taken 
by  citizens.  398 :  analyses  of.  385  :  by 
two  chemists.  398;  instruments  to  be 
tested.   398. 

Milk  :   condensed.   .",7.">. 

Milk:  inspection  of.  382-397;  by  state 
officials,  383;  laws  concerning,  8*8; 
where  made.  387,  388;  record  of.  889; 
in  New  York  City,  390-397.  See  Milk 
adulteration. 

Milk  inspectors,  383  et  seq.;  appointment 
of,  384;  power  to  enter  premises,  385; 
duties.  385;  as  chemists,  ."*.">:  collec- 
tors of  samples  for.  386;  officials 
charged  with  the  duty.  386;  number 
and  salary.  386;  buggy  for.  388;  outfit 
Eor  samples,  389-92.  See  Milk  adul- 
teration. 

Milk  dealers'  licenses.  378-382,  888,  889; 
application  for.  380,  886-888;  revoca- 
tion of.  .".77:  required.  378;  issued  by 
state.  379;  by  local  officials.  379;  re- 
quirements for.  379,  380;  fees  for.  380, 
381;  license  for  -producers.  410;  deal- 
ers' reports,  380;  to  furnish  names  of 
producers,  402 :  wagons,  marking  of. 
.".si.  382;  not  to  carry  water.  370. 

Milk,  skimmed:  372;  standards.  373: 
marking.   ."74. 


Milk,  unclean  and  impure.  800  et  seq. ; 
danger  in,  399 :  disease  produced  by, 
.".'.t'.),  4(M):  from  diseased  animal.  326, 
369 :  infected  milk.  399 :  cause  of  ty- 
phoid in  Springfield,  512. 

Milk  supply  and  communicable  diseases, 
419 :  dealers'  duties  in,  462 ;  dealers 
notified  of,  490;  milk  bottles  and  tick- 
ets not  to  be  left  at  infected  house. 
462;  care  of  milk,  412,  417.  See  also 
Dairy  rules-  care  and  use  of  bottles. 
416,  417:   sterilized  milk  vessels,  417. 

Milk  wagons:  protection  of  milk  in.  418; 
ice  in.  418;  garbage  in,  49'.. 

Mills.  Hiram :  designer  of  Lawrence 
filter.  278. 

Minturn  hospital.  New  York.  017. 

Mis-branding  of  foods,  323,  326. 

Mixed  refuse.  738  et  seq.;  amount  col- 
lected in  various  cities.  740;  cost  of 
collection  in  various  cities.  740;  depart- 
ments which  collect.  74o :  weight  of, 
738;  receptacles  for,  7:!*:  location  of, 
780 :  frequency  of  collection.  739;  hours 
for  collection.  789:  vehicles  for.  7."'.» : 
disposal  of  by  cremation,  741:  cost  of, 
741:  by  dumping  on  land,  740;  by 
dumping  in  water.  741. 

Model  code  of  sanitary  regulations,  4*. 
843. 

Molasses,  330. 

Morrison-Jewell  filter.   2*2. 

Mulford's  formaldehyde  generator,  536. 

Mumps:  to  bo  reported,  439;  to  be  pla- 
carded, 444;  to  be  excluded  from 
school.  404. 

Muncie  :  smallpox  hospital.  612-613. 

Municipal  boards  under  general  laws.  2<>. 

Municipal  officers,  appoint  board  of 
health.  27. 

Municipal  sanitary  organization,  12-17. 

Municipalities.     See  Cities. 

Mutton  :  blown.  812. 

Muzzling  dogs.  777. 


NAPHTHA:   garbage   reduction.   708-70*. 
Xeedles  for  vaccination,  593. 

New  Bedford:  garbage  disposal  at.  714. 

Xew  York:  preparations  for  cholera.  517; 
typhus  fever  in.  1*02.  512;  milk  inspec- 
tion in,  390-397;  sanitary  organization, 
.",'.). 

Night  schools  and  communicable  disease, 
407. 

Night  soil,  742  et  seq.;  amount  collected 
in  certain  cities.  7ol  :  license  for  re- 
moval of.  742:  application  for,  939; 
by  whom  issued,  743 :  fee  for,  748  ; 
fond  for,  748:  exclusive  license.  740; 
removal   of.   thoroughness   and   prompt- 


INDEX. 


963 


-  required,  753;  returns  of  work 
done,  7.~>4.  755;  rules  for  removal.  747: 
price  of  removal  tixeil  by  ordinance. 
7  is  :  control  of,  748  et  s<  q. :  by  the  mu- 
nicipality, 753  :  permits  for  cleaning 
vaults.  752,  7.":'..  940-942;  disinfection 
of  night  soil,  7.".*!:  apparatus  for  re- 
moval of,  74:i  :  barrels.  7  H.  745;  box 
gons,  74  1  :  odorless  or  pneumatic  ap- 
paratus, 746;  pumps.  7 Hi:  pitting  ap- 
paratus, 746;  <are  of,  717:  in  be  ba- 
ted, 748;  transported  by  scow,  755; 
disposal  of,  751  :  by  cremation.  1T,7>. 
7.">7 :  by  burial,  755;  by  drying,  755; 
as  a  fertilizer.  755,  7.">f>.  7.">7 :  deposit 
in  water,  756. 

forbidden,    158;     noisy     animals. 
170. 

Notice  "I"  funerals,  47-">. 

Nuisance:  definition  of,  108,  123,  843, 
8G9;  early  control  of.  Ins.  ion ;  rela- 
tion to  public  health,  108,  109;  preven- 
tion <>f.  109;  complain!  of,  130,  871  : 
prohibition  of,  legislation,  123  </  seq.j 
local  authority  concerning,  124,  125, 
143  el  scq. 

Nuisances,  abatement  of:  legislation,  109- 
11.".:  officials  charged  with  the.  duty  of, 
110,  111  :  orders  for,  113,  133,  875- 
orders  for  preliminary  bearing, 
L15 ;  service  ut  orders,  11*'>.  136;  time 
allowed,  115,  11'"':  work  of  abatement, 
lis.  137,  138;  injunction  not  allowed. 
119;  officers  required  to  abate,  119; 
costs  of  abating,  paymenl  fur.  119-121; 
bj  injunction.  121;  abatemenl  of,  by 
state  board  of  health,  1 1 1.  r_"J. 

Nuisances  <>n  water  shed,  270. 

Nuisances:  inspectors  of.  See  Sanitary 
inspectors. 

as   guard   for  communicable  dis- 
193 :     e  ccepted     from     isolal  ion 
rules.    150;  duties  of.   iu  communicable 
154,    I"'"'. 

Nursing  l. ..til.-.  80J 

Oaths:  administering,  29,    17;  power  of 

registrar    to    administer,    s'.>'    oath    of 

office,  ■_".'. 

noting  officers,    12,    I  1  '.. 
Odorless  apparatus  for  re v;*l  of  night 

snil     7  W. 

i\  •■  mat  ten     rules  for  i  e \  al  and 

transportation,  717.  704 
Offensive  trades,    199;   location  of  bj    the 

.iu! horit ies,  umi  202  :  rules  for  in 

men  I    of,   202  21  I,   843  ;    licenses,    203 

204     forbidden,  212  _'l  1 
Officials:    subordinate,    -".7:    appointmcnl 

ut.   '■'■'■'..   '■'•'■>  :   c'liu  .it  i I.    I  I  :    tun. 

1 1     protect  ion  of,   I" 
< »tli.  •    library,  81(1 


Oleomargarine.     Sec  Butterine. 

Olive  oil.  336. 

ophthalmia,  contagious:  control  of.  803; 

tu  he  excluded  from  school,  464. 
Organization  of  board  of  health.  :J!>. 
<  Iver-erowding.  154. 

Overseer  of  poor  on  heard  of  health.  23. 

Owatonna :  diphtheria  in  school  at,  516. 

I'a<  cages  for  food  to  be  dean.  :'.17:  for 
fruit.  321. 

Paper:  for  records,  90;  waste  collection 
of,  7"_>:i :  waste  in  dry  refuse,  utiliza- 
tion of.  7-".7. 

Paper  carts,  7:'."J.  7:'..".. 

Paper   mills:    vaccination    in.   579. 

Parent-:  excluded  from  scln.nl.  404  :  tu 
control  children  with  communicable 
disease,   1 18,  450. 

Parish    hoard  of  health.  8. 

Parke,  Davis  &  Co.'s  formaldehyde  gen- 
erator, 539. 

Parochial  schools  and  communicable  dis- 
ease. 4< >T  :   vaccination  in.  578,  590. 

Passengers:  duties  at  quarantine,  637; 
statement  of.  64  I  :  treatmenl  of.  6  15. 

Pasteurized  milk:  municipal  distribution, 
420. 

Paterson :  garbage  disposal  at,  714. 

Pathogenic  organisms  in  water.  I'd.;. 

Pat  ienl  :   isolal  ion  of.    150. 

Pawtucket    smallpox   hospital.   603. 

Paymenl  for  -nods  destroyed  in  disinfec- 
tion. 528. 

Peddlers  of  food.  316,  :;17.  320. 

Pediculosis  in  schools:   treatment   of.   786. 

Penal  institutions-,  communicable  disease 
in.  606. 

Penall  ies  :  17  ;  lor  not  report  ing  commu- 
nicable disease.  I  12  :  for  food  laws, 
351  ;     I'm-     violation     of     funeral     rules. 

177:  for  milk  laws,  376,  377 ;  for  plumb- 
ing laws.  261  :  for  violating  quarantine, 
639;  for  leaving  quarantine  ground, 
638;  for  registration  laws.  99;  for  dis- 
regarding   nuisance    orders,    117.    137; 

for   nuisance   laws.    1'_'.".. 

Pensions,  1 1. 
Peppermint  test,  260. 

I'est     hollies.    007. 

Philadelphia  :  smallpox  in.   19 

Phthisis.     See  <  lonsumpt  ion. 

Physicians :  on  board  of  health,  ll.  II  16, 
L'.'-..  28,  '-"•':  license  foi-.  96;  physician 
I'm-  si,  u  poor,  mis:  for  ambulance,  630; 
i,,    report    communicable   disease,     130, 

t ■".'_' :  excepted  from  isolation  rule-.    150; 

dui.\  of  in  communicable  disease,  154; 
to  h\  duration  of  Isolation,  157,  158; 
in  e\i  hide  children  from  scl I  in  com- 
municable disease,  I'm  to  not  if)  health 
department  of  recoverj  of  natient,   190, 


964 


IXDEX. 


.  494;  precautions  to  be  taken  by,  519; 
in  smallpox.  503;  to  certify  to  disinfec- 
tion, 552 :  may  exempt  from  vaccina- 
tion, 577. 

Pig  :  flesh  of  immature.  313,  844. 

Pigeons.  172. 

Pilots:  duties  of,  636,  641. 

Pioscope,  389. 

Pitch  of  drains  and  pipes,  22:;.  233. 

Placards  for  communicable  disease  re- 
quired, 441':  in  certain  diseases.  443; 
in  suspected  contagion.  -144;  responsi- 
bility for  removal.  444:  where  placed, 
44.").  4.~»0  ;  health  officer  to  placard,  445  ■ 
officers  who  put  up,  488"  how  removed, 
405;  to  be  kept  up  after  death.  450 ; 
form,  size  and  color,  44<'>.  447.  8it&,  899  : 
how  fastened.  447. 

Plague:  to  be  reported,  4::o  ;  placard  for, 
443. 

Plan:  of  privy  vault  in  Cleveland.  170;  in 
District  of  Columbia.  183;  of  valve  for 
flush  vault.  ISO;  of  plumbing  to  be 
Bled,  224. 

Planing  mill  smoke.  219. 

Plumbers  :  license  for.  252 :  examination 
of.  253-256;  fee,  256;  registration.  255, 
256;  publishing  license,  256:  bonds, 
256. 

Plumbing :  not  to  be  used  until  approved, 
260;  defective  work,  penalty.  201;  cer- 
tificate of  work.  260;  in  old  houses, 
150-152.  251. 

Plumbing  inspection :  department  in 
charge  of.  252:  application  for  permit. 
880  :  notification  that  work  is  ready,259  : 
inspection  to  be  made  promptly,  259; 
tests  for  plumbing.  259;  certificate  of 
inspection.  SS5 ;  inspectors,  authority 
to  appoint.  257:  duties.  257;  salary. 
258;  inspector  on  board  of  health,  23. 

Plumbing  rules:  first  adopted,  220;  stat- 
utes authorizing,  220-222:  model  codes 
of.  222,  22.'! :  applied  to  old  plumbing, 
251  :  back  aii'  pipes  required,  242:  size 
and  direction,  24.'!;  material,  244;  back 
pressure  valve.  2.">0  ;  bath  tubs  required, 
240;  boilers,  240:  clean  outs,  236; 
drain,  size  of.  227 :  material  of,  222, 
228 :  joints  of.  228 :  surface  drains, 
240:  sub-soil.  250;  changes  in  direction. 
Si'-',.  234  :  deviation  from  rules  permit- 
ted. 220:  exposure  of  plumbing.  235  ; 
fresh  air  inlet.  241  ;  joints,  how  made, 
XVI  :  materials  and  workmanship,  220; 
McLellan  vent,  2-1.'! ;  openings  for  pipes. 
2o4 :  overllow  pipes,  245;  pitch  of 
drains  and  pipes.  22.'!.  2.'!.'!;  plans 
to  be  tiled.  222-220;  form  for,  881- 
884;  approval  of  plans.  225:  rain 
water  leaders.  238 ;  refrigerator  wastes, 
245:    safe   wastes.    245;    sewer  connec- 


tions, 222  and  226;  sinks,  wooden  not 
allowed.  240;  soil  pipe.  220  et  seq.; 
size  of,  220;  material.  230-232;  ter- 
mination at  roof.  237;  specifications 
for  plumbing,  22."> :  steam  not  allowed 
in  sewer.  250;  strainers.  240;  supports 
for  pioes.  2:!4  :  termination  of  pipes  at 
roof.  237 :  trap,  main,  230 ;  for  fixtures. 
240:  grease  trap.  241;  non-syphoning. 
242.  24.'! :  sanitas  trap.  243 :  tubs, 
wooden  not  allowed.  240;  urinals,  250; 
water  closets  required,  240;  certain 
closets  forbidden,  240:  floor  flanges, 
246:  ventilation  of,  247:- seat  ventila- 
tion.240  ;  water  closets,  location  of.247  ; 
water  supply  for.  248;  water  pipe,  250; 
waste  pipe.  220  et  xcq.;  size  of.  229; 
material.  230-232;  termination  at  roof, 
237. 

Pneumatic  wagon  for  removal  of  night 
soil.   74."i.   740. 

Pneumonia  :  to  be  reported,  440. 

Poisonous  plants,  150. 

Police:  assistance  in  communicable  dis- 
ease. 486,  404;  to  collect  culture  outfits 
for  diphtheria.  565,  500. 

Police  commissioner  on   board   of   health. 

15,  2:!.  25. 

Police    power.   2. 

Pollution  of  rivers.     See  Rivers;  Water. 

Ponds:  filling  and  draining  to  prevent 
cholera.   517. 

Poor:  care  of  sick.      See  Sick  poor. 

Poor:  assistance  of  in  communicable  dis- 
ease. 4S7.  400. 

Poor  :   overseer  of    on  board  of  health.  2-".. 

Poor  house  :  managed  by  board  of  health, 
806. 

Port :  health  officer  of.  on  board  of  health. 
23. 

Portable  apparatus  for  steam  disinfec- 
tion. 548. 

Port  la  ml.  Me.  :  communicable  disease  hos- 
pital, ois. 

Post  office:  notified  of  communicable  dis- 
ease.  490. 

Poughkeepsie  filter.  280. 

Poultry.  309;  undrawn.  312:  slaughter 
of.  315,  316;  garbage  for.  700. 

Pratique:  when  given.  044. 

Pregnant   animals:    food   from.   311. 

Prescriptions  for  the  poor.  810. 

Preservatives  in  milk.  300. 

President  of  board  of  health.  37. 

President  of  council  on  board  of  health, 
2.'!. 

Press:  the.  and  the  health  department, 
sir,. 

Presses  for  garbage.  70S. 

Prison.      See  Penal   institution. 

Private  premises:  authority  to  enter,  42. 
112,  345.  385,  485. 


INDEX. 


965 


Privies:  for  schoolhouses,  780. 

Privy  vaults,  17U:  permits  for,  174:  in- 
spection of,  174:  location  of,  175;  size, 
176;  depth,  177:  materials  for  con- 
struction, 177.  843 :  bottom  construc- 
tion, 177-8;  openings  and  ventilation, 
17i>:  sewer  and  Hush  vaults,  178; 
school  sinks.  181  :  wells  not  to  1"'  used 
as,  179;  sluice  vaults.  181;  connection 
with  sewer,  180;  overflow  from,  182; 
box  privies,  182-4;  ran-  of,  improper 
materials  in,  ool  to  overflow,  distance 
of  contents  from  top.  186;  obstruction 
152:  unused,  to  be  filled,  192;  re- 
moval <>i'  on  sewered  streets,  187-192; 
cleaning  of,  187,  843;  permits  tor  clean- 
ing, 752,  753;  frequency  of  cleaning, 
7"i1  :  hours  for  cleaning,  751.  See  also 
-In  soil. 
--  bul  t>  r,  365. 

Prosecution  for  milk  adulteration,  397, 
398. 

Protection :  for  officials,  40;  by  vaccina- 
tion, 595;  of  working  children,  804, 
946,   '.'17. 

Providence  ambulance,  629. 

Provisions.     See  Pood. 

I'ul»li<;  conveyances.  See  Carriages :  Com- 
municable disease,  removal  of. 

Public  libraries  and  communicable  dis- 
ease,   1'''i! :  not  ices  sen!   to,   189. 

Public  places:  no  communicable  disease 
in    4  is    154. 

Public  safety:  department  of  and  health 
department,  16,  l'  1.  26. 

Public  works:  president  of  board  on 
board  of  health,  23. 

- 1 1  i  n  ir :  aames  of  violators  of  food 
laws  354;  of  violators  of  milk  laws. 
•  177:  quarantine  regulations,  635. 

Puerperal  fever:  to  be  reix>rted,    [■'•'■>. 

Puncl  ure  :   \  accinat  ion  l>.\ .  59 1 

Putificatiou  of  water   -71  <  i  s<  </. 

'ji  «i  iik  moNH  for  members  of  board 
of  health,  28. 

in  tine.     Bee   Isolation. 

-    630  i  /  m  7  :  definit  ion  of, 
630;    most    important    sanitarj     work. 
\S>    authority  of  local  board,   Il'7. 
Quarantine:     power    of    state   hoard    of 
health,    126. 

nl  mi-  inland  :  earliest,  II 19  ;  inter 
•  quaranl  ine,  I)  H) :  authority  to  es 
tahlish.  650;  state  rules  for,  651;  of 
i  rains.  651,  653.  658,  659,  663;  emer 
ind,  651  :  federal  conl  rol  of, 
652:  local  control  of,  652;  state  eon 
trol  of,  651;  where  required,  653;  in 
\i-i\  Knglnnd,  •  '•■"•■': .  disinfection,  055 
>'•'<!  baggage  disinfect  Ion, 
657     «  ravel  rertifii  116 1. 


'.»:;7:  absolute  in  West  Virginia.  658; 
freight  quarantine  of,  658:  in  yellow 
fever,  659  </  seq.j  control  of  yellow 
fever  by,  <'><'><'  et  seq.;  guards  for,  660; 
passes  given,  661;  detention  camps, 
661. 
Quarantine:  maritime,  630  et  •*<</..■ 
earliest,  630;  national  established,  630; 
maintained  by  Marine  Hospital  Ser- 
vice, 632;  secretarj  of  tin'  treasury  to 
make  rules.  632;  state  control  of,  *'>'■'<-: 
quarantine  board,  •;.",:;:  state  hoard  of 

health     to    coin  rol.    »'.:;:;:    on    lakes    and 
rivers,  634;  authority  to  declare.  631  : 

-is  subject  to,  U34,  636,  639; 
uvtions  in  cities,  634;  publishing 
regulations,  635 :  season  for,  <'>."!•".  640; 
pilot  and  tow  hoar  captains'  duties,  •■>.*!•>. 
641;  passengers'  duties,  637,  644;  com- 
munication with  vessels,  637;  inspec- 
tion of  vessels.  i;.,.>.  r,4l.  (',40  :  Blasters, 
duties  of.  635,  636,  641;  quarantine 
grounds,  641;  signals,  641;  statement 
of  master,  643;  treatment  of  passen- 
gers, 645;  treatment  of  crew,  645; 
fruit  trade,  control  of.  646;  bag 
treatment  of,  645,  646;  bedding  and 
clothing,  treatment  of,  646;  cargo, 
treatment  of,  «'>4i'f:  ballast,  treatment 
of,  647;  sick,  care  of  at,  638;  vaccina- 
tion of  immigrants,  639,  c>\l;  expenses 
to  be  borne  by  vessel,  639;  fees,  i'^'1. 
tits:  penalties.  639;  treasury  rules, 
640;  disinfection,  639,  648;  of  ballast, 
648. 

Quarantine  of  communicable  diseases  of 
animals.   766,   771. 

Quinness  butter,  365. 


LtABIES  :  control  of,  77''.:   laboratory  diag 

iiosis  of,    ~>7l'. 

collection  of,  759;  from  dumps  not 

to   be    sold    during    cholera    outbreaks. 

518  :  storage  of,  21 1. 
Railroad:  coaches,  closets  of,   157;  truin* 

and  cars.     See  Trains  and  cars. 
Ilain  water  leaders.  '_'•".*. 
Raymond,    Dr.    J.    II.:    preparations    for 

cholera,  516;  on  disinfection,  529. 
Receptacles  for  garbage,  '  ■  T •  * :   for  mixed 

refuse,  738;  for  drj   refuse,  7-".<». 
Recording  officers:  viial  records,  87. 

da    ol  births,  marriages  and  deaths, 

8'.'.  H  1 ndmenl  of,  02  ;  copies 

of,  '•'•'■•.  care  of,  '.»'_':  paper  for,  90;  ink 

fo  .   00;    index,   '.'i  ;   of   communicable 

diseases    190,  '.Ms.  020;  of  tuberculosis. 

52  1 
Reduction  process  for  garbage,  701  <t  teq, 
■  •1  a  1  or  w  aates,  "_'  15 
s.c  1  >rt  refuse. 


966 


IXJJEX. 


Registration :  a  sanitary  function,  53 ; 
earliest,  52 :  reports  long  published  by 
certain  cities.   813 

Registration  :  of  physicians,  undertakers, 
etc..  96;  of  plumbers,  255. 

Relapsing  fever:  to  be  reported,  439. 

Removal  of  bodies  dead  of  communicable 
disease.  47li.  477.  '.n>3  :  of  cases  of  com- 
municable disease.  449 :  to  hospital, 
148,  450,  451,  605. 

Rendering,  207-S. 

Rendering  processes  for  garbage  disposal. 
708-714. 

Renovated  butter.  365. 

Reports  of  health  officials.  42:  weekly 
and  monthly.  SIC;  annual.  817-819; 
to  state  board  of  health.  841;  of  regis- 
trars, 95. 

Restaurant:  sale  of  food  in.  320,  350. 

Reynolds,  Dr.  A.  K. :  method  of  collect- 
ing records  of  births.   74. 

Rider  garbage  crematory.   727. 

Ring-worm  :  to  be  excluded  from  school, 
4(J4. 

Riseley  garbage  crematory,  7li7. 

River  pollution:  nuisance  caused  by.  i".)7  ; 
laws  concerning.  298-300,  843.  869; 
power  of  state  board  of  health,  299. 

Roofs  :  must  not  leak.  153. 

Rules:  how  enacted  and  promulgated,  46. 

Rural  sanitation,    12. 

Safe  wastes.  24.". 

Safety:  director  of  public,  on  board  of 
health.  23. 

Salary:  of,  boards  of  health.  31;  health 
officers,  35;  bacteriologists,  558 :  food 
inspectors,  .".44:  of  medical  inspectors 
of  schools.  7X4.  7S7.  788 :  of  milk  in- 
spectors,  386;  of  plumbing  inspectors, 
258;  of  physicians  to  the  poor.  809; 
<>f  sanitary  inspectors.  12S;  of  vaccina- 
tors, 591. 

Salem  :  smallpox.  1678,  2.  42."). 

Saleratus,  :::;::. 

Salt  in  streets,   157. 

Samples.  See  Food.  340,  :',4.-;.  and  Milk 
386,  389. 

Sanitary  codes.  48,  843. 

Sanitary  committee:  chairman  on  board 
of  health,  23. 

Sanitary  Construction  Company's  formal- 
dehyde generator,  .">:'»<'>:  carbonizer,  697. 

Sanitary  inspectors,  126-130;  number  and 
salary.  128;  reports  of.  131.  871;  rec- 
ords. 131,  133,  136;  rules  for,  870 ;  du- 
ties in  communicable  diseases.  4S7. 

Sanitary  organization  :  first  independ- 
ent. -2. 

Sanitary  survey  in  communicable  disease, 
4S7. 


Sanitas  trap.  243. 

Sanitation :  earliest,  1 :  and  density  of 
population.  1. 

Scarification  for  vaccination,  594. 

Scarlet  fever:  to  be  reported.  437.  S44  : 
to  be  placarded,  443,  44G :  isolation  of 
family  in.  453  ;  isolation  of  persons  ex- 
posed to.  456 :  duration  of  isolation, 
457:  private  funeral  in.  477;  to  be  ex- 
cluded from  school.  464 ;  outbreaks  of. 
514;  results  of.  514;  closure  of  schools, 
515;  inspection  of  schools.  515:  hos- 
pitals, 612,  615;  circular,  '.hi.'). 

Scavengers:  night  soil  licenses  for,  742; 
return  of  work  done.  754.  7.">.~>. 

Schering  &  Glatz :  formaldehyde  genera- 
tor. 538. 

School  attendance.  See  Communicable 
disease  and  school  attendance. 

School  authorities  to  enforce  vaccination 
laws.  585,  587 :  to  offer  vaccination. 
587. 

School  baths,  781. 

School  books.     See  Books. 

School  children.  See  Vaccination  :  Com- 
municable disease  and  school  attend- 
ance. 

Schoolhouse  construction  :  supervision  of. 
771);  heating  and  ventilation,  781; 
privies,  780  ■  inspection  of.  781  et  seq. 

School  hygiene.  77N  et  seq. :  laws  concern- 
ing, 778. 

School  inspectors:  to  inspect  school- 
houses.  783. 

School  sinks,  181. 

Schools:  medical  inspection  of.  784  et  seq. 
See  Medical   inspection  of  schools. 

Schools  :  rules  for  communicable  disease 
to  be  posted  in.  469  :  closure  of,  469. 

Scientific  investigation  by  sanitary  offi- 
cials. 811. 

Scows:  for  garbage,  687;  night  soil.  75t'>: 
refuse,    7-"><i. 

Seal  for  registrars,  89. 

Sealing  of  openings  for  disinfection#530, 
531. 

Season  for  cpiarantiue,  635,  640. 

Second-hand   clothing.   209. 

Secretary  of  board  of  health.  29.  37. 

Secretary  of  the  treasury  to  make  quar- 
antine rules,  632,  652;  rules,  t!4i»,  652. 

Sedgwick :  investigation  of  typhoid  in 
Springfield.  511. 

Selectmen :  as  board  of  health,  11 ;  ap- 
point board  of  health,  27. 

Separator:  milk,  373. 

Septic  tank.  301. 

Sewage  disposal,  300 ;  by  broad  irriga- 
tion, :!(!();  intermittent  filtration,  301; 
septic  tank.  301  :  disposal  on  private 
premises,  192. 


INDEX. 


96' 


Sewer  connection  required,  189-192,  843; 
order  for,  879;  how  made  226;  steam 
not  allowed  in  sewer,  "-'."it. 

Sever  gas  and  disease:  studied  in.  Bos- 
ton, 813. 

vaults.    178. 
-  :  chairman  of  committee,  on  hoard 
of  health.  23. 

-:   construction  of.  296;  !>y  health 
department,  i  B 

Sexton's  return  deaths,  til. 

Shark.  .•'.•_'::. 

Sheep  :   gai  bage   for.  699. 

Shields:  for  vaccination,  596. 

Shores  :    tilth    upon,    192. 

Shrimp,  .'117. 

Sick  at  quarantine:  care  of,  6,  8 

Siek  children:  excursions  for.  804. 

Sick  person  :  removal  to  hospital,  605. 

Sick  poor,  38;  care  of  by  health  depart- 
ment, 808;  rules  for  physicians  to.  808; 
Dumber  of  physicians  in  certain  cities. 
809;  salaries  and  work  done.  809;  pre- 
scriptions for.  Mn:  ••summer  corps"  in 
New  York  and  Hartford.  810. 

Sidewalks.     See  Streets. 

Simonin  process  of  garbage  disposal,  706, 
7" '7. 

Single  headed  department  ol  health.  25, 
26. 

Sinks.  249. 

Skimmed  milk.  372-374. 

Slaughter  houses.  2<>r,-7.  M  I. 

Slaughtering:  manner  of.  310,  .".11.  315; 
inspection  of.  346,  347. 

Slopv  :  definil  ion  of.  665. 

Smallpox:  quarantine  in  New  England, 
1885,  653:  state  quarantine  at  Muncie, 
657;  in  Boston,  1678  1.  125;  in 
Philadelphia,    19;    in    Salem.    1678,    1. 

125  I      to     III'     repented.      136 ;      to     lie     phi 

carded,  II"..  146;  isolation  of  family  in. 
153;  isolation  of  persons  exposed  to, 
156;  duration  of  isolation,  ).">7  :  private 
fiHicr.il     in.     177:    !•>    be    excluded    from 

school,  164;  exempts  from  vaccination, 
."77:  management  of  outbreaks,  500; 
discovery  of  cases,  500;  failure  of  diag 
■  ■  •  l  :  isolal ion  at  home  ~»« » 1  ;  re- 
moval   to    the    hospital,    difficulty 

502  :      iSOlal  i( f      those     exposed 

precaution   by   physician   in.  .Mi:;;   hos 

pital  for.  ."hi  :  vaccinati luring,  501  . 

t  of  outbreaks, 
507. 
Smallpox  hospitals,  607:  location  of,  608; 
cities    without      607,    012  I    cities    with. 

tiOH .    at    Asbury    Park,   603 :    <  !h 

611 ;      I  larrisburg,   ''.1  I  :      Lincoln, 

r.n*-  :  Muncie,  612  613  .  Pawtuckt 
Sun  :nl  system  of  ventilation,  783, 
Smear  examinations   in  diphtheria,   ">''>7. 


Smith    garbage   crematory.    722-72o. 
Smoke    nuisance:    where    forbidden,    214: 

ordinances,     214-17:      inspectors     and 

their   work.   217-18;    firemen,   rules    for. 

218;  smoke  consuming  devices.  218-19; 

bituminous  coal  forbidden,  219. 
Smoke  test.  260. 
Soda   fountains.  .", 1!  1 . 
Soil  :  disturbance  of.  155. 
Soil  pipe.  229  '  /  seq. 

Solicitor:    city,    on    hoard    of    health.    2.'!. 
Attorney. 
throat:   to  he  reported,  4-".7 :    to  be 

excluded   from   school.   467. 

Spatula;:  for  throat  examinations,  ."ill. 

Special  laws  for  sanitary  organization, 
18. 

Spitting  forbidden,  158-161. 

Sponge  Meet:   inspection  of.  641. 

Spray:  formaldehyde  for  disinfection. 
539,  553;  bi-chloride  of  mercury,  539, 
."!»7.  509;  for  disinfecting  vehicles,  544. 

Springfield:   typhoid   fever  in.  511. 

Springs,  291. 

Sputum:  examination  of  for  tuberculosis, 
569;  samples,  care  of.  .".72. 

Stable  for  cows.    1 1.".. 

Stable  manure.  164  :  removal  of,  165, 
166  :  disposal  of.   166. 

Stables:  state  legislation,  161;  location 
of.  161;  permits  and  application  for. 
161,  162;  cleanliness  prescribed,  162; 
must  not  he  noisy.  162;  Moor  imper- 
vious, 162-161  :  bedding,  ic>7. 

Stagnant  water,  196:  penalty  for  caus- 
ing, 869. 

Standards  of  purity   for   milk.  371. 

State  hoard  of  agriculture  controls  dis- 
eases of  animals.   77i». 

State    hoard    of    health:     appointment     of 

local  by,  27:  controls  diseases  of  ani- 
mals, 770;  and  communicable  disease, 
125  128;   legislative  power,    12:  control 

of   water   supplies.   261    ct    *<</■.'    rules   of. 

268;  abatement  of  nuisances  on  water 
shed.  27'»:  power  in  regard  to  river  pol- 
lution. 299;  to  control  quarantine,  633; 
maj  declare  quarantine,  634;  to  esttfb 
lish  quarantine,  650;  report  of  local 
board  to.  8  1 1 . 

control     in    local    sanitary    affairs, 
in    communicable   diseases,      125 
128. 
St.iti    registration  of  vital  sintisiii ...  pi 

Steam.      Se<     I  'i  -inl'eci  inn    with. 
Steam  not  allowed  in  sewer.  250. 
Steamers:     regular,    quaranti f,    •'•II. 

645. 
Sterilizing     iuatruments    for   vaccination, 

593. 
Sternberg :    pi  i  •  ■■:!    disinfection, 

529. 


968 


IXIJEX. 


Still  births,  77  :  return  of,  85S. 

Sr.  Louis  ambulance  a  disgrace,  «'.2S. 

Strainer  for  drain,  150. 

Strangers :  registration  of  births,  mar- 
riages and  deaths  at  place  of  residence. 
63,  73,  84. 

Strauss.  Nathan:  distribution  of  pasteur- 
ized milk.  421. 

Street  cars  :  no  cushions  in.  cleansing  of. 
transportation  of  clothing,  ventilation 
of.  open  cars,  1.T7. 

Street  cleaning,  704. 

Streets  and  alleys  :  chairman  of,  on  board 
of  health,  23. 

Streets :  filth  in,  l4.>.  84."'. :  washing  ve- 
hicles in.  146;  gutters,  obstruction  of, 
14C>:  fish  cleaning  forbidden.  14tj : 
cleaning  of  by  abutters,  147:  removal 
of  filth  before  washing,  140. 

Streets  :  roping  off  in  sickness,  l.'iS. 

Subordinate  officers,  •'!•">.  37,  39. 

Subpoenas,  47. 

Substitution  in  foods.  .',>24  et  seq. 

Sugar.  330. 

Sulphur.     See  Disinfection  with. 

"Summer  corps"  of  physicians  to  the 
poor.  810. 

Sunday  schools  and  communicable  dis- 
ease.  4<i7. 

Supervisors:  appointment  of  board  of 
health  by,  27:  as  board  of  health.  11. 

Supreme  court:  appointment  of  health 
officers  by,  27. 

Swabs :  for  diphtheria  cultures.  561  ; 
wires  for,  559. 

Swamps:  draining  and  filling,  107. 

Sweat   shops.  835. 

Swift.   Dr.  W.  X.  :  on  vaccination.  .ri(.i2. 

Swill  :  definition  of,  665. 

Swill  milk.  369. 

Swimming  pools.  793. 

Swine:  keeping  forbidden.  1»'>7:  seizure 
of,  K',7;  permits  for,  !<'>'.):  pens  for. 
168;  yarding,  169;  garbage  for,  7<m. 

Syrup,  330. 

Tagging  of  meat,  847. 

Tankage  from  garbage,  7<>2.  7<i."!.  7<>4.  7ns. 

Tanneries.  209. 

Taylor's  paraform  candles.  .j.'J'J. 

Teachers:  excluded  from  school,  4f>4.  400; 
to  exclude  communicable  disease,  4<'i0. 
4<;7;  to  teach  the  prevention  of  com- 
municable disease,  469;  isolation  of  in 
communicable  disease,  153 :  to  report 
communicable  disease.  4.'!2  :  vaccination 
of,  576. 

Telephone:  reports  of  communicable  dis- 
ease by.  4.".4. 

Tenement  houses.  822  et  seq.j  statement 
of  problem.  822;  laws  concerning,  824 
et   seq.;  defined,   ^24.  826;   ventilation 


of,  824.  825.  827:  roofs,  stairs  and  fire 
escapes.  824,  829,  828;  sleeping  rooms. 
824 :  sewer  connections.  824 :  cellars, 
824,  N2.~>.  827  :  bakery  and  bar-room  in, 
825;  receptacles  for  refuse.  825,  820; 
registration  of  owner.  825,  826,  040: 
inspection  of,  825,  826,  830,  831,  890; 
amount  of  lot  to  be  covered.  825,  827  ; 
elevator  well,  825;  water  closet  room. 
825  :  not  to  be  used  for  other  purposes. 
825  :  size  of  rooms.  825,  828 :  chimney 
openings,  825 :  windows,  size  of.  825, 
828:  halls,  ventilation  of,  825;  night 
lights.  825;  janitor  required,  825:  air 
space  required.  825,-829;  duties  of 
board  of  health.  826;  penalty.  826; 
height  of,  828  :  water  closets  required. 
828;  whitewashing,  829;  fire  protec- 
tion, 825,  829;  water  supply.  829;  in 
Xew  York  and  St.  Louis,  831. 

Terms  of  office.   30. 

Terre  Haute  :   abattoir.  205. 

Test  for  plumbing,  260. 

Test  tubes  for  diphtheria  cultures,  560. 

Thackeray  crematory.   741. 

Tin  cans  in  garbage.  f><'>7. 

Tomb:  communicable  disease  not  to  be 
put    in,  470. 

Tow  boat  captains:  duties  of,  636,  641. 

Town  council ,  board,  or  trustees:  as  board 
of  health,  11:  to  appoint  board  of 
health.  27. 

Townships  and  counties  :  relative  import- 
ance, <>.  10;  township  sanitary  organi- 
zation. 11  - 1  < i ;  under  general  laws.  20; 
to  establish  quarantine,  650,  »'>">2. 

Train  inspection.  651,  •'>■">•">.  659,  ''>t;:;. 

Transit  permits,  61,  <i2.  850. 

Trait.  223,  239;  grease  trap,  241;  non- 
syphoning.  242-4.'!:  required  in  drain. 
l.~><>:  in  soil  and  waste  pipe,  151. 

Travellers:  statement  of,  '.».'!7:  certificate. 
C.-.7.  659,  664. 

Treasury.     See  Secretary  of. 

Trichinosis:  to  be  reported,  439 :  in  gar- 
bage feil  swine.   700. 

Trillat's  autoclave.  536. 

Trustees :  township  as  board  of  health, 
11. 

Tubercle  bacilli   in  vaccine  virus.  582. 

Tuberculin  test  for  milch  cows.  404-407 : 
how    applied,    4n7:    in    various    states. 

Tuberculosis  (animal),  771  et  seq.;  im- 
portation forbidden,  771:  eradication 
of  in  various  states.  772-774:  milk  from 
tuberculous  cows.  408;  tuberculin  test. 
4<  >4-4l)7.  772-77.".. 

Tuberculosis :  laboratory  diagnosis  of. 
569;  to  be  repotted.  438,  139,  521;  pri- 
vate funeral  in.  477:  municipal  control 
of.  520;  circulars.  520,  509,  '.12.'!.  924, 
927  :    reports  of  cases  and  deaths.  ."121  : 


IXDEX. 


969 


management  of  in  New  York.  r>21  ;  rec- 
ord of  cases,  map  for,  521  ;  inspection 
of  premises,  521  :  disinfection,  '>-'-  :  in 
bakeries  and  markets,  522 :  hospitals, 
522-525.     See  also   Consumption. 

Tubs.  249. 

Typhoid  fever:  to  l"'  reported,  138  844; 
circular.  '.HI.  '.UU:  outbreaks,  discovery 
of  origin,  510,  920:  investigation  of 
outbreak  in  Springfield,  1892,  511  <t 
seq.;  laboratory  diagnosis  of,  569,  '•»•'>'_'. 

Typhus  fever:  to  be  reported,  438  844; 
isolation  during  exposure  to,  456;  pri- 
vate funeral  in,  477:  outbreak  in  New- 
York.  1892,  512. 

Udders  :  washing  of,  416. 

Unclean  milk.  399  et  seq. 

Undertaker:  license  of,  •"'• :  to  report 
deaths  from  communicable  disease, 
I7<>:  disinfection  of,  471:  responsible 
for  funeral  notice,  475;  responsible  for 
violation  of  rules.  477. 

Undertaker's  wagon  used  as  ambulance. 
1128. 

Unsanitary  conditions  and  communicable 

disease.    4^7. 

I  n-\ aceinaied      children:       number      in 

school,  587. 
Unwholesome  food,  308  et  seq. 
Upholstered     furniture:     disinfection    of, 

553. 
Up-turning  of  soil.    155. 
Urban  population,  12. 
Urinals,  250;  .are  of,  152;  public,  •V|,7. 
Utica :  disposal  <>f  garbage  in,  714. 

\  \<  wi  lots:  cleansing  of  t<>  prevent 
cholera,  .">17:  not  to  l><  tilled  with  tilth. 
194 :  care  of,  fencing  of,  combustible 
material  on,  195;  stagnanl  water  on, 
196. 
Vacation  of  premises,  138;  order  for,  s~'.i 
Vaccination,  -"»7.".  </  seq.;  legislation,  573; 
of  immigrants,  "»7.'! :  local  regulations, 
authority  for,  574:  smallpox  outbreaks, 
vaccination  during,  505,  574;  enforce- 
ment of  laws  by  school  authorities,  ~'s~'. 
587;  of  Bchool  children,  575;  where  re- 
quired, 576,  577  :  exceptions,  575;  fail- 
ure to  enforce.578  ;  in  parochial  schools, 
578,  590;  of  employes  required,  578;  in 
paper  mills.  578;  of  fruit  growers  and 
packers,  579;  compulsory,  579;  \irus 
used  580  ci  neq.;  public  nl  vaccinator's 
office,  589;  public  in  schools,  589;  by 
school  inspectors,  786;  house  to  house 
vaccination,  590;  decisions  in  regard 
To    ."i7.">.  o7'i.  590;    payment    for,  591; 

may   be   marie  compulsory   by   cities   and 

tow  ns.  585;   to  I Bfered  by  board  of 


health.  587;  school  authorities  to  offer 
vaccination.  587:  of  the  poor.  588; 
methods  of,  592  ■  (  seq. :  implements  for 
inoculation,  593;  cleansing  the  arm. 
593;  methods  of  inoculation.  .">'.i4  :  place 
for  insertion.  .V.i4  :  number  of  points  of 
insertion.  595;  protection  of,  595; 
shields  for.  596;  directions  for  care  of, 
596;  contra  indications.  597;  success 
in  vaccinating,  597  :  circulars  concern- 
ing, 598;  of  immigrants,  639,  «'>44  :  tees 
for,  649. 

Vaccination  certificate:  required,  585; 
form  of,  586,  '.'.'"_'.  '•••"-4:  cicatrix  value 
as  evidence,  586;  returns  to  be  made  to 
state  board  of  health.  586,  933;  to  be 
recorded,  586. 

Vaccinators:  public.  588,  591  :  reports  of, 
590,  591. 

Vaccine  virus.  580  et  seq.;  humanized 
virus.  580,  592,  .">!>:',:  bovine  virus.  580, 
592;  control  of  by  state.  581;  tests  of, 
582;  furnished  by  city  or  state.  582; 
preparation  of  in  New  York.  ,~>N.", : 
glycerinized,  preparation  of,  584;  forms 
in  which  sold.  592;  <>n  ivory  points. 
7,'.\-J.:  in  capillary  tubes.  ."V.r_>:  in  vials. 
593;  humanized  crusts.  593;  study  of 
in  New  York.  586. 

Vacuum  as  an  aid  to  steam  disinfection. 
542. 

Vans.     See   Disinfecting,   vans  for. 

Vaults  :  for  the  dead.  lnj.  L03. 

Veal:  blown.  312;  immature.  313,  844. 

Vegetables,  309,  321 

Vehicles:    for   disinfectors,   519-552;    for 

dead  animals.  7»'.:',  :  for  mixed  refuse. 
739;  for  removal  <>(  night  soil,  744: 
for  the  collection  of  dry  refuse,  731, 
7:;:;. 

Veiller,  Lawrence:  report  on  tenement 
houses,  823. 

Venerea]  diseases:  in  bakeries,  319;  lack 
of  control  of  in  United  States.  525; 
attempts  al  control.  526;  in  public  in- 
stitutions. 526;  a  legal  bar  to  marriage, 
526. 

Ventilation:  of  plumbing.     See  Back  air; 

Of  BOll  and  waste  pipes.  1 .".  1  ;  of  school- 
llOlls.s.    7M . 

j:  subject  to  quarantine,  634,  636, 
630;  inspection  of,  638,  641,  642;  i" 
bear    quarantine   expenses,   639;     "via 

•  Is."   till  ;   disinfection   of,   639,   648, 

Veterinarian!      343;     to     ins] t     dairy 

farms.  103,  111:  to  investigate  diseases 
of   animals.    7<>7,    771. 

"Via   \  ess,  is."  641. 

Villages:  sanitarj  organization,  13  17. 

Vinegar,  328,  329. 

Virus,     See  Vaccine  \  irus. 

Visits:  to  infected  house  forbidden,    154, 


970 


INDEX. 


Vital       statistics.         See       Registration ; 

Births:     Marriages;     Deaths;     Births. 

Marriages  and  Deaths. 
Vivartos  garbage  crematory,  727. 

Wage  earners  :  isolation  of,  452,  453, 
899;  permits  for  work    (minors),  945. 

Ward  :  member  of  board  of  health  from 
each,  8.  28. 

Ward's  formaldehyde  generator,  533. 

Waring:  on  garbage  utilization,  702,  703. 

Warning  to  milk  dealers.  890. 

Warning  sign  for  communicable  disease. 
See  Placard. 

Washing  soda:  a  disinfectant  in  tubercu- 
losis.  522,   550. 

Washing    vehicles.    140.    167. 

Waste  pipe,  229  et  seq. 

Water:  analysis  of  chemical.  273 :  bacte- 
riological. 273:  microscopical,  273; 
chemical  composition.  203  :  suspended 
matter  in.  203 :  color.  263;  taste,  263; 
odor.  203;  pathogenic  organisms  in, 
263;  control  of  by  state  board  of 
health.  264  et  seq.;  control  of  by  local 
health  officers.  264,  265;  pollution  of. 
statutes  concerning,  265-270,  869; 
cemeteries.  207-08:  local  rules  concern- 
ing,  271.  843;  state  board  of  health 
rules,  268;  inspection  of  water  shed. 
271:  purification  of,  274  et  seq.;  by 
aeration.  275;  by  sedimentation.  27."> : 
by  nitration.  27.">  et  seq. 

Water   required    for   tenements.   829. 

Water  for  cows.  41<i. 

Water  closets,  246;  certain  closets  for- 
bidden. 246;  door  flanges.  246;  seat 
ventilation,  246;  ventilation  of.  247: 
location  of.  247:  water  supply  for.  248: 
water  required,  151.  828.  832;  obstruc- 
tion of.  151,  l.~>2:  construction  of.   152. 

Water  pipes,  250. 

Water  supplies  in  the  United  States.  262. 


Water  test  for  plumbing.  250. 

Weeds,   156. 

Weight  of  cubic  yard:  of  garbage.  007: 
of  dry  refuse.  72!) :  of  mixed  refuse. 
738. 

Wells  :  danger  in  contamination  of.  2S7  : 
examination  of,  288.  291 :  laws  relat- 
ing to.  289;  closure  of.  289.  290:  to 
prevent  cholera.  .">17  :  not  to  be  used  as 
vaults.  179. 

Wesbrook.  Dr.  F.  F.  :  diphtheria  at  Owa- 
tonna.   516. 

Whipple,  Geo.  F. :  microscopical  exami- 
nation of  water.  274. 

AVhite,  Henry:  report  on  sweat  shops, 
835. 

Whooping  cough  :  duration  of  isolation. 
459;  private  funeral  in.  477:  circular. 
908. 

Widal  test  for  typhoid.  569 :  report  of, 
932. 


on  state  registration 

1)4. 

diphtheria   at  <  >wa- 


Wilbur,  Dr.  Cressy : 

of  vital  statistics. 
Wilson.    Dr.    L.    B. : 

tonna.   516. 
Wine.  327,  328. 
Witnesses.  47. 

Wood  alcohol  :  for  disinfection.  .">.",:;. 
Working  children  :  protection  of.  804. 
Wounded  animals  :  food  from,  310. 
Wright,   Carroll    D.  :   report  on   marriage 

and  divorce,  78. 

Yellow  fever  :  at  Boston.  2.  10 :  to  be  re- 
ported. 43S,  S44 :  isolation  during  ex- 
posure to.  456;  private  funeral  in.  477: 
disinfection  in.  555;  inland  quarantine 
in  659  et  sc<j.:  outbreaks  of,  507;  dis- 
covery of  cases.  508;  hospital  removal 
to.  508;  isolation  at  home,  guards.  508; 
care  of  the  sick.  509;  disinfection,  509; 
airing  of  houses  after.  510. 

Young  animals  :   food   from.  313.  S44. 


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